Custodio-Lumsden Christie L, Wolf Randi L, Contento Isobel R, Basch Charles E, Zybert Patricia A, Koch Pamela A, Edelstein Burton L
Section of Population Oral Health, Columbia University College of Dental Medicine, New York, NY, USA.
Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA.
J Public Health Dent. 2016 Mar;76(2):136-42. doi: 10.1111/jphd.12122. Epub 2015 Oct 6.
There is a recognized need for valid risk assessment tools for use by both dental and nondental personnel to identify young children at risk for, or with, precavitated stages of early childhood caries (i.e., early stage decalcifications or white spot lesions).The aim of this study is to establish concurrent criterion validity of "MySmileBuddy" (MSB), a novel technology-assisted ECC risk assessment and behavioral intervention tool against four measures of ECC activity: semi-quantitative assays of salivary mutans streptococci levels, visible quantity of dental plaque, visual evidence of enamel decalcifications, and cavitation status (none, ECC, severe ECC).
One hundred eight children 2-6 years of age presenting to a pediatric dental clinic were recruited from a predominantly Spanish-speaking, low-income, urban population. All children received a comprehensive oral examination and saliva culture for assessment of ECC indicators. Their caregivers completed the iPad-based MSB assessment in its entirety (15-20 minutes). MSB calculated both diet and comprehensive ECC risk scores. Associations between all variables were determined using ordinal logistic regression.
MSB diet risk scores were significantly positively associated with salivary mutans (P < 0.05), and approached significance with visible plaque levels (P < 0.1). MSB comprehensive risk scores were significantly associated with both oral mutans and visible plaque (P < 0.05). Neither was associated with visually evident decalcifications or cavitations.
Findings suggest that MSB may have clinical utility as a valid risk assessment tool for identifying children with early precursors of cavitations but does not add value in identifying children with extant lesions.
牙科和非牙科人员都需要有效的风险评估工具,以识别有患幼儿早期龋齿前期风险(即早期脱矿或白斑病变)或已患有该疾病的幼儿。本研究的目的是建立“MySmileBuddy”(MSB)的同时效度,MSB是一种新型的技术辅助幼儿早期龋齿风险评估和行为干预工具,通过四项幼儿早期龋齿活动指标进行评估:唾液变形链球菌水平的半定量检测、牙菌斑的可见量、牙釉质脱矿的视觉证据以及龋洞状态(无、幼儿早期龋齿、严重幼儿早期龋齿)。
从主要讲西班牙语、低收入的城市人群中招募了108名2至6岁到儿科牙科诊所就诊的儿童。所有儿童都接受了全面的口腔检查和唾液培养,以评估幼儿早期龋齿指标。他们的照顾者完整地完成了基于iPad的MSB评估(15 - 20分钟)。MSB计算了饮食和综合幼儿早期龋齿风险评分。使用有序逻辑回归确定所有变量之间的关联。
MSB饮食风险评分与唾液变形链球菌显著正相关(P < 0.05),与可见菌斑水平接近显著相关(P < 0.1)。MSB综合风险评分与口腔变形链球菌和可见菌斑均显著相关(P < 0.05)。两者均与视觉上明显的脱矿或龋洞无关。
研究结果表明,MSB作为一种有效的风险评估工具,在识别有龋洞前期的儿童方面可能具有临床实用性,但在识别已有病变的儿童方面没有额外价值。