PREDICTING CARIES RISK IN UNDERSERVED CHILDREN, FROM TODDLERS TO THE SCHOOL-AGE YEARS, IN PRIMARY HEALTHCARE SETTINGS

预测初级医疗保健机构中从幼儿到学龄儿童的龋齿风险

基本信息

批准号：
10361268
负责人：
Margherita R Fontana
金额：
$ 0.76万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10361268
关键词：
5 year old 8 year old Academy Age Age-Years American Area Assessment tool Biological Child Childhood Chronic Disease Cohort Studies Data Data Analyses Dental Dental Care Dental caries Dentists Development Disease Dyes Early treatment Enrollment Environment Expenditure Experimental Designs Follow-Up Studies Funding Goals Grant Health Health Care Costs Health Personnel Health Services Accessibility Healthcare Incidence Interdisciplinary Study Intervention Lesion Life Cycle Stages Medical Methods Minority Groups Mixed Dentition Monitor National Institute of Dental and Craniofacial Research Oral Oral health Participant Patients Pattern Pediatrics Policies Population Group Population Heterogeneity Predictive Value Prevalence Prevention Preventive Preventive therapy Primary Dentition Primary Health Care Process Provider Publishing Questionnaires Research Research Personnel Resources Risk Risk Assessment Risk Factors School-Age Population Schools Specialist Strategic Planning Temperament Therapeutic Time Toddler Tooth structure Triage Visit Work aged base care providers clinical risk cohort cost cost effective craniofacial deciduous tooth design disorder prevention early childhood ethnic minority population evidence base experience health assessment health care delivery health care settings innovation low socioeconomic status multidisciplinary neglect parent grant permanent tooth prevent primary caregiver programs racial and ethnic racial minority sex tool tooth surface

项目摘要

SUMMARY OF FUNDED PARENT GRANT: Dental caries, one of the most common chronic diseases of childhood, is a largely preventable disease, yet approximately 23% of U.S. children 2-5 years-of-age experience dental caries, and this number more than doubles to 56% among those aged 6-8. In the current environment of escalating healthcare costs and resource constraints, the large disparities in caries experience and access to care that exist in the U.S., especially among low socioeconomic status (SES) and minority population groups, call for a greater focus on targeted (at the patient and tooth surface level), risk-based caries preventive and therapeutic strategies to be delivered through interprofessional partnerships, including primary healthcare settings. Our team has just finished following 1,326 children from age 1 to age 4, and we have started data analyses to validate a caries risk questionnaire for use by medical providers to accurately identify high caries risk toddlers. The problem is that, while caries experience more than doubles from ages 2-5 to 6-8, caries in primary teeth during mixed dentition is a largely neglected area of research and prevention, there is no validated caries risk tool for medical settings to easily help triage 5-8 year old children, and there have been almost no studies following the life-course progression of caries in children 1-8. This information is critically important, as designing and targeting efficacious and cost-effective preventive therapies that can adapt to changes in the life-course from toddlers to school-age children is dependent on accurate risk factor and tooth surface assessment. Thus, the objectives of this innovative continuation renewal study are: 1) to develop a practical and easily-scored caries risk tool for use in primary medical healthcare settings to identify high caries risk children, expanding from the toddler (1-4) to the school-age years (5-8); and 2) to determine the relationships between caries risk profiles and caries disease patterns (e.g., occlusal vs. proximal) in the mixed dentition. This will be accomplished by following a cohort of 876 primary caregiver (PCG)-child pairs from our ongoing U01’s enrolled pairs. This cohort represents a diverse population, including ethnic/racial minorities and low SES groups. The PCG will complete a caries risk questionnaire and the child will have caries examinations at baseline (child’s age 6.5 years old + 3 months), and again at 18 months (child’s age 8 years + 3 months) and 36 months after baseline (child’s age 9.5 years + 3 months) to monitor the caries disease process. Longitudinal caries risk data and caries disease prevalence/incidence and tooth surface pattern information collected from age 1-4 (ongoing U01) and 5-8 (proposed continuing renewal) will be used to assess risk of caries in children ages 5-8. A great strength of this proposal is that it involves four experienced medical and dental investigator groups, who have successfully worked together for the past 5.5 years and can facilitate follow-up of the study cohort. The significance is that identification of high caries risk children in primary healthcare settings will allow cost- effective preventive and/or referral strategies to be developed, targeted and used in interprofessional settings to prevent caries development from the toddler to the school-age years. This will have immediate broad impact and influence on existing and/or new policies and programs to be delivered by non-dental professionals in medical settings and other non- healthcare settings (e.g., school-based), as well as by dental professionals in dental healthcare settings.

资助父母赠款的摘要：龋齿是童年最常见的慢性疾病之一，是一种可预防的疾病，但大约是 23％的美国儿童2 - 5年的龋齿经验，这一数字在其中的56％至56％ 6-8岁。在当前升级医疗保健成本和资源限制的环境中，大型分布在美国存在的性经验和获得护理的经验，尤其是社会经济地位（SES）和少数族裔人群，要求更大的关注目标（在患者和牙齿表面水平），基于风险的汽车通过跨专业伙伴关系（包括初级医疗保健）提供的预防和治疗策略设置。我们的团队刚刚结束了1,326名儿童从1岁到4岁，我们已经开始进行数据分析到验证医疗提供者使用的性风危风险问卷，以准确地识别高性风险幼儿。问题是，虽然龋齿经历了2-5岁至6-8岁的两倍以上，但在混合期间，龋齿龋齿牙列是一个很大程度上被忽视的研究和预防领域，没有经过验证的龋齿风险工具用于医疗环境为了轻松帮助分类5-8岁的孩子，在生命过程中，几乎没有研究携带儿童1-8。这些信息至关重要，因为设计和定位有效且具有成本效益可以适应生命课程从幼儿变为学龄儿童的预防疗法取决于准确的危险因素和牙齿表面评估。这是这项创新延续研究的目标是： 1）开发一种实用且易于评分的龋齿风险工具，以在主要医疗保健环境中使用 Caries冒着危险儿童，从蹒跚学步的孩子（1-4）扩展到学龄（5-8）； 2）确定关系在混合牙列中，龋齿风险谱和龋齿疾病模式（例如，咬合与近端）之间。这将是通过遵循我们正在进行的U01的注册对的876个主要照顾者（PCG） - 儿童对完成。这队列代表潜水员人口，包括种族/种族少数民族和低SES群体。 PCG将完成 Caries风险问卷调查和孩子将在基线时进行龋齿检查（儿童6.5岁 + 3个月），再次在18个月（儿童8岁 + 3个月）和基线后36个月（儿童9.5岁 + 3个月）监测龋齿疾病过程。纵向龋齿风险数据和龋齿病的患病率/发病率，也从1-4岁（正在进行的U01）和5-8（拟议继续续订）收集的表面模式信息将用于评估5-8岁儿童汽车的风险。该提议的一个很大的优势是，它涉及四个经验丰富的医学和牙科研究员团体，在过去的5。5年中成功合作，可以促进随访研究队列。意义在于，在初级医疗保健环境中，高携带风险儿童的识别将允许成本 - 有效的预防和/或推荐策略要在跨专业设置中开发，定位和使用，以防止从幼儿到学年的发展。这将立即对非牙科专业人员在医疗环境以及其他非 - 医疗保健环境（例如，基于学校）以及牙科医疗保健环境中的牙科专业人员。