Most adults in the US are affected by tooth loss due to periodontal disease or dental caries. Prevention of tooth loss is achieved through professional dental treatment and personal oral health self-care by maintaining the natural dentition in a state of comfort and function. In order to develop appropriate dental treatment planning, dental health care professionals must understand the most effective biological, socio-demographic, behavioral and other medical factors that can affect tooth loss as determined by periodontal disease or dental caries status. Currently, however, there is no consensus concerning the most important factors that may influence dental disease, nor the optimal statistical methods for identifying these factors. There is a need for variable selection methods in robust statistical models for periodontal disease and dental caries outcomes that accommodate the clustered nature of these data (i.e. multiple outcomes from each subject). Goals: The proposed study will develop fixed effects (covariates) and random effects selection techniques for multivariate dental data with robust modeling of the latent random effects induced by clustering and will apply these methods to available databases recording dental health status to advance knowledge about factors associated with tooth loss. Subjects: The statistical methods will be evaluated on a dataset of 300 dentate subjects who were enrolled in the Gullah African-American (AA) Diabetics Study as part of the SC COBRE for Oral Health. For generalizability, the methods will be investigated on national data collected as part of NHANES (1999- 2004). Available data and study design: Periodontal status (determined by pocket depth and clinical attachment level), caries status (determined by tooth level DMFS index), other relevant biological/medical status, smoking, behavioral (brushing and flossing), demographic (poverty status) and other parameters have been collected at the Medical University of South Carolina. The Gullah AA subjects represent an interesting population with minimal genetic admixture whose dental health status remains vastly unknown. NHANES data are publicly available. Significance: The new statistical methods will advance public health by providing dental researchers enhanced knowledge about the nature of the associations between covariates and dental health and, more broadly, by enabling researchers to better target risk assessment and prevention strategies, thereby improving health status.

Public Health Relevance

There is a lack of consensus among dental hygenists to select the most important covariables that might influence tooth loss as determined by caries and periodontal disease. Our proposed robust statistical methods will address this issue with specific applications to explore the dental health status of Gullah-speaking African- Americans, as well as national data collected as part of NHANES (1999-2004). Our methods will have a profound impact on overall public health and the long term goal is to provide dental researchers (as well as other health scientists) a better understanding about repeated and longitudinal dental (health) data so as to prevent and control disease and improve dental health.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Small Research Grants (R03)
Project #
1R03DE020114-01A1
Application #
7991211
Study Section
Special Emphasis Panel (ZDE1-VH (07))
Program Officer
Atkinson, Jane C
Project Start
2010-07-01
Project End
2012-06-30
Budget Start
2010-07-01
Budget End
2011-06-30
Support Year
1
Fiscal Year
2010
Total Cost
$155,550
Indirect Cost
Name
Medical University of South Carolina
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
183710748
City
Charleston
State
SC
Country
United States
Zip Code
29425
Cai, Bo; Bandyopadhyay, Dipankar (2017) Bayesian semiparametric variable selection with applications to periodontal data. Stat Med 36:2251-2264
Jin, Ick Hoon; Yuan, Ying; Bandyopadhyay, Dipankar (2016) A BAYESIAN HIERARCHICAL SPATIAL MODEL FOR DENTAL CARIES ASSESSMENT USING NON-GAUSSIAN MARKOV RANDOM FIELDS. Ann Appl Stat 10:884-905
Hill, E G; Slate, E H (2014) A SEMI-PARAMETRIC BAYESIAN MODEL OF INTER- AND INTRA-EXAMINER AGREEMENT FOR PERIODONTAL PROBING DEPTH. Ann Appl Stat 8:331-351
Mutsvari, Timothy; Bandyopadhyay, Dipankar; Declerck, Dominique et al. (2013) A multilevel model for spatially correlated binary data in the presence of misclassification: an application in oral health research. Stat Med 32:5241-59
Bandyopadhyay, Dipankar (2013) From Mouth-level to Tooth-level DMFS: Conceptualizing a Theoretical Framework. J Dent Oral Craniofac Epidemiol 1:3-8
Sora, Nicoleta D; Marlow, Nicole M; Bandyopadhyay, Dipankar et al. (2013) Metabolic syndrome and periodontitis in Gullah African Americans with type 2 diabetes mellitus. J Clin Periodontol 40:599-606
Cancho, Vicente G; Bandyopadhyay, Dipankar; Louzada, Francisco et al. (2013) The destructive negative binomial cure rate model with a latent activation scheme. Stat Methodol 13:48-68
Reich, Brian J; Bandyopadhyay, Dipankar; Bondell, Howard D (2013) A nonparametric spatial model for periodontal data with non-random missingness. J Am Stat Assoc 108:
Slate, Elizabeth H; Hill, Elizabeth G (2012) Discovering factors influencing examiner agreement for periodontal measures. Community Dent Oral Epidemiol 40 Suppl 1:21-7
Van Meter, Emily M; Garrett-Mayer, Elizabeth; Bandyopadhyay, Dipankar (2012) Dose-finding clinical trial design for ordinal toxicity grades using the continuation ratio model: an extension of the continual reassessment method. Clin Trials 9:303-13

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