PREDICTION OF S MUTANS INFECTION AND CARIES

1991年3月底，我们完成了由NIDR赞助的与 确定化疗干预效果的具体任务 关于预防或延缓变形链球菌(MS)传播的研究 母亲给她们的婴儿。母亲被认为是“高风险”，基于她们的 既往龋齿经历和唾液中高水平多发性硬化症 全面的牙齿修复治疗，随后是一系列 碘氟化钠或安慰剂溶液的应用。母亲和 婴儿在干预前后的细菌谱是 一直监测到孩子3岁生日。达到了最初的目标 在合同中，我们收集了一个关于48位母亲的全面数据库- 婴儿配对；3个月时拍摄的详细细菌学特征。间隔时间， 包括口服多发性硬化症、乳杆菌、血链球菌、总链球菌、 和母亲唾液中的可培养细菌总数，以及菌斑和唾液 婴儿的数量。据我们所知，这是唯一的数据库 世界上最善良的人。变形链球菌、其他细菌的冷冻库 还可用于分析物种和唾液免疫球蛋白。在……里面 此外，根据本研究中关于 与儿童获得多发性硬化症相关的潜在因素 从353名市中心儿童那里收集了补充数据 5-12岁和他们的母亲在一项横断面研究中。 这里提出的研究的总体目标是利用这两个现有的 数据库，以及随后的年度检查结果，以 制定获得MS和其他细菌的预测模型(例如， 美国血吸虫)和儿童的龋齿发展。这将会实现的 使用回归分析技术，包括一种称为 广义等值方程(GEE)。因为观察是在 同一人随着时间的推移，在纵向研究中，吉可以调整为内- 自变量的人的相关性。多发性硬化的可能预测因素 根据母亲的情况，儿童的殖民和/或龋齿结果 特征，包括母亲过去的牙科和病史， 唾液细菌谱，年龄，种族，饮食历史，以及其他。 来自婴儿/儿童数据的潜在预测因素包括人口统计学和 其他危险因素；牙齿萌出的时间和模式， 细菌定植，看护史，氟化物，抗生素暴露， 和节食。每个孩子的出生体重和胎龄都是可用的， 将被包括在一些分析中。 这项研究的结果将有助于确定多发性硬化症的预测因素 儿童的定居和龋病将把公共卫生措施的重点放在 确定被认为是“高风险”的婴儿。这又将允许指定的 卫生资金将用于预防那些 个人。将获得有关以及 疾病，以及对其他影响婴儿和 年幼的孩子。

At the end of March, 1991, we completed a NIDR-sponsored contract with the specific task of ascertaining the effect of a chemotherapeutic intervention on preventing or delaying the transmission of mutans streptococci (MS) from mothers to their infants. Mothers deemed "high risk, " based upon their past caries experience and high levels of MS in saliva, received comprehensive dental restorative treatments followed by a series of applications of either iodine-NaF or placebo solutions. Mothers' and infants' bacterial profiles prior to and following intervention were monitored until the child's 3rd birthday. Having answered the initial aims of the contract, we have amassed a comprehensive database on 48 mother- infant pairs; detailed bacteriological profiles taken at 3 mo. intervals, including levels of oral MS, lactobacilli, S. sanguis, total streptococci, and total cultivable bacteria in saliva of mothers, and plaque and saliva of infants. To our knowledge, this constitutes the only database of this kind in the world. Frozen stores of mutans streptococci, other bacterial species, and salivary immunoglobulins are also available for analysis. In addition, based on the observations made in this study regarding the potential factors associated with the acquisition of MS by children, we have gathered complementary data from 353 inner city children between the ages 5-12 years and their mothers in a cross-sectional study. The overall goal of the study proposed here is to use these two existing databases, as well as the results of the subsequent yearly examinations to formulate prediction models for acquisition of MS and other bacteria (e.g., S. sanguis) and caries development in children. This will be accomplished using regression analysis techniques, including a technique called generalized equating equation (GEE). Since observations are made on the same person over time in the longitudinal study, GEE can adjust for within- person correlation of independent variables. Possible predictors of MS colonization and/or caries outcome in the child, based on mother's characteristics, include past dental and medical histories of the mother, salivary bacterial profiles, age, race, and diet history, among others. Potential predictors from infant/child data include demographic as well as other risk factors; timing and pattern of tooth eruption, sequence of bacterial colonization, caretaker history, fluoride, antibiotic exposure, and diet. Birth weight and gestational age of each child are available and will be included in some of the analyses. Results of this study will allow identification of predictors for MS colonization and caries in children to focus public health measures at identifying infants deemed "high risk." This in turn will allow specified health dollars to be directed toward preventive measures for those individuals. Basic information will be obtained concerning well as disease, and insight into other infectious diseases affecting infants and young children.