Severe Early Childhood Caries: Role of Dietary Cariogenicity and Eating Patterns

描述（由申请人提供）：幼儿龋齿是一种严重的儿科健康问题，对社会经济地位较低的儿童的影响尤为严重。在美国，儿童早期龋齿影响了2%到20%的学龄前儿童。尽管人们普遍认识到儿童牙齿问题的严重性以及饮食中糖在蛀牙发展中的作用，但在如何最好地表征儿童饮食的蛀牙性、儿童饮食的哪些方面对蛀牙的发展最重要、以及牙科治疗如何影响随后的饮食模式等方面，我们的知识仍存在重大空白。作为东北评估和消除牙科差异研究中心项目的一部分，这项探索性/发展性研究利用了对900名儿童前瞻性收集的丰富的牙科和饮食数据。在12个月的时间里，研究人员分三个时间点对2至6岁的低收入儿童（主要是非白人）进行了研究。患有严重早期儿童期龋齿的儿童和没有龋齿的对照组儿童的人数相等。以24小时饮食回忆访谈和食物频次问卷确定的食物为基础，建立致牙性分类体系，并系统开发和测试儿童“饮食致牙性指数”，根据食物的物理形态和食用时间来表示总的膳食致牙性。其次，我们将全面探讨S-ECC对饮食模式的影响，并评估综合牙科治疗后饮食模式和饮食致龋性的变化。总的来说，这些活动将提高我们用与口腔健康有关的方法描述儿童饮食特征的能力，并为预防工作提供信息，并提高我们对患有早期儿童龋齿的儿童进行干预的能力。项目说明：迫切需要改进研究口腔健康/营养联系的方法，以及更好地了解饮食模式与幼儿龋齿之间的联系。总之，这些进展将支持针对儿童早期龋齿的预防和治疗工作的临床研究，这种疾病对种族/少数民族儿童以及社会经济地位较低的儿童的影响尤为严重。

Description (provided by applicant): Early childhood caries is a serious pediatric health problem that disproportionately impacts children of lower socioeconomic status. In the U.S., early childhood caries affects 2 to 20% of pre-school children. Despite the general appreciation for the magnitude of childhood dental problems and the role of dietary sugars in the development of caries, there are critical gaps in our knowledge regarding how best to characterize the cariogenicity of child diet, what aspects of child diet are most important in the development of caries, and how dental treatment influences subsequent dietary patterns. The proposed exploratory/developmental research makes use of a rich complement of dental and dietary data being collected prospectively on 900 children as part of project within the Northeast Center for Research to Evaluate and Eliminate Dental Disparities. Low-income predominantly non-white children ages 2 to 6 years are being studied at three time points over a 12-month period. Equal numbers of children with severe early childhood caries and caries-free control children have been enrolled. A cariogenicity classification system will be developed based on foods identified by 24-hour diet recall interview and food frequency questionnaire, and used to systematically develop and test a pediatric "dietary cariogenicity index" to represent total dietary cariogenicity based on both the physical form and timing of food consumed. Secondarily, we will explore comprehensively the impact of S-ECC on dietary patterns, and evaluate changes in dietary patterns and dietary cariogenicity following comprehensive dental treatment. Collectively, these activities will improve our ability to characterize child diets with methodology relevant for oral health, and to inform prevention efforts and our ability to intervene in children with early childhood caries. Project Narrative: Improved methodology for the study of oral health/nutrition linkages as well as better understanding of the associations between eating patterns and early childhood caries are urgently needed. Together these advances will support increasingly focused clinical research in prevention and treatment efforts aimed at early childhood caries, a condition which disproportionately impacts children of racial/ethnic minorities as well as those of lower socioeconomic status.