Epidemiology of Dental Caries and Immunity in Children

描述（由申请人提供）：龋齿是一种多因素和复杂的传染性和传染性疾病，然而，变形链球菌（MS）一直与病因有关。因此，研究龋齿的自然历史与儿童多发性硬化症感染/定植有关，对了解这种疾病至关重要。我们项目的总体目标是对不同的儿童群体进行纵向研究，即索引儿童，以获得MS；描述这一高危人群的龋齿特征；并确定关键的免疫学关系，以进一步了解龋病的病因和预防。在之前的资助期间，两个按年龄定义的队列，即5-6岁和6- 18个月的婴儿，被纵向跟踪调查新出牙的定植，因为这与龋齿发展的关键因素有关。我们已经在这一高危人群中发现了有限数量的MS菌株（变形链球菌），现在可以随着时间的推移，从最初在口腔和特定牙齿上的定植到龋齿的发展。我们已经证明，这个群体中的个体有一种“主要”菌株（基因型），随着时间的推移保持相对稳定。这种菌株的特异性稳定性允许流行病学评估感染/定植与诸如龋发病率和流行率、唾液免疫、饮食和其他行为风险因素等因素的关系。我们还记录了儿童家庭成员的信息，以评估与指数儿童相关的MS遗传多样性，龋齿和行为风险因素，并将继续这项工作。在目前的应用中，我们建议通过继续跟踪这些儿童并增加额外的老年队列，将年龄上的两个队列连接起来，并将原始年龄范围扩展到另一个重要的牙齿发育里程碑（即青少年和恒磨牙的出现）。因此，这项建议将继续并以头五年获得的重要资料为基础，并纳入为提高数据收集和处理的效率所取得的经验。我们发现重复性基因外回文PCR （rep- PCR）和数据输入系统的发展极大地提高了我们开展研究的能力。在当前供资期间开发的这些创新将在我们继续进行拟议的续期时提高数据收集和分析的效率和有用性。一个由牙医、基础科学家、流行病学家和统计学家组成的跨学科团队参与了这项研究，将提高我们对儿童龋齿的宿主-寄生虫关系的理解。这些研究的结果将为制定有助于预防这种传染病的战略提供关键信息。在位于“黑带”的阿拉巴马州Uniontown继续进行的研究将改善这一服务不足人口的口腔健康。在这一服务不足的人群中建立的社区联系对于本研究的继续以及我们对这一高危人群牙科保健差距的理解至关重要。

DESCRIPTION (provided by applicant): Dental caries is an infectious and transmissible disease that is multifactorial & complex, however, the mutans streptococci (MS) are consistently implicated in the etiology. Therefore, studies on the natural history of dental caries as it relates to MS infection/colonization in children are critical to understanding this disease. The overall goal of our project is to perform a longitudinal study of a disparate population of children, i.e., index children, for MS acquisition; characterize dental caries within this high risk population; and identify critical immunological relationships in order to further our understanding of dental caries etiology and prevention. In the previous funding period, two cohorts defined by age, i.e., 5-6 year and 6- 18 month olds, have been longitudinally followed for colonization of newly erupting teeth as this relates to factors critical in caries development. We have identified a finite number of MS strains (Streptococcus mutans) in this high risk population, which can now be followed over time from initial colonization of the oral cavity and specific teeth to the development of caries. We have demonstrated that individuals in this population have a "primary" strain (genotype) that remains relatively stable with time. This strain specific stability allows for epidemiological evaluation of infection/colonization with factors such as caries incidence and prevalence, salivary immunity, diet, and other behavioral risk factors. We have also documented information from the children's household family members to evaluate MS genetic diversity, dental caries and behavioral risk factors associated with the index children and will continue this work. In the present application, we propose to connect the two cohorts in age and extend beyond the original age ranges to another important dental developmental milestone (i.e., adolescents, and emergence of permanent 2nd molar teeth) by continuing to follow these children and add an additional older cohort. This proposal will, therefore, continue and build on the important information gained in the first five years and incorporate what has been learned to improve the efficiency of data collection and processing. We have found that repetitive extragenic palindromic-PCR (rep- PCR), and the development of a data entry system vastly improves our ability to carry out the studies thus far. These innovations developed in the current funding period will extend the efficiency and usefulness of data collection and analysis as we continue in this proposed renewal. An interdisciplinary team of dentists, basic scientists, epidemiologists and statisticians that has been involved in this study will improve our understanding of the host-parasite relationship of dental caries in children. The results of these studies will provide key information for the development of strategies to help prevent this infectious disease. The continuation of studies in Uniontown, Alabama, which is located in the "Black Belt", will improve oral health in this underserved population. The established community links in this underserved population will be critical for the continuation of this study as well as our understanding of gaps in dental health care in this high risk population. PUBLIC HEALTH RELEVANCE: This project will provide critical knowledge of the epidemiology of dental caries in a high-risk population, which resulting in valuable data useful in the design of future preventive therapeutics in dentistry. Additionally, the proposed studies conducted in Uniontown, Alabama, also referred to as the "Black Belt", will provide much needed oral health education and some preventive oral care to children and their household family members improving oral health in this underserved/disparate population. The information obtained in this project will contribute significantly to the achievement of goals outlined for oral health in the NIH report, "Healthy People 2010" (www.healthypeople.gov/document/html/objectives/21-01.htm) as we look forward to the goals for 2020.