PREVENTION MODEL OF EARLY CHILDHOOD CARIES

本研究的目的是评估以婴幼儿口腔护理计划为基础的牙病预防管理模式的有效性。该干预措施旨在降低婴幼儿早期龋齿的患病率。高风险包括那些有ECC早期症状，口腔卫生不良，氟化物暴露有限，以及经常暴露于高糖饮食的人。这些儿童和他们的照顾者将有针对性的专业预防计划，包括预期的指导咨询，使用洗必泰冲洗产后妇女和应用氟化物清漆为他们的婴儿。该提案与研究中心的主题有关，该中心通过减少位于美墨边境的牙科疾病高风险人群中的牙科差异来减少口腔健康差异。多学科团队汇集了加州大学弗朗西斯科分校、圣伊西德罗社区卫生中心、圣地亚哥州立大学和洛杉矶加州大学之间的合作努力。这项合作将提供专业知识，在社区卫生中心环境的科学研究的发展，确定最佳的预防策略，为ECC在服务不足的人口，口腔健康的差距是流行病。该项目模式的相关性在于，通过将口腔健康促进和疾病预防作为多学科方法的一部分与其他卫生服务相结合，它有可能被复制和转移到其他社区卫生中心和公共卫生实体。拟议的临床研究的具体目的是：1）确定一个有效的疾病预防行为管理模式，从产前护理开始，并与其他医疗保健提供者和服务合作; 2）比较两种前瞻性干预措施对孕妇及其新生儿的疗效：单独咨询与咨询结合洗必泰冲洗的母亲和使用氟化物保护漆的婴儿; 3）采用单克隆抗体龋病诊断试验评估幼儿及其母亲患龋的风险（照顾者）; 4）评估预防龋齿方案在降低产后妇女唾液中突变链球菌水平方面的有效性，抑制这些细菌的生长，延缓感染过程。从出生后第一年开始，对龋齿发展的迹象进行早期筛查，将确定有发展ECC风险的婴儿和幼儿，并将有助于向来自服务不足社区的父母提供有关促进口腔健康和预防牙病的信息。

The goal of this project is to assess the effectiveness of a dental disease prevention management model based on an infant oral care program. The intervention is aimed at reducing the prevalence of early childhood caries infants and toddlers. High-risk include those with early signs of ECC, poor oral hygiene, limited exposure to fluorides, and frequent exposure to high dietary sugars. These children and their caregivers will be targeted with a professional preventive program that includes anticipatory guidance counseling, the use of chlorhexidine rinses for postpartum women and the application of fluoride varnish for their infants. This proposal relates to the theme of the Centers for Research to Reduce Oral Health Disparities by reducing dental disparities among a population at high risk for dental disease located at the US-Mexican border. The multi-disciplinary team brings together a collaborative effort between the University of California, San Francisco, San Ysidro Community Health Center, San Diego State University and the University of California, Los Angeles. This collaboration will provide expertise in the development of scientific based research in the community health center environment by identifying the best prevention strategies for ECC in an underserved population where oral health disparities are epidemic. The relevance of the project model is its potential for replication and transfer to other community health centers and public health entities through the integration of oral health promotion and disease prevention as part of a multi-disciplinary approach with other health services. The specific aims of the proposed clinical research study are: 1) To identify an effective disease prevention behavioral management model for ECC starting with prenatal care and with collaboration of other health care providers and services; 2) To compare the efficacy of two prospective interventions for pregnant women and their newborns: counseling alone versus counseling combined with chlorhexidine rinses for mothers and the use of fluoride varnish for infants; 3) To assess the risk for ECC based on a monoclonal antibody caries diagnosis test in very young children and their mothers (caregivers); 4) To assess the effectiveness of a caries-preventive regimen in lowering salivary mutants streptococci level in post-partum women and, subsequently, in inhibiting the growth of these bacteria, delaying the infectious process. Early screening for signs of caries development, starting from the first year of life, will identify infants and toddlers who are at risk of developing ECC and will assist in providing information to parents from an underserved community about the promotion of oral health and prevention of dental disease.