: This study seeks to identify the relationships between lead levels, intake of dietary fats and sugars, and dental caries experience in disadvantaged African-American children, and to identify how these variables in the parent/caregiver relate to the child?s oral health status. The purpose is to identify areas for successful intervention toward reducing the disparities between those with the poorest oral health and their better-off peers. The population to be studied is children ages 0-5, and their primary caregivers, in the poorest 39 census tracts in Detroit. To be eligible, children must be equal or lower than 250 percentof the federal poverty line. Children and caregivers will be followed-up for 4 years. There will be 3 cycles of data collection over that time, in years 2, 4, and 6, so that for each family there are 2 years between data collection points. For adequate statistical power, the intent is to have the final data collection cycle include 833 children. Sampling, conducted by the Methodological Core (MC) for the center, has the study beginning with 994 adult caregivers for interview and 1,089 children for examination (two age-eligible children per family can be accepted). Each caregiver will complete a food frequency questionnaire (FF9) at home for him/herself and for the child(ren). The completed FFQs will be brought to the clinical examination, at which time an interviewer will review the FFQs with the caregiver. At this same appointment, both caregiver and child(ren) will receive a dental examination, and an FFQ for the child will be completed by interview. The adult caregiver will be asked for a finger stick blood sample and a saliva aboutample (for lead assay); saliva samples will be sought from the children only at the exams in years 4 and 6. Participants will also be measured for height and weight at the first and later examinations. Data from these interviews, exams, and assays of the samples will be managed by the MC. For testing the hypotheses, the outcomes will be severe dental caries experience in the child, and exposures will be lead levels in child, and sugars and fats in the diets of child and caregiver. Other variables, such as the demographic information collected in other center studies and body mass index of the caregiver and child, will be included in the multivariate analyses to determine relative risk. Nested case-control studies, with several measures of caries as the outcomes, will also be conducted. The significance of this study will be that it will identify areas for intervention and produce a unique database from an African-American population. The child?s FFQ, to be developed for this study, will also be a valuable tool for other studies of child obesity and nutrition.
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