Dental caries is an infectious and transmissible disease that is multifactorial &complex, however, the mutans streptococci (MS) are consistently implicated in the etiology. Therefore, studies on the natural history of dental caries as it relates to MS infection/colonization in children are critical to understanding this disease. The overall goal of our project is to perform a longitudinal study of a disparate population of children, i.e., index children, for MS acquisition;characterize dental caries within this high risk population;and identify critical immunological relationships in order to further our understanding of dental caries etiology and prevention. In the previous funding period, two cohorts defined by age, i.e., 5-6 year and 6- 18 month olds, have been longitudinally followed for colonization of newly erupting teeth as this relates to factors critical in caries development. We have identified a finite number of MS strains (Streptococcus mutans) in this high risk population, which can now be followed over time from initial colonization of the oral cavity and specific teeth to the development of caries. We have demonstrated that individuals in this population have a """"""""primary"""""""" strain (genotype) that remains relatively stable with time. This strain specific stability allows for epidemiological evaluation of infection/colonization with factors such as caries incidence and prevalence, salivary immunity, diet, and other behavioral risk factors. We have also documented information from the children's household family members to evaluate MS genetic diversity, dental caries and behavioral risk factors associated with the index children and will continue this work. In the present application, we propose to connect the two cohorts in age and extend beyond the original age ranges to another important dental developmental milestone (i.e., adolescents, and emergence of permanent 2nd molar teeth) by continuing to follow these children and add an additional older cohort. This proposal will, therefore, continue and build on the important information gained in the first five years and incorporate what has been learned to improve the efficiency of data collection and processing. We have found that repetitive extragenic palindromic-PCR (rep- PCR), and the development of a data entry system vastly improves our ability to carry out the studies thus far. These innovations developed in the current funding period will extend the efficiency and usefulness of data collection and analysis as we continue in this proposed renewal. An interdisciplinary team of dentists, basic scientists, epidemiologists and statisticians that has been involved in this study will improve our understanding of the host-parasite relationship of dental caries in children. The results of these studies will provide key information for the development of strategies to help prevent this infectious disease. The continuation of studies in Uniontown, Alabama, which is located in the """"""""Black Belt"""""""", will improve oral health in this underserved population. The established community links in this underserved population will be critical for the continuation of this study as well as our understanding of gaps in dental health care in this high risk population.

Public Health Relevance

This project will provide critical knowledge of the epidemiology of dental caries in a high-risk population, which resulting in valuable data useful in the design of future preventive therapeutics in dentistry. Additionally, the proposed studies conducted in Uniontown, Alabama, also referred to as the Black Belt, will provide much needed oral health education and some preventive oral care to children and their household family members improving oral health in this underserved/disparate population. The information obtained in this project will contribute significantly to the achievement of goals outlined for oral health in the NIH report, Healthy People 2010 ( as we look forward to the goals for 2020.

National Institute of Health (NIH)
National Institute of Dental & Craniofacial Research (NIDCR)
Research Project (R01)
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Application #
Study Section
Oral, Dental and Craniofacial Sciences Study Section (ODCS)
Program Officer
Atkinson, Jane C
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Project End
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Budget End
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University of Alabama Birmingham
Schools of Dentistry
United States
Zip Code
Momeni, Stephanie S; Whiddon, Jennifer; Moser, Stephen A et al. (2018) Transmission patterns of Streptococcus mutans demonstrated by a combined rep-PCR and MLST approach. Clin Oral Investig 22:2847-2858
Ghazal, Tariq S; Levy, Steven M; Childers, Noel K et al. (2018) Survival analysis of caries incidence in African-American school-aged children. J Public Health Dent :
Ghazal, Tariq S; Levy, Steven M; Childers, Noel K et al. (2018) Mutans Streptococci and Dental Caries: A New Statistical Modeling Approach. Caries Res 52:246-252
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Childers, Noel K; Grenett, Hernan; Morrow, Casey et al. (2017) Potential Risk for Localized Aggressive Periodontitis in African American Preadolescent Children. Pediatr Dent 39:294-298
Momeni, Stephanie S; Whiddon, Jennifer; Cheon, Kyounga et al. (2016) Genetic Diversity and Evidence for Transmission of Streptococcus mutans by DiversiLab rep-PCR. J Microbiol Methods 128:108-117
Ghazal, Tariq S; Levy, Steven M; Childers, Noel K et al. (2016) Dental Caries in High-risk, School-age African American Children in Alabama: A Six-year Prospective. Pediatr Dent 38:224-30
Momeni, Stephanie S; Whiddon, Jennifer; Cheon, Kyounga et al. (2015) Assessment of two multilocus sequence typing (MLST) schemes available for Streptococcus mutans. Arch Oral Biol 60:1769-76
Ghazal, Tariq; Levy, Steven M; Childers, Noel K et al. (2015) Factors associated with early childhood caries incidence among high caries-risk children. Community Dent Oral Epidemiol 43:366-74
Momeni, Stephanie S; Whiddon, Jennifer; Cheon, Kyounga et al. (2015) Assessment of clonality and serotypes of Streptococcus mutans among children by multilocus sequence typing. Eur J Oral Sci 123:416-24

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