Predicting Caries Risk in Underserved Toddlers

描述（由申请人提供）：根据首份北美口腔卫生报告（2000年），龋齿是最常见的儿童慢性疾病。此外，该国儿童中大多数（75-80%）的严重龋齿问题发生在一小部分人口中（20-25%），这一问题在少数民族和移民中尤为普遍。这些受影响的儿童也经常出现在较低的社会经济阶层，通常在很小的时候就患上龋齿。因此，必须在儿童生命早期对其进行评估，以确定并最终治疗那些患早期儿童龋齿（ECC）风险最大的儿童，最好是在疾病发展之前。本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齿风险问卷，以确定发生ECC的最高风险的幼儿（18-36个月），重点关注高危人群（如非洲裔美国人和西班牙裔）。重点将是确定主要照顾者和儿童的龋齿风险行为，他们对口腔健康的知识对这些因素的影响，以及他们对牙齿健康的看法对寻求牙科护理的影响。将包括可能影响这些人群的传播、龋齿发展、一般健康和获得保健的一系列社会、文化、功能、心理、社会人口、饮食和生物因素。调查问卷将分三个阶段编制。第一阶段将包括由牙科同行和目标主要护理人员的焦点小组对初步草案进行改进。在第二阶段，修订后的版本将用于大型测试人群（400对主要照顾者/儿童）。该提案的优势在于，它将使用两种最具创新性和敏感性的龋齿检测和监测方法，即国际龋齿检测和评估系统（ICDAS）和定量光诱导荧光系统（QLF），作为预测建模（第3阶段）的结果变量，检测和12个月监测早期，预防龋齿病变。这将允许更准确的评估疾病的发展和进展随着时间的推移比传统水平的腔检测。

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.