DECREASING RATES OF EARLY CHILDHOOD CARIES

幼儿龋病是影响幼儿初级牙列的一种严重的龋病，尤其以少数民族贫困儿童为主。为了预防ECC，至关重要的是，向有风险的儿童及其照顾者提供有关预防这种疾病的方法的建议和咨询，并且那些患有这种疾病的儿童可以尽早发现，以便他们能够接受必要的恢复性治疗和咨询。因此，儿科医生可以通过检查患者的ECC，并向父母和护理人员提供有关减少儿童接触疾病风险因素的建议和咨询，从而成为对抗ECC的天然盟友。我们提出了一项创新的社区干预试验，该试验将利用一种行之有效的教育方法来提高儿科医生就降低儿童早期龋齿风险向患者父母或照顾者提出建议和咨询的能力。这样的教育项目改变了医生的行为，并通过他们影响了父母或照顾者行为的改变，这一系列事件预计将降低儿童ECC的风险和发病率。我们将为专门的儿科医生提供培训和教育项目，主要服务于低收入的非裔美国人和拉丁裔儿童。这些项目的目的是增加对家长/照顾者关于减少ECC风险因素的建议和咨询，以及使用简短的临床口腔检查和使用氟化物清漆治疗ECC，而其他人将提供常规护理。此外，我们会为干预组实施一套办公室提醒系统，以协助他们实践先前教导的干预措施。为了评估干预的有效性，我们将首先测量一组初始年龄为12个月、24个月和36个月的儿童中ECC的基线患病率和ECC相关危险因素，这些儿童在儿科医生的办公室进行了健康儿童访问，然后我们将在一年后和两年后评估ECC的发病率和患病率。我们还将评估儿科医生在基线、一年后和两年后对队列和对照组儿童进行咨询、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.