Low-income children, particularly Mexican-Americans, are especially at high risk for early childhood caries (ECC). While caries prevalence in other age groups has been declining in past decades, it is increasing among preschool-aged children. Our research team already demonstrated fluoride varnish (FV) efficacy in preventing ECC. This proposal continues our effort with our community partners to seek effective interventions. Resin-based dental sealants have been under-utilized in preschool children because of application difficulty. New materials, such as the refined fluoride-releasing, self-bonding glass ionomer (Gl) sealant, decrease the need for meticulous tooth-surface drying during application and provide an advantage for treating young children. The goal of this project is to conduct a community-based randomized clinical trial (RCT) to determine the relative efficacy of different combinations of Gl sealants on occlusal surfaces of primary molars, FV on all teeth, and parental counseling/anticipatory guidance (C) in reducing the caries incidence/increment in 3-6-year-old children. A 2x2 factorial design RCT, stratified by study site (one dental and one non-dental), will be conducted among initially 3-year-old children. Those eligible will be randomized to four groups (C, C+FV, C+GI, C+FV+GI) and followed for 3 years. The RCT will take place at two sites serving primarily Hispanic low-income populations in Southern California: the dental facility of the San Ysidro Health Center located near the U.S.-Mexican Border and the location of our current ECC prevention RCT for 0-3 year olds and a new partnership with La Maestra Health Center, in a non-dental setting near their dental clinic. Both sites are affiliated with WIC and Head Start.
Other aims are (1) to identify child, family and community-level factors affecting caries incidence/increment;(2) to assess parental acceptance of interventions, retention in the study as well as compliance with multiple treatment visits in the RCT;and (3) to compare oral-healthcare settings/delivery systems and to assess differences as they relate to intervention outcomes. Information about the non-dental setting will inform future dissemination approaches. The proposed research will continue to establish the scientific evidence base for interventions to prevent ECC among underserved communities where oral health disparities still prevail.
|Garcia, Raul I; Tiwari, Tamanna; Ramos-Gomez, Francisco et al. (2017) Retention strategies for health disparities preventive trials: findings from the Early Childhood Caries Collaborating Centers. J Public Health Dent 77:63-77|
|Barker, Judith C; Guerra, Claudia; Gonzalez-Vargas, M Judy et al. (2017) An ethnographic study of salt use and humoral concepts in a Latino farm worker community in California's Central Valley. J Ethnobiol Ethnomed 13:11|
|Garcia, Raul I; Gregorich, Steven E; Ramos-Gomez, Francisco et al. (2017) Absence of Fluoride Varnish-Related Adverse Events in Caries Prevention Trials in Young Children, United States. Prev Chronic Dis 14:E17|
|Heaton, Brenda; Crawford, Andrew; Garcia, Raul I et al. (2017) Oral health beliefs, knowledge, and behaviors in Northern California American Indian and Alaska Native mothers regarding early childhood caries. J Public Health Dent 77:350-359|
|Albino, Judith; Tiwari, Tamanna; Gansky, Stuart A et al. (2017) The basic research factors questionnaire for studying early childhood caries. BMC Oral Health 17:83|
|Wilson, Anne R; Mulvahill, Matthew J; Tiwari, Tamanna (2017) The Impact of Maternal Self-Efficacy and Oral Health Beliefs on Early Childhood Caries in Latino Children. Front Public Health 5:228|
|Dooley, Diane; Moultrie, Nicolette M; Heckman, Barbara et al. (2016) Oral Health Prevention and Toddler Well-Child Care: Routine Integration in a Safety Net System. Pediatrics 137:|
|Cheng, Jing; Cheng, Nancy F; Guo, Zijian et al. (2016) Mediation analysis for count and zero-inflated count data. Stat Methods Med Res :962280216686131|
|Braun, P A; Quissell, D O; Henderson, W G et al. (2016) A Cluster-Randomized, Community-Based, Tribally Delivered Oral Health Promotion Trial in Navajo Head Start Children. J Dent Res 95:1237-44|
|Hoeft, K S; Barker, J C; Shiboski, S et al. (2016) Effectiveness evaluation of Contra Caries Oral Health Education Program for improving Spanish-speaking parents' preventive oral health knowledge and behaviors for their young children. Community Dent Oral Epidemiol 44:564-576|
Showing the most recent 10 out of 43 publications