Severe Early Childhood Caries: Role of Dietary Cariogenicity and Eating Patterns

描述(由申请人提供)：儿童早期龋病是一种严重的儿科健康问题，对社会经济地位较低的儿童影响不成比例。在美国，2%到20%的学龄前儿童会患幼儿龋齿。尽管人们普遍认识到儿童牙齿问题的严重性和膳食糖在龋齿发展中的作用，但在如何最好地描述儿童饮食的致龋性、儿童饮食的哪些方面对龋齿的发展最重要以及牙科治疗如何影响随后的饮食模式方面，我们的知识存在严重差距。作为东北研究中心评估和消除牙齿差异项目的一部分，这项拟议的探索性/发展研究利用了对900名儿童进行前瞻性收集的丰富的牙科和饮食数据。对2至6岁的低收入儿童(主要是非白人儿童)进行为期12个月的三个时间点的研究。有严重早期儿童龋齿的儿童和无龋齿对照儿童的人数相等。将根据24小时饮食回忆访谈和食物频率问卷确定的食物建立致龋性分类系统，并用于系统地开发和测试基于食物的物理形式和食用时间的代表总的膳食致龋性的儿科“饮食致龋性指数”。其次，我们将全面探讨S-ECC对膳食结构的影响，并评估综合牙科治疗后膳食结构和膳食致龋性的变化。总的来说，这些活动将提高我们用与口腔健康相关的方法描述儿童饮食的能力，并为预防工作和我们干预儿童早期龋齿的能力提供信息。项目说明：迫切需要改进研究口腔健康/营养联系的方法，以及更好地了解饮食模式和幼儿龋齿之间的联系。这些进展将共同支持针对儿童早期龋齿的预防和治疗工作中日益集中的临床研究，这种疾病对种族/少数民族儿童以及社会经济地位较低的儿童的影响不成比例。

Description (provided by applicant): Early childhood caries is a serious pediatric health problem that disproportionately impacts children of lower socioeconomic status. In the U.S., early childhood caries affects 2 to 20% of pre-school children. Despite the general appreciation for the magnitude of childhood dental problems and the role of dietary sugars in the development of caries, there are critical gaps in our knowledge regarding how best to characterize the cariogenicity of child diet, what aspects of child diet are most important in the development of caries, and how dental treatment influences subsequent dietary patterns. The proposed exploratory/developmental research makes use of a rich complement of dental and dietary data being collected prospectively on 900 children as part of project within the Northeast Center for Research to Evaluate and Eliminate Dental Disparities. Low-income predominantly non-white children ages 2 to 6 years are being studied at three time points over a 12-month period. Equal numbers of children with severe early childhood caries and caries-free control children have been enrolled. A cariogenicity classification system will be developed based on foods identified by 24-hour diet recall interview and food frequency questionnaire, and used to systematically develop and test a pediatric "dietary cariogenicity index" to represent total dietary cariogenicity based on both the physical form and timing of food consumed. Secondarily, we will explore comprehensively the impact of S-ECC on dietary patterns, and evaluate changes in dietary patterns and dietary cariogenicity following comprehensive dental treatment. Collectively, these activities will improve our ability to characterize child diets with methodology relevant for oral health, and to inform prevention efforts and our ability to intervene in children with early childhood caries. Project Narrative: Improved methodology for the study of oral health/nutrition linkages as well as better understanding of the associations between eating patterns and early childhood caries are urgently needed. Together these advances will support increasingly focused clinical research in prevention and treatment efforts aimed at early childhood caries, a condition which disproportionately impacts children of racial/ethnic minorities as well as those of lower socioeconomic status.