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： 青少年蛀牙及其并发症会降低生活质量并可能导致丧失能力 学生时代、急诊室就诊，甚至在极端情况下，牙科密封剂都会导致死亡。 有效干预措施可减少蛀牙，但青少年中封闭剂的流行 仍然较低，并且因社会人口特征而存在差异，而第二磨牙则存在差异。 很少会在中学之前爆发到需要接受密封剂的程度，大多数 校本密封剂计划 (SBSP) — 一项有效的公共卫生举措，通常旨在 低收入学校——仅为小学提供服务，因此主要限制了其覆盖范围 第二磨牙缺乏 SBSP 代表了一个关键差距。 对青少年实施有效的口腔健康干预措施，效果也很好 本研究的目的是调查减少差异的效果。 第二磨牙密封剂对龋齿的影响，美国中学密封剂计划的覆盖范围，以及 通过 SBSP 增加第二磨牙封闭剂的使用对口腔健康及相关的影响 青少年之间的差距。 第一个目标是确定第二磨牙封闭剂的流行率以及由此产生的结果 对不同种族/族裔和收入群体青少年龋齿的影响。 多变量回归模型将用于检查接受第二磨牙的概率 密封剂以及在存在/不存在密封剂的情况下经历龋齿。 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 项目主管、SBSP 协调员和提供者将分析这些数据以了解情况。 青少年 SBSP 的可用性和覆盖范围，包括中学项目的数量， 它们的规模、项目特点、资助机制、成本和学生参与率。 第三个目标是评估增加 SBSP 对青少年的影响 来自目标 1、目标 2 和文献的估计和数据将建立一个模拟模型。 模拟各种 SBSP 特性并测量密封剂数量的影响， 避免衰退，以及按种族/族裔和收入水平避免恢复的成本节约。 这项研究将填补有关 SBSP 信息的关键空白，并提供更清晰的信息 了解第二磨牙封闭剂和相关龋齿的经验 调查结果将提供有关种族/民族和收入水平的全面信息。 它将对该国中学密封剂计划的状况进行可靠的估计。 扩大 SBSP 覆盖范围至更多青少年的潜在影响及其对 该 R21 将导致后续的 R01 项目以支持增加。 实施针对青少年的 SBSP，确定提高这些计划效率的方法 计划并减少口腔健康差异。