Reducing dental caries and oral health disparities among adolescents: The impact of increasing 2nd molar sealants through school-based sealant programs

减少青少年的龋齿和口腔健康差异：通过学校封闭剂计划增加第二磨牙封闭剂的影响

• 批准号: 10706531
• 负责人: Shillpa Naavaal
• 金额: $ 18.17万
• 依托单位: KENNESAW STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-21 至 2024-09-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10706531
• 关键词: Address; Adolescent; Adoption; Age; Cessation of life; Characteristics; Child; Consolidated Framework for Implementation Research; Cost Savings; Country; Data; Dental; Dental caries; Disparity; Education; Emergency department visit; Ethnic Origin; Foundations; Funding Mechanisms; Future; Goals; Health Services; Hour; Income; Infection; Intervention; Knowledge; Learning; Literature; Low income; Measures; Methods; Modeling; National Health and Nutrition Examination Survey; Oral health; Pain; Pathway interactions; Persons; Pit and Fissure Sealants; Predisposition; Prevalence; Preventive; Probability; Program Efficiency; Provider; Public Health; Publishing; Quality of life; Race; Recommendation; Research; Research Methodology; Role; Schools; Students; Surveys; Techniques; Territoriality; adolescent health; age group; cost; cost efficient; demographics; disparity reduction; economic disparity; effective intervention; eighth grade; elementary school; experience; health disparity; high risk; improved; junior high school; models and simulation; programs; racial disparity; restoration; sealant; second grade; seventh grade; sixth grade; sociodemographic disparity; socioeconomics; student participation; uptake

Project Summary/Abstract: Adolescent dental decay and its complications diminish quality of life and can lead to lost school days, emergency room visits, and in extreme cases even death. Dental sealants are an effective intervention to reduce dental decay, but sealant prevalence among adolescents remains low and has disparities by sociodemographic characteristics. While 2nd molars are seldom erupted enough to receive sealant application prior to middle school, the majority of school-based sealant programs (SBSP) — an efficient public health initiative typically aimed at low-income schools — serve elementary schools only, and thus predominantly limit their reach to 1st molars. This lack of adoption of SBSPs for 2nd molars represents a critical gap in implementation of an effective oral health intervention for adolescents that is also well documented to reduce disparities. The objective of this research is to investigate the effect of 2nd molar sealants on dental caries, the reach of middle school sealant programs in the US, and the impact of increasing access to 2nd molar sealants through SBSPs on oral health and related disparities among adolescents. The first aim is to determine the prevalence of 2nd molar sealants and the resulting impact on dental caries in adolescents among various racial/ethnic and income groups. Multivariable regression models will be used to examine the probabilities of receiving 2nd molar sealants and of experiencing dental caries in the presence/absence of sealants. The second aim is to gather data on middle school sealant programs in the US by surveying state oral health program directors, SBSP coordinators, and providers. This data will be analyzed to understand availability and reach of SBSPs to adolescents including number of middle school programs, their size, program characteristics, funding mechanisms, costs and student participation rates. The third aim is to estimate the impact of increasing availability of SBSPs to adolescents using estimates and data from Aim 1, Aim 2, and the literature. A simulation model will be built to model various SBSP characteristics and to measure resulting impact in number of sealants, averted decay, and cost-savings of averted restoration by race/ethnicity and income level. This research will fill a critical gap in information on SBSPs and provide clearer understanding of the sealant and related dental caries experience for 2nd molars by race/ethnicity and income level. The findings will furnish comprehensive information about the status of middle school sealant programs in the country. It will produce reliable estimates of the potential impact of increasing the reach of SBSPs to more adolescents and its contribution to reducing disparities. This R21 will lead to a subsequent R01 project to support increased implementation of SBSPs for adolescents, identify ways to improve the efficiency of these programs and reduce oral health disparities.

项目摘要/摘要： 青春期牙齿衰减及其并发症的并发症会降低生活质量，并可能导致失去 上学日，急诊就诊，甚至在极端情况下死亡。牙科密封剂是 有效的干预措施减少牙齿衰减，但青少年的密封剂患病率 保持较低，并且由于社会人口统计学特征而存在差异。而第二磨牙是 大多数 基于学校的密封剂计划（SBSP） - 有效的公共卫生计划通常针对 低收入学校 - 仅服务小学，因此主要限制了他们的影响力 到第一磨牙。缺乏对第二磨牙的SBSP的采用代表了一个关键的差距 为青少年实施有效的口腔健康干预措施 记录以减少分布。这项研究的目的是研究 龋齿上的第二磨牙密封剂，美国中学密封剂的覆盖范围以及 通过SBSP增加获得第二摩尔密封剂对口腔健康和相关的影响 青少年之间的差异。 第一个目的是确定第二摩尔密封剂的患病率和结果 对各种种族/种族和收入群体中青少年牙科车的影响。 多变量回归模型将用于检查接收第二磨牙的可能性 在存在/不存在密封剂的情况下，密封剂和经验牙科车。第二个 目的是通过调查州口腔健康来收集美国中学密封剂计划的数据 计划主管，SBSP协调员和提供商。这些数据将进行分析以了解 SBSP的可用性和覆盖范围，包括中学计划的数量， 它们的规模，计划特征，资金机制，成本和学生参与率。 第三个目的是估计使用SBSP可用性增加对青少年的影响 AIM 1，AIM 2和文献的估计和数据。将建立模拟模型 建模各种SBSP特征，并测量密封剂数量的影响， 避免衰减，并根据种族/种族和收入水平避免恢复成本。 这项研究将填补有关SBSP的信息的关键空白，并提供更清晰的信息 了解密封胶和相关的龋齿体验第二磨牙的牙齿体验 种族/种族和收入水平。这些发现将提供有关 该国中学密封剂计划的状况。它将产生可靠的估计值 将SBSP覆盖到更多青少年的潜在影响及其对 减少分布。该R21将导致随后的R01项目，以支持增加 为青少年实施SBSP，确定提高这些效率的方法 计划并减少口腔健康差异。