DECREASING RATES OF EARLY CHILDHOOD CARIES

儿童早期龋病是一种严重的龋病，影响幼儿的乳牙期，尤其是少数民族贫困儿童。为了预防ECC，至关重要的是向高危儿童及其照顾者提供关于预防这种疾病的方法的建议和咨询，并使那些确实患上这种疾病的儿童能够尽早被发现，这样他们就可以接受必要的恢复性治疗和咨询，以便每年都能接受必要的恢复性治疗和咨询，这样儿科医生就可以成为对抗ECC的天然盟友，通过检查他们的患者的ECC，并建议和咨询父母和照顾者减少儿童接触疾病的风险因素。我们提出了一项基于社区的创新干预试验，该试验将利用经过验证的教育方法来增强儿科医生的能力，即就降低儿童早期龋病的风险向患者的父母或照顾者提供建议和咨询。这样的教育项目改变了医生的行为，并通过它们影响父母或照顾者行为的变化。这一系列事件预计将降低儿童中ECC的风险和发生率。我们将向指定的儿科医生提供培训和教育项目，主要服务于低收入的非洲裔美国人和拉美裔儿童。这些计划旨在增加父母/照顾者关于减少ECC风险因素的建议和咨询，并使用简短的临床口腔检查和使用氟化物清漆来治疗ECC，而其他计划将提供常规护理。此外，对于干预组，我们将实施以办公室为基础的提醒制度，以便于实践之前教授的干预。为了评估干预措施的效果，我们将首先在一组最初年龄为12、24和36个月的儿童中测量ECC和ECC相关危险因素的基线患病率，这些儿童在他们的儿科医生办公室就诊，然后我们将在一年和两年后评估ECC的发病率和患病率。我们还将评估儿科医生在基线以及一年和两年后对队列成员和对照组儿童使用咨询、检查或应用氟化物清漆的情况。

Early childhood caries (ECC) is a serious form of dental caries that affects the primary dentition of young children, which disproportionately affects poor children from racial/ethnic minority group. In order to prevent ECC, ti is vital that at-risk children and their caregivers be advised and counseled about ways to prevent this disease, and that those children who do develop it can be identified as early as possible, so they can receive necessary restorative treatment and counseling to year, so pediatricians could be natural allies in the battle against ECC by examining their patients for ECC and advising and counseling parents and caregivers about decreasing the child's exposure to risk factors for the disease. We propose an innovative community based intervention trial that will utilize a proven education methodology for enhancing pediatricians' ability to advise and counsel their patients' parents or caregivers regarding decreasing risks for early childhood caries. Such educational programs change physician behaviors and through them, effect changes in parent or caregiver behavior This chain of events is anticipated to decrease the risks and rates of ECC among children. We will provide training and educational programs to specified pediatricians in a practice serving primarily low income African American and Latino children. These programs are designed to increase advising and counseling parents/caregivers about decreasing ECC risk factors, and the use of a brief clinical oral examination and application of fluoride varnish for ECC, while others will provide usual care. In addition, for the intervention group, we will implement an office-based reminder system to facilitate the practice of the previously-taught intervention. To assess the efficacy of the intervention, we will first measure the baseline prevalence of ECC and ECC related risk factors among a cohort of children with initial ages of 12, 24 and 36 months, who present for well- child visits at their pediatricians's office, then we will assess ECC incidence and prevalence one and two years later. We will also assess the pediatrician's use of counseling, examining, or applying fluoride varnish to members of the cohort and control groups of children at baseline, and one and two years later.