1 University of Michigan, Ann Arbor, MI, USA.
2 Indiana University, Indianapolis, IN, USA.
J Dent Res. 2019 Jan;98(1):68-76. doi: 10.1177/0022034518799080. Epub 2018 Sep 11.
Expanded partnership with the medical community is a promising strategy for reducing disparities in dental caries among young children. However, no validated caries risk instrument exists for use in primary health care settings. To help resolve this gap, a 52-item caries risk questionnaire was developed and targeted to primary caregivers (PCGs) to test in a 3-y prospective study. To begin to understand the validity of the questionnaire items, the purpose of this study was to compare responses to the questionnaire based on key demographic characteristics known to be associated with disparities in caries experience (e.g., race/ethnicity and insurance status). A total of 1,323 one-year-old children were recruited primarily through 3 medical research networks. Baseline questionnaire responses were analyzed via logistic regression. The sample was 49% female. Its racial/ethnic makeup was as follows: 13% Hispanic, 37% White, 37% Black, and 13% other or multiracial. Sixty-one percent were enrolled in Medicaid, and 95% resided in urban communities. Mothers represented 94% of PCGs. There were significant differences ( P < 0.05) in baseline responses based on Medicaid status and race/ethnicity. As compared with those not enrolled in Medicaid, children in the Medicaid group were significantly more likely (after adjusting for race/ethnicity) to 1) go to sleep while nursing or drinking something other than water, 2) eat sugary snacks between meals, 3) consume sugary drinks between meals, 4) receive topical fluoride from a health professional, 5) visit the dentist, and 6) not have an employed adult in the household. PCGs of children enrolled in Medicaid were significantly more likely to be the mother, have bleeding gums, eat sugary snacks between meals, consume sugary drinks between meals, eat or drink something other than water before going to bed, and not get regular dental checkups. In conclusion, there are significant differences in caries risk questionnaire responses based on Medicaid status and race/ethnicity that provide construct and criterion validity to the developed caries risk tool (ClinicalTrials.gov NCT01707797).
扩大与医学界的伙伴关系是减少幼儿龋齿差异的一项有前途的策略。然而，在初级保健环境中，没有经过验证的龋齿风险工具。为了帮助解决这一差距，开发了一个 52 项龋齿风险问卷，并针对主要照顾者 (PCG) 进行了 3 年前瞻性研究。为了开始了解问卷项目的有效性，本研究的目的是根据已知与龋齿经历差异相关的关键人口统计学特征（例如，种族/民族和保险状况）比较对问卷的反应。共招募了 1323 名一岁儿童，主要通过 3 个医学研究网络进行招募。通过逻辑回归分析了基线问卷的反应。该样本中有 49%为女性。其种族/民族构成如下：13%为西班牙裔，37%为白人，37%为黑人，13%为其他或多种族裔。61%的人参加了医疗补助，95%的人居住在城市社区。母亲代表了 94%的主要照顾者。根据医疗补助状况和种族/民族，基线反应存在显著差异（P<0.05）。与未参加医疗补助的儿童相比，参加医疗补助的儿童在调整种族/民族后，1）在哺乳或饮用非水液体时入睡，2）在两餐之间吃含糖零食，3）在两餐之间饮用含糖饮料，4）从健康专业人员处接受局部氟化物，5）看牙医，以及 6）家中没有就业成年人，其可能性显著更高。参加医疗补助的儿童的主要照顾者更有可能是母亲，牙龈出血，在两餐之间吃含糖零食，在两餐之间饮用含糖饮料，在睡前吃或喝非水液体，并且没有定期进行牙科检查。总之，根据医疗补助状况和种族/民族，龋齿风险问卷的反应存在显著差异，为开发的龋齿风险工具提供了结构和标准效度（ClinicalTrials.gov NCT01707797）。
