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October 1, 2001

UCSF School of Dentistry Receives $11 Million Grant To Establish Center To Prevent Oral Health Disparities

The School of Dentistry at the University of California, San Francisco has
received an $11 million grant from the National Institute of Dental and
Craniofacial Research (NIDCR) to study eliminating painful, difficult, and
expensive treatments for tooth decay in children as young as one year old.
Targeted at children from environments with a high incidence of dental
problems, the project aims to eventually find results which will help all young
people maintain healthy teeth and mouths.

Jane A. Weintraub, DDS, MPH, Lee Hysan Professor of Oral Epidemiology and
Dental Public Health, will assume additional duties as director of the new
Center to Address Disparities in Children's Oral Health, based in San
Francisco. The Center will collaborate in a seven-year program with the San
Francisco Department of Public Health and the San Ysidro Community Center,
located at the Mexican border south of San Diego. An additional 12 institutions
located along the West Coast will participate in the work of CAN-DO, the
acronym for the center.

"This is the first time that the NIDCR (part of the National Institutes of Health) has funded a project so closely networked with community organizations," Weintraub said.

A California survey of children showed that 33 of every 100 children in
Headstart programs had cavities, with even higher rates among children of Asian
heritage (44 of every 100) and Latino children (39 of every 100).

"The prevalence of early childhood caries (tooth decay) is particularly high
among some racial and ethnic minorities and low socioeconomic groups,"
Weintraub said. "The primary goals of the Center are to understand, prevent and
reduce oral health disparities among young children, with a primary focus on
preventing early childhood caries."

A secondary focus of the Center is to understand the interactions between the
oral health and medical delivery systems that can affect children's oral health, Weintraub explained.

The goals will be pursued from two directions:

1. retrospective data-based projects to increase understanding of the causes
of oral health disparities and to identify children most susceptible and

2. intervention projects to prevent disease.

More than 25 UCSF faculty members are involved in the multidisciplinary
projects, including faculty from the UCSF Schools of Dentistry, Medicine,
Nursing and Pharmacy, the Comprehensive Oral Health Research Center of
Discovery, the Centers for Health and Community, Health Professions, Workplace Studies, Cochrane Collaboration, Health Improvement and Prevention Studies, Oral AIDS, Medical Effectiveness Research, Philip R. Lee Institute for Health Policy Studies, and the Departments of Epidemiology and Biostatistics, Pediatrics, Medical Anthropology, History and Social Medicine, Family and Community Medicine, Family Health Care Nursing, Medicine and Psychiatry.

The Center has four main projects:

- Prevention and Treatment Options for Early Childhood Caries (ECC) previously
called Baby Bottle Tooth Decay and Nursing Caries. This randomized clinical
trial which tests the efficacy of fluoride varnish to prevent ECC has already
been funded by NIDCR as part of the UCSF Comprehensive Oral Health Research
Center of Discovery. UCSF is partnering with the San Francisco Department of
Public Health, the Chinatown Public Health Center and San Francisco General
Hospital to conduct this study.

- Prevention Management Model for Early Childhood Caries. The goal of this
project, led by Francisco Ramos-Gomez, DDS, MS, MPH, is to increase
understanding and to assess the effectiveness of a dental disease prevention
management model based on an infant oral care program. This project is
partnered with the San Ysidro Community Health Center. High-risk children
include those with early signs of ECC, poor hygiene, limited exposure to
fluorides, and frequent exposure to high dietary sugars. The children and
their caretakers will be targeted with a professional preventive program that
includes anticipatory guidance counseling, the use of chlorhexidine for
postpartum women and the application of fluoride varnish for their infants.

- Understanding Ethnic/Racial Cultural Differences Related to Oral Health.
This project is partnered with the San Francisco Department of Public Health
with Patricia Evans, MD, MPH, as the lead investigator. The goal of this
project is to identify barriers (racial, ethnic and cultural) to accessing
preventive oral health care among African American, Chinese, Filipino and
Hispanic caregivers of children between one and five years of age. This study
will address assessment of barriers to preventive oral health care and may
impact policy development and assurance to improve the oral health of the
affected population.

- Assessing Risk for Early Childhood Caries. This study, led by Stuart Gansky,
DrPH, will utilize statewide and local cross-sectional data sources to develop,
test and refine an ECC risk association model to be tested with longitudinal
data from the NIDCR funded UCSF fluoride varnish trial. The partner for this
project is the San Francisco Department of Public Health and collaborators
include the Alameda County Health Care Services and California Department of
Health Services. This is the first study to simultaneously examine individual,
family and community level characteristics related to ECC with data mining
techniques.* This study coordinates with three existing studies (California
Department of Health Services/CDC, the Center for Medicare and Medicaid
Services and NIDCR) as well as the other projects and the cores of this
proposed center. The project will provide input to the San Ysidro intervention
study, the San Francisco focus group project and provide risk assessment models that can be tested and refined with their study data.

"Findings from the Center research will identify cultural, environmental,
workforce, behavioral and biologic factors associated with health disparities
among ethnic/racial groups in the very diverse California environment,"
Weintraub said.

"We also hope to enhance our ability to target children likely to be at risk
for dental caries, provide successful interdisciplinary interventions to
prevent disease and reduce oral health disparities. The Center will also
provide an enriched environment for training future health-care professionals
and scientists, especially those from underrepresented groups. This award
provides a tremendous opportunity to improve the oral health of children,"
Weintraub explained.

*Data mining is the process of selecting, exploring and modeling large data
bases using a variety of tools. These models can then be used for prediction
in new data bases.

UCSF News Release
Source: Twink Stern


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