PREDICTING CARIES FROM BIOLOGICAL & SOCIAL VARIABLES

从生物学角度预测龋齿

基本信息

批准号：
2130474
负责人：
NORMAN TINANOFF
金额：
$ 14.1万
依托单位：
UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
依托单位国家：
美国
项目类别：
财政年份：
1990
资助国家：
美国
起止时间：
1990-09-30 至 1995-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2130474
关键词：
antibiotics bacterial disease dental caries dental disorder diagnosis dentifrices diet disease /disorder prevention /control disease /disorder proneness /risk health economics human subject longitudinal human study low socioeconomic status mathematical model nutrition related tag preschool child (1-5) preventive dentistry social psychology socioenvironment

项目摘要

The yearly costs of treating dental caries in children is enormous. In contrast to the time period prior to the 1960's, caries activity is now found primarily in a specific segment of this population. Obstacles in understanding this disease process making progress toward its eradication are (1) the poor understanding of the relative contribution of certain psycho-social and biological factors in the caries process and (2) the lack of a method to predict with high sensitivity and specificity individuals who are at high risk for caries. Previous caries prediction studies using single biological variables, evaluating caries activity as mean "dmf", and using coefficient of determination to measure the strength of association, have shown little success in correlating caries incidence to specific variables, or assessing caries risk in specific populations. Recent research by ourselves and others have shown improved results by using a combination of discriminators, by examining variables as "positive" or "negative", and by limiting the focus to well defined populations (i.e., children under age 6). The major objectives of this proposal are to (1) identify the factors associated with high caries risk in 500 low income children over a 3 year period, (2) develop a model that can reliably predict individuals at high/low risk to develop caries. Predictor variables to be examined will include biological parameters such as S. mutans infection levels, diet, exposure to fluoridated dentifrice and optimally fluoridated water, and frequency of antibiotic usage. Sociodemographic and psychological variables collected will include family income, marital status, parents' oral health status, locus of control, self-efficacy, level of psychosocial stress, and knowledge of dental prevention. After the caries risk factors are identified and the risk assessment model is developed, we will utilize a decision analytic framework and cost-effectiveness analysis to estimate costs and outcomes of various preventive strategies with and without the screening instrument. A precise screening instrument will allow significant improvement in the identification of low income and minority children at high risk for developing dental caries. Dental prevention programs targeted to the caries risk factors in high risk children could then reduce costs greatly.

每年治疗儿童龋齿的费用是巨大的。在与 1960 年代之前的时期相比，现在的龋齿活动主要发现于该人群的特定部分。障碍在了解这种疾病的过程并在根除方面取得进展 (1) 对某些因素的相对贡献缺乏了解龋齿过程中的心理社会和生物因素以及（2）缺乏一种以高灵敏度和特异性预测个体的方法患龋齿的高风险人群。先前使用单一生物变量的龋齿预测研究，将龋齿活动评估为平均值“dmf”，并使用系数衡量协会强度的决心，几乎没有表现出成功地将龋齿发生率与特定变量相关联，或评估特定人群的龋齿风险。我们自己和最近的研究其他人通过结合使用显示出更好的结果判别器，通过检查变量为“正”或“负”，并通过将重点限制在明确的人群（即年龄以下的儿童） 6). 该提案的主要目标是 (1) 确定因素与 3 年内 500 名低收入儿童的高龋齿风险相关期间，（2）开发一个模型，可以可靠地预测个体发生龋齿的高/低风险。要检查的预测变量将包括生物参数，例如变形链球菌感染水平、饮食、接触氟化牙膏和最佳氟化水，以及抗生素使用频率。社会人口学和心理变量收集的内容包括家庭收入、婚姻状况、父母的口腔健康状况状态、控制源、自我效能、社会心理压力水平，以及牙齿预防知识。识别龋齿风险因素并建立风险评估模型后开发完成后，我们将利用决策分析框架成本效益分析，以估计各种成本和结果使用和不使用筛查仪器的预防策略。精确的筛选仪器将显着改善识别高风险的低收入和少数民族儿童发展成龋齿。针对龋齿的牙科预防计划高危儿童的危险因素可以大大降低成本。