Validation of chair-side biochemical screening instruments for dental caries

椅旁龋齿生化筛查仪器的验证

• 批准号: 8189157
• 负责人: EVANGELIA MOROU-BERMUDEZ
• 金额: $ 26.25万
• 依托单位: UNIVERSITY OF PUERTO RICO MED SCIENCES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-08 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8189157
• 关键词: Acids; Address; Adopted; Adult; Affect; Age; Alkalies; Area; Behavioral; Biochemical; Biological; Biological Process; Biology; Caries prevention; Child; Child Support; Clinical; Clinical Research; Communities; Cross-Sectional Studies; Data; Dental; Dental General Practice; Dental Plaque; Dental Technology; Dental caries; Dentists; Detection; Development; Disease; Effectiveness; Figs - dietary; Foundations; Future; Generations; Goals; Gold; Health; Health Professional; Individual; Infant; Intervention; Knowledge; Lesion; Measures; Methodology; Methods; Modeling; Onset of illness; Patients; Population; Population Study; Prevalence; Preventive; Problem Solving; Procedures; Production; Prospective Studies; Public Health; Quality of life; Regression Analysis; Research; Research Design; Risk; Risk Assessment; Risk Factors; Saliva; Salivary; Sampling; School Nursing; Screening procedure; Side; Source; Streptococcus mutans; Sugar Acids; Test Result; Testing; United States; Urea; Validation; Validity and Reliability; Visual; Work; age group; base; community intervention; cost; early childhood; ethnic minority population; experience; health disparity; high risk; innovation; instrument; low socioeconomic status; meetings; novel; novel strategies; pediatrician; post intervention; psychosocial; research study; socioeconomics; success; tool

DESCRIPTION (provided by applicant): The need to develop an accurate chair-side screening instrument for caries activity and caries risk has been long recognized and extensive research work has been done in this area without much success. Our study takes a new approach in solving this problem. This approach is founded on a novel model, the Caries Risk Pyramid (CRP), which summarizes the available knowledge regarding the biology of dental caries. HYPOTHESIS: Based on the CRP model, we hypothesize that measuring the ability of dental plaque and/or saliva to generate alkali from urea, or other salivary substrates, together with the ability to generate acid from sugars, can provide an accurate estimation of an individual's caries status and possibly future caries risk because they summarize the combined effect of other caries risk factors. OBJECTIVE: In order to test this hypothesis we have developed an array of novel, chair-side tests for measuring acid and alkali generation in plaque and in saliva. The objective of this study is to assess the reliability and validity of these tests as screening tools for dental caries and to explore possible ways of combining the results of these tests in order to accurately identify individuals with caries. To accomplish this objective, a cross-sectional study on 200 adult subjects is proposed. SIGNIFICANCE: The proposed tests are novel because they consider the ability to generate alkali in plaque as a potential caries risk factor, which has not been previously included in existing multivariate risk assessment models. They are of low cost and give faster results compared to available biological caries risk tests. They do not require dental expertise, which makes them suitable for use by non-dental professionals. Once the tests have been validated in adults, our ultimate goal is to validate them in children and infants as screening tools for Early Childhood Caries (ECC), and ultimately as a predictor of future caries risk, either independently, or in combination with other caries risk factors. Another important potential application for the proposed tests would be the comparison of pre- to post- intervention risk in clinical dental practice, in research, and in community interventions. PUBLIC HEALTH RELEVANCE: Dental caries affects more than 50% of the children (ages 5 to 9 years) and 84% of the adults in the USA and it has a significant impact on the health, quality of life, and on the economy. The prevalence of dental caries is higher in certain ethnic minority populations and in individuals of low socioeconomic status and for that reason the disease is considered as an important health disparity. Interestingly, while the prevalence of dental caries has been declining slowly over the past thirty years in the United States, this decline has not been observed in the youngest age groups, those of 2 to 5 years. These facts demonstrate that the generalized measures currently available for caries prevention and management are not effective for all individuals and that there is a need to identify and address novel risk factors in high-risk populations. The proposed study is significant because it addresses this important issue. The objective of the study is to validate a new method for identifying individuals who have dental caries, or who are at risk to develop caries in the near future. This method consists of an array of simple tests that can be performed chair-side. The innovation of the method is that these tests measure risk factors that have not been previously considered in the existing caries risk assessment models. The advantages of the proposed tests are low cost and much faster results compared to available caries risk tests. More importantly, they do not require any dental expertise, which makes them suitable for use by non-dental professionals. Once the tests have been validated in adults, our ultimate goal is to validate them in children and infants as screening tools for Early Childhood Caries (ECC), and ultimately as a predictor of future caries risk, either independently, or in combination with other caries risk factors. They could be used by pediatricians and school nurses to identify infants and small children at an immediate risk to develop ECC, as well as by lay public and health professionals to identify high caries risk individuals and refer them to dentists for appropriate treatment. In addition, the proposed tests could be used for evaluating the effectiveness of preventive and clinical interventions in private dental practice, in research, and in community interventions, by comparing caries risk before and after the interventions.

描述（由申请人提供）：长期以来，已经认识到，在这一领域已经做出了长期以来的认可，并且在这一领域已经完成了广泛的研究工作，但没有取得太大的成功。我们的研究采用了一种解决这个问题的新方法。这种方法建立在一种新型模型，龋齿风险金字塔（CRP）上，该模型总结了有关龋齿生物学的可用知识。假设：基于CRP模型，我们假设测量牙菌斑和/或唾液从尿素或其他唾液底物产生碱的能力，以及从糖中产生酸的能力，可以提供对个体的人的准确估计。龋齿状态以及可能未来的龋齿风险，因为它们总结了其他龋齿风险因素的综合作用。目的：为了检验这一假设，我们开发了一系列新颖的椅子测试，用于测量斑块和唾液中的酸和碱产生。这项研究的目的是评估这些测试的可靠性和有效性，作为龋齿的筛选工具，并探索将这些测试结果结合起来的可能方法，以便准确地识别出患有龋齿的人。为了实现这一目标，提出了针对200名成人受试者的横断面研究。意义：拟议的测试是新颖的，因为它们认为在斑块中产生碱的能力是潜在的龋齿风险因素，这尚未包含在现有的多元风险评估模型中。与可用的生物龋齿风险测试相比，它们的成本低廉，并提供更快的结果。他们不需要牙科专业知识，这使得它们适合非牙科专业人员使用。一旦在成年人中进行了测试，我们的最终目标是在儿童和婴儿中验证他们作为幼儿龋齿（ECC）的筛查工具（ECC），并最终作为对未来龋齿风险的预测指标，无论是独立的还是与其他龋齿结合在一起的。风险因素。拟议测试的另一个重要应用是将临床牙科实践，研究和社区干预中的干预后风险进行比较。 公共卫生相关性：龋齿影响了50％以上的儿童（5至9岁）和84％的美国成年人，这对健康，生活质量和经济产生了重大影响。在某些少数民族人群和社会经济地位低下的个体中，龋齿的流行率更高，因此该疾病被认为是重要的健康差异。有趣的是，尽管在美国过去的三十年中，龋齿的患病率一直在缓慢下降，但在最年轻的年龄段（2至5年的年龄段）中尚未观察到这种下降。这些事实表明，当前可用于预防龋齿和管理的广义措施对所有个人都无效，并且有必要识别和解决高风险人群中新型风险因素。 拟议的研究很重要，因为它解决了这一重要问题。该研究的目的是验证一种新方法，以识别有龋齿的人或在不久的将来有龋齿的风险。该方法由一系列可以执行椅子侧的简单测试组成。该方法的创新是，这些测试测量了现有的Caries风险评估模型中先前未考虑的风险因素。与可用的龋齿风险测试相比，提议的测试的优点是低成本和更快的结果。更重要的是，它们不需要任何牙科专业知识，这使其适合非牙科专业人员使用。 一旦在成年人中进行了测试，我们的最终目标是在儿童和婴儿中验证他们作为幼儿龋齿（ECC）的筛查工具（ECC），并最终作为对未来龋齿风险的预测指标，无论是独立的还是与其他龋齿结合在一起的。风险因素。儿科医生和学校护士可以使用它们来识别有远处发展ECC的婴儿和小孩，以及外行公共和卫生专业人员，以识别高龋齿风险，并将其转介给牙医接受适当的治疗。此外，建议的测试可用于评估私人牙科实践，研究和社区干预措施中预防和临床干预措施的有效性，并在干预措施前后比较龋齿风险。