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.

资助的家长补助金摘要：龋齿是儿童最常见的慢性疾病之一，在很大程度上是可以预防的疾病，但大约 23% 的 2-5 岁美国儿童患有龋齿，这一数字增加了一倍多，达到 56% 在当前医疗费用不断上涨和资源有限的环境下，6-8岁儿童的收入差距巨大。携带者在美国的经验和获得护理的机会，特别是在社会经济地位较低 (SES) 和少数群体呼吁更加关注有针对性的（在患者和牙齿表面水平）、基于风险的龋齿通过跨专业伙伴关系提供预防和治疗策略，包括初级保健我们的团队刚刚完成对 1,326 名 1 至 4 岁儿童的追踪，并开始进行数据分析。验证龋齿风险调查问卷，供医疗服务提供者使用，以准确识别高龋齿风险的幼儿。问题是，虽然从 2-5 岁到 6-8 岁，乳牙的龋齿数量增加了一倍多，但混合期乳牙的龋齿数量却增加了一倍多。牙列是一个在很大程度上被忽视的研究和预防领域，目前还没有针对医疗环境的经过验证的龋齿风险工具轻松帮助对 5-8 岁儿童进行分类，并且几乎没有研究跟踪儿童的生命历程进展该信息对于 1-8 岁儿童的龋齿至关重要，因为设计和瞄准有效且具有成本效益。能够适应从幼儿到学龄儿童生命历程变化的预防性疗法取决于准确的风险因素和牙齿表面评估因此，这项创新的持续更新研究的目标是： 1) 开发实用且易于评分的龋齿风险工具，用于初级医疗保健机构，以识别高龋齿风险儿童龋齿风险，从幼儿 (1-4) 扩展到学龄期 (5-8)，以及 2) 确定关系；混合牙列中的龋齿风险概况和龋齿疾病模式（例如，咬合面与近端面）之间的关系。这是通过跟踪我们正在进行的 U01 登记组中的 876 组主要看护者 (PCG)-儿童组来完成的。队列代表多元化人群，包括少数族裔/种族和社会经济地位低的群体。PCG 将完成一个调查。龋齿风险问卷，孩子将在基线时进行龋齿检查（孩子年龄6.5岁+3个月），并在基线后 18 个月（儿童年龄 8 岁 + 3 个月）和 36 个月（儿童年龄 9.5 岁 + 3 个月）再次进行监测龋病的纵向风险数据和龋病患病率/发病率和牙齿。从 1-4 岁（正在进行的 U01）和 5-8 岁（建议继续更新）收集的表面图案信息将用于评估 5-8 岁儿童的龋齿风险该提案的一大优势在于它涉及四位经验丰富的医疗和专家。牙科调查员小组在过去 5.5 年中成功合作，可以促进后续工作研究队列的意义在于，在初级医疗机构中识别高龋齿风险儿童将有助于降低成本。预防在跨专业环境中制定、有针对性和使用的有效和/或转介策略，以预防这将对从幼儿到学龄期的职业发展产生直接广泛的影响和影响。由非牙科专业人员在医疗环境和其他非牙科环境中实施的现有和/或新政策和计划医疗机构（例如学校）以及牙科医疗机构中的牙科专业人员。