Reducing dental caries and oral health disparities among adolescents: The impact of increasing 2nd molar sealants through school-based sealant programs

减少青少年的龋齿和口腔健康差异：通过学校封闭剂计划增加第二磨牙封闭剂的影响

• 批准号: 10706531
• 负责人: Shillpa Naavaal
• 金额: $ 18.17万
• 依托单位: KENNESAW STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-21 至 2024-09-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10706531
• 关键词: Address; Adolescent; Adoption; Age; Cessation of life; Characteristics; Child; Consolidated Framework for Implementation Research; Cost Savings; Country; Data; Dental; Dental caries; Disparity; Education; Emergency department visit; Ethnic Origin; Foundations; Funding Mechanisms; Future; Goals; Health Services; Hour; Income; Infection; Intervention; Knowledge; Learning; Literature; Low income; Measures; Methods; Modeling; National Health and Nutrition Examination Survey; Oral health; Pain; Pathway interactions; Persons; Pit and Fissure Sealants; Predisposition; Prevalence; Preventive; Probability; Program Efficiency; Provider; Public Health; Publishing; Quality of life; Race; Recommendation; Research; Research Methodology; Role; Schools; Students; Surveys; Techniques; Territoriality; adolescent health; age group; cost; cost efficient; demographics; disparity reduction; economic disparity; effective intervention; eighth grade; elementary school; experience; health disparity; high risk; improved; junior high school; models and simulation; programs; racial disparity; restoration; sealant; second grade; seventh grade; sixth grade; sociodemographic disparity; socioeconomics; student participation; uptake

Project Summary/Abstract: Adolescent dental decay and its complications diminish quality of life and can lead to lost school days, emergency room visits, and in extreme cases even death. Dental sealants are an effective intervention to reduce dental decay, but sealant prevalence among adolescents remains low and has disparities by sociodemographic characteristics. While 2nd molars are seldom erupted enough to receive sealant application prior to middle school, the majority of school-based sealant programs (SBSP) — an efficient public health initiative typically aimed at low-income schools — serve elementary schools only, and thus predominantly limit their reach to 1st molars. This lack of adoption of SBSPs for 2nd molars represents a critical gap in implementation of an effective oral health intervention for adolescents that is also well documented to reduce disparities. The objective of this research is to investigate the effect of 2nd molar sealants on dental caries, the reach of middle school sealant programs in the US, and the impact of increasing access to 2nd molar sealants through SBSPs on oral health and related disparities among adolescents. The first aim is to determine the prevalence of 2nd molar sealants and the resulting impact on dental caries in adolescents among various racial/ethnic and income groups. Multivariable regression models will be used to examine the probabilities of receiving 2nd molar sealants and of experiencing dental caries in the presence/absence of sealants. The second aim is to gather data on middle school sealant programs in the US by surveying state oral health program directors, SBSP coordinators, and providers. This data will be analyzed to understand availability and reach of SBSPs to adolescents including number of middle school programs, their size, program characteristics, funding mechanisms, costs and student participation rates. The third aim is to estimate the impact of increasing availability of SBSPs to adolescents using estimates and data from Aim 1, Aim 2, and the literature. A simulation model will be built to model various SBSP characteristics and to measure resulting impact in number of sealants, averted decay, and cost-savings of averted restoration by race/ethnicity and income level. This research will fill a critical gap in information on SBSPs and provide clearer understanding of the sealant and related dental caries experience for 2nd molars by race/ethnicity and income level. The findings will furnish comprehensive information about the status of middle school sealant programs in the country. It will produce reliable estimates of the potential impact of increasing the reach of SBSPs to more adolescents and its contribution to reducing disparities. This R21 will lead to a subsequent R01 project to support increased implementation of SBSPs for adolescents, identify ways to improve the efficiency of these programs and reduce oral health disparities.

项目概要/摘要： 青少年蛀牙及其并发症降低生活质量，并可能导致失去 上学的日子，急诊室的访问，在极端情况下甚至死亡。牙科密封剂是一种 有效的干预措施，以减少蛀牙，但密封剂流行的青少年 仍然很低，并且在社会人口特征方面存在差异。而第二磨牙是 很少爆发足以接受密封剂应用之前，中学，大多数 校本密封剂计划（SBSP）-一个有效的公共卫生倡议，通常旨在 低收入学校-只为小学服务，因此主要限制了它们的覆盖范围 到第一臼齿。第二磨牙缺乏SBSP的采用代表了 为青少年实施有效的口腔健康干预， 以减少差距。本研究的目的是探讨 第二磨牙封闭剂对龋齿的影响，美国中学封闭剂项目的覆盖范围，以及 通过SBSP增加获得第二磨牙封闭剂对口腔健康和相关的影响 青少年之间的差距。 第一个目的是确定第二磨牙封闭剂的流行率以及由此产生的 对不同种族/族裔及收入组别青少年龋齿的影响。 将使用多变量回归模型来检查接受第二磨牙的概率 密封剂以及在有/没有密封剂的情况下出现龋齿。第二 目的是通过调查各州的口腔健康状况，收集美国中学密封剂项目的数据 项目主管、SBSP协调员和提供者。我们将分析这些数据， 向青少年提供中等教育支助方案的情况和范围，包括中学方案的数量， 他们的规模，计划特点，资助机制，成本和学生参与率。 第三个目标是评估青少年越来越多地获得SBSP的影响， 目标1、目标2和文献中的估计值和数据。将建立模拟模型， 模拟各种SBSP特性并测量密封剂数量的影响， 按种族/民族和收入水平划分的避免衰退和避免恢复的成本节约。 这项研究将填补关于SBSP的信息方面的一个关键空白，并提供更清晰的 了解第二磨牙的密封剂和相关的龋齿经验， 种族/民族和收入水平。调查结果将提供有关 全国中学密封胶项目的现状。它将产生可靠的估计， 将SBSP扩大到更多青少年的潜在影响及其对 减少差距。此R21将导致后续的R 01项目，以支持增加的 为青少年实施SBSP，确定提高这些效率的方法 减少口腔健康差距。