Glass Ionomer Sealant & Fluoride Varnish Randomized Clinical Trial to Prevent ECC

低收入家庭的儿童，特别是墨西哥裔美国人，特别是在儿童早期龋齿的高风险 （ECC）。虽然其他年龄组别的患龋率在过去数十年一直下降， 在学龄前儿童中。我们的研究团队已经证明了氟化物涂膜（FV）在治疗 防止ECC。这项建议继续我们的努力，与我们的社区合作伙伴，以寻求有效的 干预措施。树脂基牙科密封剂在学龄前儿童中的使用不足， 应用难度。新材料，如精制的氟化物释放、自粘合玻璃离子（GI） 密封剂，减少了在应用过程中对细致的牙齿表面干燥的需要， 用于治疗幼儿。本项目的目标是进行一项以社区为基础的随机临床试验 (RCT)为了确定GI密封剂的不同组合在患者的咬合表面上的相对功效， 乳磨牙，所有牙齿的FV，以及减少龋齿的父母咨询/预期指导（C） 3-6岁儿童发病率/增加率。一项2x2析因设计RCT，按研究中心分层（一个牙科 和一个非牙科），将在最初3岁的儿童中进行。将对符合条件的患者进行随机分组 C组、C+FV组、C+GI组、C+FV+GI组，随访3年。RCT将在两个研究中心进行 主要服务于南加州的西班牙裔低收入人群：San Ysidro健康中心位于美国附近-墨西哥边境和我们目前的ECC预防的位置 针对0-3岁奥尔兹的RCT以及与La Maestra健康中心的新合作伙伴关系，在附近的非牙科环境中 他们的牙科诊所这两个网站都隶属于WIC和Head Start。其他目的是（1）识别儿童， 影响龋病发病率/增长的家庭和社区因素;（2）评估父母的接受程度 干预、研究中的保留以及RCT中多次治疗访视的依从性;以及 (3)比较口腔保健设置/提供系统，并评估差异，因为它们与 干预结果。关于非牙科环境的信息将为未来的传播方法提供信息。 拟议的研究将继续为干预措施建立科学证据基础， 在口腔健康差距仍然普遍存在的服务不足社区开展幼儿保育。

Low-income children, particularly Mexican-Americans, are especially at high risk for early childhood caries (ECC). While caries prevalence in other age groups has been declining in past decades, it is increasing among preschool-aged children. Our research team already demonstrated fluoride varnish (FV) efficacy in preventing ECC. This proposal continues our effort with our community partners to seek effective interventions. Resin-based dental sealants have been under-utilized in preschool children because of application difficulty. New materials, such as the refined fluoride-releasing, self-bonding glass ionomer (Gl) sealant, decrease the need for meticulous tooth-surface drying during application and provide an advantage for treating young children. The goal of this project is to conduct a community-based randomized clinical trial (RCT) to determine the relative efficacy of different combinations of Gl sealants on occlusal surfaces of primary molars, FV on all teeth, and parental counseling/anticipatory guidance (C) in reducing the caries incidence/increment in 3-6-year-old children. A 2x2 factorial design RCT, stratified by study site (one dental and one non-dental), will be conducted among initially 3-year-old children. Those eligible will be randomized to four groups (C, C+FV, C+GI, C+FV+GI) and followed for 3 years. The RCT will take place at two sites serving primarily Hispanic low-income populations in Southern California: the dental facility of the San Ysidro Health Center located near the U.S.-Mexican Border and the location of our current ECC prevention RCT for 0-3 year olds and a new partnership with La Maestra Health Center, in a non-dental setting near their dental clinic. Both sites are affiliated with WIC and Head Start. Other aims are (1) to identify child, family and community-level factors affecting caries incidence/increment; (2) to assess parental acceptance of interventions, retention in the study as well as compliance with multiple treatment visits in the RCT; and (3) to compare oral-healthcare settings/delivery systems and to assess differences as they relate to intervention outcomes. Information about the non-dental setting will inform future dissemination approaches. The proposed research will continue to establish the scientific evidence base for interventions to prevent ECC among underserved communities where oral health disparities still prevail.