This proposal aims to examine the impact of severe early childhood caries (S-ECC) and of a subsequent, comprehensive, dental intervention on growth. Further, we will evaluate whether delays in treatment further retard growth patterns, compared to children without early childhood caries (ECC). Early childhood Caries (ECC) is a form of rampant decay of the primary dentition that is distinguished by the specificity of tooth surfaces involved and the rapid progression of carious lesions on those surfaces that are considered, otherwise, to be at low risk to decay. Throughout this proposal, we will define children with S-ECC as children with at least three smooth surface carious lesions, including at least one pulpally involved tooth. In addition, we will focus this study on children with S-ECC who have no other chronic medical problems and who have not previously received invasive dental treatment (i.e., treatment other than diagnostic and preventive care). We will also use a group of comparison subjects for this study. Comparison subjects are defined as healthy, caries-free children who do not have S-ECC that are matched 1:1 with S-ECC children based on age (in months) and gender. Comparison subjects will be selected from the same clinical populations during the same time period to ensure comparability to S-ECC children with respect to parents' education, self-reported ethnicity, and insurance status. If we are unable to identify and recruit appropriate age-matched comparison subjects under age 3 from the dental clinics, subjects will be recruited from children who are scheduled for a well-child clinic examination at the same institutions. Finally, because treatment is often delayed due to imbalances between resources and demands in clinics providing care for these children, we will also have an opportunity to study the impact of delayed treatment in these children.
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