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

低收入儿童，特别是墨西哥裔美国人，儿童早期龋齿的风险尤其高 (ECC)。虽然其他年龄段的患龋率在过去几十年里一直在下降，但它正在上升。 在学龄前儿童中。我们的研究小组已经证明了氟化物清漆(FV)在 防止ECC。这项建议继续我们与社区合作伙伴的努力，以寻求有效的 干预措施。树脂基牙密封剂在学龄前儿童中未得到充分利用，因为 应用难度大。新型材料，如精制的释氟自粘结玻璃离子(Gl) 封闭剂，减少使用过程中对牙齿表面的细致干燥的需要，并提供优势 治疗年幼的孩子。该项目的目标是进行一项基于社区的随机临床试验 (RCT)确定不同组合的Gl封闭剂对牙合表面的相对疗效 乳磨牙、所有牙齿上的FV和父母咨询/预期指导(C)在减少龋病方面的作用 3-6岁儿童发病率/增量。2x2析因设计随机对照试验，按研究地点分层(一个牙齿 和一个非牙科)，将在最初3岁的儿童中进行。符合条件的人将被随机分配 分为C组、C+FV组、C+GI组、C+FV+GI组，随访3年。RCT将在两个地点进行 主要服务于南加州的西班牙裔低收入人群：旧金山的牙科设施 伊西德罗健康中心位于美国-墨西哥边境附近，也是我们目前预防ECC的地点 针对0-3岁儿童的RCT，以及与La Maestra Health Center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/增量的家庭和社区因素；(2)评估父母的接受度 干预措施、研究中的保留以及随机对照试验中多次治疗访问的遵从性；以及 (3)比较口腔保健设置/提供系统，并评估它们相关的差异 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预防的干预措施建立科学证据基础。 在服务不足的社区中，口腔健康差距仍然很大。

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.