Predicting Caries Risk in Underserved Toddlers

描述(申请人提供)：根据首份北美卫生局局长口腔健康报告(2000年)，龋齿是最常见的儿童慢性疾病。此外，该国大多数(75%-80%)的儿童严重龋病问题发生在一小部分人口(20%-25%)中，这一问题在少数族裔和移民中尤为普遍。这些受影响的儿童也经常出现在较低的社会经济阶层，通常在很小的年龄就患上龋齿。因此，当务之急是对儿童进行早期评估，以确定并最终治疗那些儿童早期龋齿(ECC)风险最大的儿童，最好是在疾病发展之前。这项探索性研究的目的是开发一种创新的自我管理的结构化龋病风险问卷，以确定幼儿(18-36个月)患ECC的风险最高，重点关注高危人群(例如，非裔美国人和西班牙裔)。重点将确定主要照顾者和儿童具有的龋齿危险行为，他们对口腔健康的知识对这些因素的影响，以及对他们牙齿健康的看法对寻求牙科护理的影响。将包括一系列可能影响这些人口的传播、龋齿发展、一般健康和获得护理的社会、文化、功能、心理、社会人口、饮食和生物因素。问卷将分三个阶段编制。第一阶段将涉及完善由牙科同行和目标主要照顾者的焦点小组的初始草案。在第二阶段，修订后的版本将在大量测试人群中使用(400名主要照顾者/儿童配对)。这项提议的一个优点是，它将作为预测建模(阶段3)的结果变量，使用国际龋齿检测和评估系统(ICDAS)和定量光诱导荧光系统(QLF)这两种最具创新性和最敏感的龋病检测和监测方法，对早期、早期的龋损进行检测和12个月的监测，这将允许比传统的龋洞检测水平更准确地评估疾病的发展和进展。

DESCRIPTION (provided by applicant): According to the first-ever Surgeon General's report on oral health in North America (2000), dental caries is the most common chronic childhood disease. In addition, most (75-80%) of the severe caries problems in children in this country occur in a small segment of the population (20-25%), and this problem is particularly prevalent in minorities and immigrants. These affected children are also often found in the lower socioeconomic strata and commonly develop caries at a very early age. Therefore, it is imperative that early in life a child is assessed to identify and eventually treat those children who are at greatest risk for the development of Early Childhood Caries (ECC), preferably before disease development. The purpose of this exploratory study is to develop an innovative self-administered structured caries risk questionnaire to identify toddlers (18-36 months of age) at the highest risk of developing ECC, focusing on at-risk population groups (e.g., African American and Hispanic). The focus will be to identify the caries risk behaviors that the primary caregiver and child have, the impact that their knowledge on oral health has on these factors, and the influence that perceptions of their dental health have on seeking dental care. A range of social, cultural, functional, psychological, socio-demographic, dietary and biological factors that may affect transmission, development of caries, general health, and access to care in these populations will be included. The questionnaire will be developed in three phases. Phase 1 will involve refinement of an initial draft by dental peers and a focus group of target primary caregivers. In Phase 2, this revised version will be then used in a large test population (400 primary caregivers/child pairs). A strength of this proposal is that it will use as the outcome variable for predictive modeling (Phase 3), the detection and 12-month monitoring of early, precavitated caries lesions, using two of the most innovative and sensitive methods for caries detection and monitoring, the International Caries Detection and Assessment System (ICDAS) and the Quantitative Light induced Fluorescence system (QLF), which will allow for a more accurate assessment of disease development and progression over time than traditional level of cavity detection.