Browsing by Author "Keels, Martha Ann"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Influence of Temperament As a Risk Indicator for Early Childhood Caries
    (Ingenta, 2020-11-15) Quinonez, Rocio B.; Santos, Robert G.; Eckert, George J.; Keels, Martha Ann; Levy, Steven; Levy, Barcey T.; Jackson, Richard; Fontana, Margherita; Biostatistics, School of Public Health
    Purpose: To evaluate the association between temperament and caries. Methods: A total of 408 primary caregiver-child pairs were followed for 36 months; they completed the Early Childhood Behavior Questionnaire Very Short-Form (ECBQ-VSF) at age four years. Demographic, behavioral, and clinical data were obtained at ages one, two-and-a-half, and four years, with caries experience assessed each time using the International Caries Detection and Assessment System (ICDAS). The ECBQ-VSF (36 items) was used to measure three child temperament domains: (1) surgency; (2) negative affect; and (3) effortful control. The associations between cavitated carious lesion experience by age four years (decayed, missing, and filled primary surfaces [dmfs] score greater than zero; d equals ICDAS score greater than or equal to three) and the three ECBQ-VSF temperament domains were analyzed using generalized estimating equation models. Results: Temperament domains predicted the number of carious surfaces (dmfs). After adjusting for covariates, every one-point increase in surgency and one-point increase in negative affect were associated with 77 percent and 31 percent increases in dmfs, respectively (P<0.05), and every one-point increase in effortful control was associated with a 39 percent decrease in dmfs (P<0.05). Conclusions: By age four years, children with higher levels of surgency and negative affect have a higher caries experience, whereas children with greater effortful control have a lower caries experience.
  • Thumbnail Image
    Item
    Primary Caregiver Retention and Perceptions of Retention Strategies in a 36-Month Prospective Childhood Caries Study
    (Sage, 2022) Daly, Jeanette M.; Xu, Yinghui; Yanca, Emily; Levy, Steven M.; Levy, Barcey T.; Talbert, Jennifer; Tran, Jennifer L.; Keels, Martha Ann; Fontana, Margherita; Biomedical and Applied Sciences, School of Dentistry
    Introduction/objectives: This paper reports on participant retention from an ongoing prospective, multi-site cohort caries risk study involving parent/infant pairs. The objectives were to: (1) compare the retention rates at each intermediate contact (every 4 months) and dental visit (every 18 months) across the 3 clinical sites, (2) assess primary caregivers' perceptions at the end of the study about the retention efforts used in this longitudinal study, and (3) determine whether primary caregiver baseline demographic characteristics and child's baseline caries experience were associated with retention. Methods: 1325 primary caregiver-child pairs recruited at the child's first birthday were followed for 36 months at 3 sites. Dental visits occurred at children's ages of approximately 12, 30, and 48 months. Telephone/email intermediate contacts with the primary caregiver occurred 6 times between dental visits. The outcome variable was the retention rates at each dental visit and each intermediate contact. Primary caregivers' perceptions of intermediate contacts were evaluated. Retention rates were compared by maternal age, race, ethnicity, Medicaid status, yearly household income, baseline caries experience (defined as decayed, missing due to caries, or filled tooth surfaces) at 12 months, and the number of teeth erupted. Results: 1325 primary caregiver/infant pairs were enrolled and completed the first in-person dental visit, 1062 pairs (80%) completed the second visit and 985 (74%) completed the third. Most primary caregivers were female (94%), with a mean age of 29 years and 667 (50%) self-identified as White, 544 (41%) as Black, and 146 (11%) as Hispanic. The percentages of successful intermediate contacts were 95% at 4 months decreasing to 82% at 34 months. Almost all 964 (98%) of 985 primary caregivers reported at the last visit that they were comfortable/very comfortable with 4-month intermediate contacts. The multivariable analysis showed that primary caregivers who were older (OR = 1.07; 95% CI, 1.04-1.09) and White (OR = 1.52; 95% CI, 1.12-2.06) were more likely to complete the study. Conclusions: Retention strategies were focused on frequent routine contact and increasing monetary incentives. Those strategies may have resulted in retention exceeding the proposed goals. At the end of the study, primary caregivers were comfortable with the 4-month intermediate contacts.
  • Thumbnail Image
    Item
    Tooth Eruption and Early Childhood Caries – A Multi-site Longitudinal Study
    (American Academy of Pediatric Dentistry, 2021) Warren, John J.; Levy, Steven M.; Xu, Yinghui; Daly, Jeanette M.; Eckert, George J.; Clements, Dennis; Hara, Anderson T.; Jackson, Richard; Katz, Barry P.; Keels, Martha Ann; Levy, Barcey T.; Fontana, Margherita; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    Objectives: This study assessed the relationship between the number of teeth present at 12 months and dmfs at 30 and 48 months. Methods: Data are from a longitudinal, multi-site study with clinical dental examinations conducted at 12, 30 and 48 months of age. Spearman correlation, and chi-square tests assessed relationships between teeth present at 12 months and decayed, missing or filled surfaces (dmfs) at 30 (n=1,062) and 48 months (n=985). Results: Spearman correlations were weak but significant for both 30- and 48-month time points (R= 0.066; p=0.032, R= 0.093; p=0.004, respectively). Mantel-Haenszel chi-square analyses of categories of teeth present at 12 months (0, 1–4, 5–8, and 9+) and categories of dmfs at 30 and 48 months (0, 1–2, 3–5, 6–15 and 16+), revealed non-significant (p=0.326) relationship with 30-month dmfs, but a significant (p=0.013) relationship with 48-month dmfs. Conclusion: Results suggest that early tooth eruption is weakly associated with occurrence of early childhood caries.