Predicting Caries Risk in Underserved Toddlers

描述（由申请人提供）：根据有史以来第一次外科医生关于北美口腔健康的报告（2000年），龋齿是最常见的慢性儿童疾病。此外，大多数（75-80%）严重的龋齿问题，在这个国家的儿童发生在一小部分人口（20-25%），这个问题是特别普遍的少数民族和移民。这些受影响的儿童也经常出现在较低的社会经济阶层，通常在很小的时候就患上龋齿。因此，必须在儿童生命早期进行评估，以确定并最终治疗那些最有可能发展为幼儿龋齿（ECC）的儿童，最好在疾病发展之前。这项探索性研究的目的是开发一种创新的自我管理的结构化龋齿风险问卷，以确定幼儿（18-36个月）发展ECC的最高风险，重点是高危人群（例如，非裔美国人和西班牙裔）。重点将是确定龋齿的风险行为，主要照顾者和儿童，他们的口腔健康知识对这些因素的影响，以及他们的牙齿健康的看法对寻求牙科保健的影响。将包括一系列可能影响这些人群的传播、龋齿发展、一般健康和获得护理的社会、文化、功能、心理、社会人口学、饮食和生物学因素。调查表将分三个阶段编制。第一阶段将涉及由牙科同行和目标主要照顾者的焦点小组完善初稿。在第2阶段，该修订版将用于大型测试人群（400对主要照顾者/儿童）。该提案的优势在于，它将使用两种最具创新性和灵敏度的龋齿检测和监测方法，即国际龋齿检测和评估系统（ICDAS）和定量光诱导荧光系统（QLF），作为预测建模（第3阶段）的结果变量，检测和12个月监测早期、前龋蚀病变，这将允许比传统的空洞检测水平更准确地评估疾病随时间的发展和进展。

DESCRIPTION (provided by applicant): According to the first-ever Surgeon General's report on oral health in North America (2000), dental caries is the most common chronic childhood disease. In addition, most (75-80%) of the severe caries problems in children in this country occur in a small segment of the population (20-25%), and this problem is particularly prevalent in minorities and immigrants. These affected children are also often found in the lower socioeconomic strata and commonly develop caries at a very early age. Therefore, it is imperative that early in life a child is assessed to identify and eventually treat those children who are at greatest risk for the development of Early Childhood Caries (ECC), preferably before disease development. The purpose of this exploratory study is to develop an innovative self-administered structured caries risk questionnaire to identify toddlers (18-36 months of age) at the highest risk of developing ECC, focusing on at-risk population groups (e.g., African American and Hispanic). The focus will be to identify the caries risk behaviors that the primary caregiver and child have, the impact that their knowledge on oral health has on these factors, and the influence that perceptions of their dental health have on seeking dental care. A range of social, cultural, functional, psychological, socio-demographic, dietary and biological factors that may affect transmission, development of caries, general health, and access to care in these populations will be included. The questionnaire will be developed in three phases. Phase 1 will involve refinement of an initial draft by dental peers and a focus group of target primary caregivers. In Phase 2, this revised version will be then used in a large test population (400 primary caregivers/child pairs). A strength of this proposal is that it will use as the outcome variable for predictive modeling (Phase 3), the detection and 12-month monitoring of early, precavitated caries lesions, using two of the most innovative and sensitive methods for caries detection and monitoring, the International Caries Detection and Assessment System (ICDAS) and the Quantitative Light induced Fluorescence system (QLF), which will allow for a more accurate assessment of disease development and progression over time than traditional level of cavity detection.