The yearly costs of treating dental caries in children is enormous. In contrast to the time period prior to the 1960's, caries activity is now found primarily in a specific segment of this population. Obstacles in understanding this disease process making progress toward its eradication are (1) the poor understanding of the relative contribution of certain psycho-social and biological factors in the caries process and (2) the lack of a method to predict with high sensitivity and specificity individuals who are at high risk for caries. Previous caries prediction studies using single biological variables, evaluating caries activity as mean """"""""dmf"""""""", and using coefficient of determination to measure the strength of association, have shown little success in correlating caries incidence to specific variables, or assessing caries risk in specific populations. Recent research by ourselves and others have shown improved results by using a combination of discriminators, by examining variables as """"""""positive"""""""" or """"""""negative"""""""", and by limiting the focus to well defined populations (i.e., children under age 6). The major objectives of this proposal are to (1) identify the factors associated with high caries risk in 500 low income children over a 3 year period, (2) develop a model that can reliably predict individuals at high/low risk to develop caries. Predictor variables to be examined will include biological parameters such as S. mutans infection levels, diet, exposure to fluoridated dentifrice and optimally fluoridated water, and frequency of antibiotic usage. Sociodemographic and psychological variables collected will include family income, marital status, parents' oral health status, locus of control, self-efficacy, level of psychosocial stress, and knowledge of dental prevention. After the caries risk factors are identified and the risk assessment model is developed, we will utilize a decision analytic framework and cost-effectiveness analysis to estimate costs and outcomes of various preventive strategies with and without the screening instrument. A precise screening instrument will allow significant improvement in the identification of low income and minority children at high risk for developing dental caries. Dental prevention programs targeted to the caries risk factors in high risk children could then reduce costs greatly.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
5R01DE009217-03
Application #
3223027
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1990-09-30
Project End
1994-09-29
Budget Start
1992-09-30
Budget End
1993-09-29
Support Year
3
Fiscal Year
1992
Total Cost
Indirect Cost
Name
University of Connecticut
Department
Type
Schools of Dentistry
DUNS #
City
Farmington
State
CT
Country
United States
Zip Code
06030
O'Sullivan, D M; Tinanoff, N (1996) The association of early dental caries patterns with caries incidence in preschool children. J Public Health Dent 56:81-3
O'Sullivan, D M; Thibodeau, E A (1996) Caries experience and mutans streptococci as indicators of caries incidence. Pediatr Dent 18:371-4
Tinanoff, N (1995) Critique of evolving methods for caries risk assessment. J Dent Educ 59:980-5
Litt, M D; Reisine, S; Tinanoff, N (1995) Multidimensional causal model of dental caries development in low-income preschool children. Public Health Rep 110:607-17
Thibodeau, E A; O'Sullivan, D M (1995) Salivary mutans streptococci and incidence of caries in preschool children. Caries Res 29:148-53
Tinanoff, N (1995) Dental caries risk assessment and prevention. Dent Clin North Am 39:709-19
Douglass, J M; Yi, W; Xue, Z B et al. (1994) Dental caries in preschool Beijing and Connecticut children as described by a new caries analysis system. Community Dent Oral Epidemiol 22:94-9
Reisine, S; Litt, M; Tinanoff, N (1994) A biopsychosocial model to predict caries in preschool children. Pediatr Dent 16:413-8
O'Sullivan, D M; Tinanoff, N (1993) Social and biological factors contributing to caries of the maxillary anterior teeth. Pediatr Dent 15:41-4
O'Sullivan, D M; Tinanoff, N (1993) Maxillary anterior caries associated with increased caries risk in other primary teeth. J Dent Res 72:1577-80