PREVENTION MODEL OF EARLY CHILDHOOD CARIES

这个项目的目标是评估基于婴儿口腔护理计划的牙病预防管理模式的有效性。这项干预措施的目的是降低婴幼儿和幼儿的龋齿患病率。高危人群包括有早期ECC症状、口腔卫生差、接触氟化物有限以及经常接触高饮食糖类的人。这些儿童及其照顾者将接受一项专业的预防计划，其中包括预见性指导咨询、产后妇女使用洗必泰漱口水以及为其婴儿应用含氟清漆。这项建议与研究中心的主题有关，该中心旨在通过减少美国-墨西哥边境牙病高危人群的牙科差距来减少口腔健康差距。这个多学科团队汇集了加州大学旧金山分校、圣伊西德罗社区卫生中心、圣地亚哥州立大学和加州大学洛杉矶分校之间的合作努力。这项合作将通过确定在口腔健康差距普遍存在的服务不足的人群中针对ECC的最佳预防策略，在社区卫生中心环境中提供基于科学的研究开发方面的专业知识。该项目模式的相关性在于，它有可能通过将口腔健康促进和疾病预防作为多学科方法的一部分与其他卫生服务相结合，复制并转移到其他社区卫生中心和公共卫生实体。拟议的临床研究研究的具体目标是：1)从产前护理开始，并与其他卫生保健提供者和服务机构合作，确定一种有效的ECC疾病预防行为管理模式；2)比较两种前瞻性干预措施对孕妇和新生儿的效果：对母亲进行单独咨询与对母亲联合使用洗必泰冲洗和对婴儿使用含氟清漆；3)基于对幼儿及其母亲(照顾者)进行的单抗龋齿诊断试验来评估ECC的风险；4)评估防龋法在降低产后妇女唾液中变异链球菌水平以及随后抑制这些细菌的生长、延缓感染过程方面的有效性。从出生第一年开始，及早筛查龋齿发展的迹象，将确定有患ECC风险的婴儿和蹒跚学步的儿童，并将帮助向服务不足的社区的父母提供关于促进口腔健康和预防牙病的信息。

The goal of this project is to assess the effectiveness of a dental disease prevention management model based on an infant oral care program. The intervention is aimed at reducing the prevalence of early childhood caries infants and toddlers. High-risk include those with early signs of ECC, poor oral hygiene, limited exposure to fluorides, and frequent exposure to high dietary sugars. These children and their caregivers will be targeted with a professional preventive program that includes anticipatory guidance counseling, the use of chlorhexidine rinses for postpartum women and the application of fluoride varnish for their infants. This proposal relates to the theme of the Centers for Research to Reduce Oral Health Disparities by reducing dental disparities among a population at high risk for dental disease located at the US-Mexican border. The multi-disciplinary team brings together a collaborative effort between the University of California, San Francisco, San Ysidro Community Health Center, San Diego State University and the University of California, Los Angeles. This collaboration will provide expertise in the development of scientific based research in the community health center environment by identifying the best prevention strategies for ECC in an underserved population where oral health disparities are epidemic. The relevance of the project model is its potential for replication and transfer to other community health centers and public health entities through the integration of oral health promotion and disease prevention as part of a multi-disciplinary approach with other health services. The specific aims of the proposed clinical research study are: 1) To identify an effective disease prevention behavioral management model for ECC starting with prenatal care and with collaboration of other health care providers and services; 2) To compare the efficacy of two prospective interventions for pregnant women and their newborns: counseling alone versus counseling combined with chlorhexidine rinses for mothers and the use of fluoride varnish for infants; 3) To assess the risk for ECC based on a monoclonal antibody caries diagnosis test in very young children and their mothers (caregivers); 4) To assess the effectiveness of a caries-preventive regimen in lowering salivary mutants streptococci level in post-partum women and, subsequently, in inhibiting the growth of these bacteria, delaying the infectious process. Early screening for signs of caries development, starting from the first year of life, will identify infants and toddlers who are at risk of developing ECC and will assist in providing information to parents from an underserved community about the promotion of oral health and prevention of dental disease.