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

描述（由申请人提供）：幼儿龋齿是一个严重的儿科健康问题，不成比例地影响社会经济地位较低的儿童。在美国，2 - 20%的学龄前儿童患有幼儿龋齿。尽管儿童牙齿问题的严重性和膳食糖在龋齿发展中的作用得到了普遍的认识，但我们对如何最好地表征儿童饮食的致龋性，儿童饮食的哪些方面在龋齿发展中最重要，以及牙科治疗如何影响随后的饮食模式的知识存在重大差距。拟议的探索性/发展性研究利用了对900名儿童前瞻性收集的丰富的牙齿和饮食数据，作为东北研究中心评估和消除牙齿差异项目的一部分。在12个月的时间里，在三个时间点对2至6岁的低收入主要是非白人儿童进行了研究。同样数量的患有严重幼儿龋齿的儿童和无龋齿的对照儿童已经被招募。将基于通过24小时饮食回忆访谈和食物频率问卷确定的食物开发致龋性分类系统，并用于系统开发和测试儿科“饮食致龋性指数”，以基于食物的物理形式和食用时间来代表总的饮食致龋性。其次，我们将全面探讨S-ECC对饮食模式的影响，并评估综合牙科治疗后饮食模式和饮食致龋性的变化。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，并为预防工作提供信息，以及我们干预儿童早期龋齿的能力。项目叙述：迫切需要改进口腔健康/营养联系的研究方法，以及更好地了解饮食模式和幼儿龋齿之间的关联。这些进展将共同支持针对幼儿龋齿的预防和治疗工作的日益集中的临床研究，这种情况对种族/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.