New study planned to help understand oral health outcomes for children in low-income areas

University of Illinois Chicago researchers have received funding from the National Institute of Dental and Craniofacial Research, a branch of the U.S. National Institutes of Health, for a five-year study to understand the oral health of children in low-income communities. 

Caries — or cavities — is the most common disease of childhood and can result in serious health issues including pain, difficulty eating, speech problems, and infections which can lead to hospitalization and surgeries for tooth extractions. The new study, backed by $1.2 million in the first year, plans to look at predictors of oral health behaviors and caries risk in low-income, urban young children over time, said UIC’s Dr. Molly Martin, associate professor of pediatrics at the College of Medicine and the principal investigator for the COordinated Oral health Promotion (CO-OP) Chicago Cohort Study. 

Dr. Molly Martin, UIC associate professor of pediatrics at the College of Medicine.

The CO-OP Chicago project was previously funded to reduce oral health disparities in children, and for that study, the researchers developed an objective assessment for tooth brushing behaviors in the homes of high-risk children under age 3. The study then tested an oral health community health worker intervention. That study did not include caries assessment. The new study builds off the previous one, this time with the goal to determine multilevel predictors of oral health behaviors and caries. 

“The original study began to define the problems facing families, but the tested intervention did not change behaviors,” Martin said. “This new study allows us to take those participants from the intervention trial and continue to follow them over the next five years so we can understand the trajectory of oral health of these young children in low-income households in Chicago.” 

The researchers will collect caregiver-reported and observed child oral health behaviors, dental plaque scores, diet, parenting styles, dental provider access and social risk factors every six months for an additional four years. Children will be evaluated for caries at ages 5 and 7.   

Martin explained why it is important to study young children’s oral health, even when children lose their first set of teeth. Baby teeth can get cavities or become infected, and in some cases, need to be surgically removed. 

“We see children having all of their front teeth extracted. They won’t get all their new front teeth until they are 5 to 9 years old. They are trying to learn to talk and eat which is difficult to do without teeth,” Martin said. Additionally, children have to undergo general anesthesia for tooth extraction which exposes them to operating room risks.  

Another reason for the study is the lack of data regarding children’s oral health. The studies have been funded by the  National Institute of Dental & Craniofacial Research because no national data on oral health behaviors for young children exists. 

Martin said researchers hope to gain insight on other factors that impact oral health including access to nutritious foods, access to dental services, and psychological stress.  

“We are also going to be looking at the community-level factors, community-level violence and area deprivation, and economic indicators. It’s very possible that a lot of these community factors influence individual behaviors much more strongly than perhaps the home factors,” Martin said. 

Researchers are still studying the role oral health has overall throughout the lifespan. 

“The assumption is that if you brush well and frequently, you will have good oral health. But there is less known about other factors. What if it’s fluoridated water that really makes the difference? What if it’s access to care?” she said. 

The project’s additional investigators from UIC include Dr. David Avenetti, Michael Berbaum and Helen Lee. 

The study includes a partnership with Mobile Care Chicago, which will conduct caries examinations in their mobile dental vans, and a partnership with University of California San Francisco for the calibration of the dental examiners.