# Predicting Caries Lesion Patterns and Trajectories in Underserved Children, from Infancy to Early Adolescence, in Primary Healthcare Settings

> **NIH NIH U01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $1,718,950

## Abstract

PROJECT SUMMARY
The recent NIDCR Oral Health in America report highlighted adolescence as a largely neglected life
stage in oral health research and practice, with persistent and largely unchanged high caries experience, and
called for strong actions to address this age cohort’s needs.1 Our team has been following a diverse cohort of
children from age 1-9.5 years, and proposes now to follow them into early adolescence, providing a unique
opportunity to assess U.S. children longitudinally culminating with much needed access and focus on
adolescence. Given the large persistent disparities in caries rates and inequities in access to care for
adolescents, targeted, risk-based healthcare delivery could be an important strategy to reduce disparities in
adolescent health, while containing costs. The problem is that there have been almost no U.S. studies
following the life-course progression of caries in children through adolescence to assess and predict caries
patterns and disease trajectories over time, and relationships between these and changing oral and systemic
health patterns in risk factors and behaviors. This is critical for targeting preventive, person-centered care in
interprofessional settings that can adapt to changes in the life-course. The aims of this innovative U.S. study
renewal are: 1) To define dental caries patterns (teeth and surfaces affected, e.g., pit-and-fissure vs. proximal,
anterior vs. posterior) in early adolescence, including the trajectories of changes in caries patterns and counts
(e.g., dmfs/DMFS) across the age-span (ages 1-15 years) (sub-aim 1a), in both primary and permanent teeth.
2) To identify patterns of caries risk factors and behaviors in the cohort when they were preschoolers (ages 1-
4), school-age (ages 6.5-9.5) and early adolescents (ages 12-15), and changes over time (sub-aim 2a). 3) To
characterize the interplay among longitudinal caries patterns and risk factor/behavior patterns that lead to
future caries development, we aim to develop risk screening tools to predict caries patterns, and predict caries
incidence (sub-aim 3a), in early adolescence. This will be accomplished by following a diverse cohort of 500
primary caregiver (PCG)-child pairs enrolled in our ongoing U01 study. The PCGs will provide medical history
and socio-demographic family information, while the adolescents will complete risk behavior questionnaires,
and will have caries examinations at 12, 13.5 and 15 years of age to determine caries incidence, patterns, and
trajectories. A great strength of this proposal is that it involves experienced medical/nursing and dental
research groups, who have successfully worked together for the past 11 years and can facilitate follow-up of
the cohort, while bringing new expertise in adolescent and behavioral health, and clinical decision-making. The
overall impact and significance of this interdisciplinary project is that accurate risk stratification can optimize
cost-effectiveness of personalized care...

## Key facts

- **NIH application ID:** 10809760
- **Project number:** 5U01DE021412-13
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Margherita R Fontana
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,718,950
- **Award type:** 5
- **Project period:** 2011-09-23 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10809760

## Citation

> US National Institutes of Health, RePORTER application 10809760, Predicting Caries Lesion Patterns and Trajectories in Underserved Children, from Infancy to Early Adolescence, in Primary Healthcare Settings (5U01DE021412-13). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10809760. Licensed CC0.

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