IADR Abstract Archives
Dental Caries Outcomes in the ZOE 2.0 Study
Objectives: Population estimates of dental caries experience among preschool-age children are scant mainly due to the difficulty accessing them in non-clinical settings. Here, we report dental caries findings of a large-scale, community-based, epidemiologic study of early childhood oral health (ZOE 2.0) in North Carolina.
Methods: Between August 2016 and February 2019, we enrolled 8,059 children ages 3-5 (mean age=53 months) attending 244 public preschool (i.e., Head Start) centers. Consenting parents/guardians completed a demographic and oral health risk factor questionnaire and enrolled children were offered a school-based clinical research examination. Clinical examinations were conducted by 10 trained and calibrated examiners using ICDAS criteria. Beyond the consensus definition (i.e., AAPD and Bangkok declaration) of ECC, for the purposes of our study we defined dental caries “cases” at the ICDAS>2 threshold. We obtained measures of prevalence and severity (i.e., dmfs index) of dental caries and examined their distribution according to key demographic characteristics (e.g., age, race/ethnicity and parental education) using bivariate tests, accounting for study design characteristics.
Results: Clinical examinations yielding usable information were completed for 79% of all those enrolled (n=6,404). ECC prevalence according to the consensus and our ICDAS>2 definition of disease was 92% (95% CI=91%-93%) and 54% (95% CI=52%-56%), respectively. Corresponding mean dmfs indices for these two definitions were 16 (95% CI=16-17) and 15 (95% CI=14-16). Three-quarters of the total caries experience (74% of dmfs) was attributed to restored disease. Hispanic (61%) and Native American/Asian (59%) participants had a higher ECC prevalence than their African American and non-Hispanic white counterparts (both 52%; P<0.0005). Parental education was strongly and monotonically associated with decreased caries prevalence (P<0.0005).
Conclusions: In this community-based sample of preschool age children from a low socio-economic background we found high levels of disease experience. Parental education appears to be a major determinant of caries experience in this population.
Methods: Between August 2016 and February 2019, we enrolled 8,059 children ages 3-5 (mean age=53 months) attending 244 public preschool (i.e., Head Start) centers. Consenting parents/guardians completed a demographic and oral health risk factor questionnaire and enrolled children were offered a school-based clinical research examination. Clinical examinations were conducted by 10 trained and calibrated examiners using ICDAS criteria. Beyond the consensus definition (i.e., AAPD and Bangkok declaration) of ECC, for the purposes of our study we defined dental caries “cases” at the ICDAS>2 threshold. We obtained measures of prevalence and severity (i.e., dmfs index) of dental caries and examined their distribution according to key demographic characteristics (e.g., age, race/ethnicity and parental education) using bivariate tests, accounting for study design characteristics.
Results: Clinical examinations yielding usable information were completed for 79% of all those enrolled (n=6,404). ECC prevalence according to the consensus and our ICDAS>2 definition of disease was 92% (95% CI=91%-93%) and 54% (95% CI=52%-56%), respectively. Corresponding mean dmfs indices for these two definitions were 16 (95% CI=16-17) and 15 (95% CI=14-16). Three-quarters of the total caries experience (74% of dmfs) was attributed to restored disease. Hispanic (61%) and Native American/Asian (59%) participants had a higher ECC prevalence than their African American and non-Hispanic white counterparts (both 52%; P<0.0005). Parental education was strongly and monotonically associated with decreased caries prevalence (P<0.0005).
Conclusions: In this community-based sample of preschool age children from a low socio-economic background we found high levels of disease experience. Parental education appears to be a major determinant of caries experience in this population.