Epidemiology of Dental Caries and Immunity in Children

描述（申请人提供）：龋齿是一种世界性的传染性疾病。这种疾病是多因素和复杂的；然而，宿主/寄生虫关系的基本概念对发病机制很重要。虽然多种细菌参与疾病过程，但变异链球菌（MS）最一致地与人类龋齿的开始有关。对婴儿的观察表明，MS在口腔的最初定植发生在乳牙的萌出。幼儿最初感染多发性硬化症的正常来源似乎是母亲的垂直传播；然而，其他家庭成员、看护人或玩伴也可能发生水平传播。除了感染的自然历史和定植位点的可用性以及饮食中的蔗糖摄入量外，有数据表明宿主对MS的免疫力的发展也参与了MS的定植。初级牙列的龋齿往往与随后发生恒牙龋齿的较高风险相对应。因此，有必要更好地定义MS感染在人类牙菌斑生物膜内克隆发育和时间稳定性方面的重要特征。本研究的目的是在与龋齿相关的重要萌牙事件（即乳牙和恒磨牙）对应的两个年龄组的家庭和儿童中，在稳定和合作的龋齿高危人群中，研究在龋齿发病和流行病学中重要的宿主/寄生虫关系。本研究利用聚合酶链反应和脉冲场凝胶电泳等最新技术，在确定的儿童和家庭成员群体中建立MS基因型的共性和稳定性。一个由医生、牙医、基础科学家、流行病学家和统计学家组成的跨学科小组已经成立，以提高我们对儿童龋齿的宿主-寄生虫关系的理解。这些研究的结果应该为制定预防这种传染病的战略提供关键信息。此外，在位于“黑带”县的阿拉巴马州Uniontown开展这些研究，将为儿童及其家庭成员提供急需的预防性口腔护理，并将与阿拉巴马州公共卫生部合作，安排必要的牙科护理，以改善这些服务不足人口的口腔健康。

DESCRIPTION (provided by applicant): Dental caries is an infectious and transmissible disease worldwide. This disease is multifactorial and complex; however the basic concepts of the host/parasite relationship are important to pathogenesis. Although various bacteria are involved in the disease process, the mutans streptococci (MS) are most consistently implicated in the initiation of caries in humans. Observations in infants indicate that the initial colonization of the oral cavity with MS occurs with eruption of the primary teeth. The normal source of the initial MS infection in young children appears to be vertical transmission from the mother; however, horizontal transmission may also occur from other family members, caretakers or playmates. In addition to the natural history of infection and availability of colonization sites as well as dietary sucrose intake, there is data to indicate that the development of the host's immunity to MS is also involved in MS colonization. Caries in the primary dentition often corresponds with subsequent higher risk for caries in permanent teeth. Therefore, it is necessary to better define important characteristics of MS infections regarding their clonal development and temporal stability within dental plaque biofilms in humans. The purpose of the studies proposed is to investigate the host/parasite relationship important in the pathogenesis and epidemiology of dental caries in a stable and cooperative high caries risk population of families and children of two age groups corresponding with important tooth eruption events (i.e., primary and permanent molar teeth) associated with caries. This proposal utilizes the latest technologies including polymerase chain reaction and pulsed-field gel electrophoresis to establish the commonality of MS genotypes and stability in a defined population of children and family members. An interdisciplinary team of physicians, dentists, basic scientists, epidemiologists and statisticians has been assembled to improve our understanding of the host-parasite relationship of dental caries in children. The results of these studies should provide key information for the development of strategies to prevent this infectious disease. Additionally, the initiation of these studies in Uniontown, Alabama that is in a "Black Belt" county will provide much needed preventive oral care to children and their household family members and will partner with the Alabama Department of Public Health to arrange necessary dental care to improve oral health in this underserved population.