Validation of chair-side biochemical screening instruments for dental caries

描述（由申请人提供）：长期以来，人们已经认识到需要开发一种用于龋齿活动和龋齿风险的准确的椅旁筛查仪器，并且在该领域进行了广泛的研究工作，但没有取得太大成功。我们的研究为解决这一问题提供了一种新的方法。这种方法是建立在一个新的模型，龋齿风险金字塔（CRP），它总结了现有的知识有关的龋齿生物学。假设：基于CRP模型，我们假设测量牙菌斑和/或唾液从尿素或其他唾液基质产生碱的能力，以及从糖产生酸的能力，可以提供对个体龋齿状态和可能的未来龋齿风险的准确估计，因为它们总结了其他龋齿风险因素的综合影响。目的：为了验证这一假设，我们开发了一系列新颖的椅旁测试，用于测量牙菌斑和唾液中的酸碱生成。本研究的目的是评估这些测试的可靠性和有效性作为筛查工具的龋齿，并探讨可能的方法，结合这些测试的结果，以准确地识别个人与龋齿。为了实现这一目标，建议对200名成人受试者进行横断面研究。重要性：所提出的测试是新颖的，因为他们认为在菌斑中产生碱的能力是一个潜在的龋齿风险因素，这是以前没有包括在现有的多变量风险评估模型。与现有的生物龋齿风险测试相比，它们成本低，结果更快。它们不需要牙科专业知识，这使得它们适合非牙科专业人士使用。一旦这些测试在成人中得到验证，我们的最终目标是在儿童和婴儿中验证它们作为早期儿童龋齿（ECC）的筛查工具，并最终作为未来龋齿风险的预测因子，无论是独立的，还是与其他龋齿风险因素相结合。所提出的测试的另一个重要的潜在应用将是在临床牙科实践、研究和社区干预中比较干预前后的风险。

DESCRIPTION (provided by applicant): The need to develop an accurate chair-side screening instrument for caries activity and caries risk has been long recognized and extensive research work has been done in this area without much success. Our study takes a new approach in solving this problem. This approach is founded on a novel model, the Caries Risk Pyramid (CRP), which summarizes the available knowledge regarding the biology of dental caries. HYPOTHESIS: Based on the CRP model, we hypothesize that measuring the ability of dental plaque and/or saliva to generate alkali from urea, or other salivary substrates, together with the ability to generate acid from sugars, can provide an accurate estimation of an individual's caries status and possibly future caries risk because they summarize the combined effect of other caries risk factors. OBJECTIVE: In order to test this hypothesis we have developed an array of novel, chair-side tests for measuring acid and alkali generation in plaque and in saliva. The objective of this study is to assess the reliability and validity of these tests as screening tools for dental caries and to explore possible ways of combining the results of these tests in order to accurately identify individuals with caries. To accomplish this objective, a cross-sectional study on 200 adult subjects is proposed. SIGNIFICANCE: The proposed tests are novel because they consider the ability to generate alkali in plaque as a potential caries risk factor, which has not been previously included in existing multivariate risk assessment models. They are of low cost and give faster results compared to available biological caries risk tests. They do not require dental expertise, which makes them suitable for use by non-dental professionals. Once the tests have been validated in adults, our ultimate goal is to validate them in children and infants as screening tools for Early Childhood Caries (ECC), and ultimately as a predictor of future caries risk, either independently, or in combination with other caries risk factors. Another important potential application for the proposed tests would be the comparison of pre- to post- intervention risk in clinical dental practice, in research, and in community interventions.