{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T11:01:40Z","timestamp":1777806100580,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["R01 DE 024985"],"award-info":[{"award-number":["R01 DE 024985"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JDR Clinical &amp; Translational Research"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Early childhood caries (ECC) is a complex oral disease that is prevalent in US children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The purpose of this 2-y prospective cohort study was to examine baseline and time-dependent risk factors for ECC onset in initially caries-free preschool children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cohort of 189 initially caries-free children aged 1 to 3 y was recruited. At each 6-mo study visit, children were examined using the ICDAS index; salivary samples were collected to assess mutans streptococci (MS), lactobacilli, Candida species, salivary cortisol (prior and after a stressor), and salivary IgA. Diet and oral health behavior were assessed from parent report. Child and family stress exposure was assessed from measures of psychological symptoms, stressful life event exposure, family organization and violence exposure, and social support. Sociodemographic factors were also considered. A Kaplan-Meier estimator of survival function of time to ECC and a Cox proportional hazards model were used to identify predictors of ECC onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Onset of ECC was associated with high salivary MS levels at baseline (log-rank test, P &lt; 0.0001). Cox proportional hazards regression showed that the risk of dental caries significantly increased with salivary MS in log scale over the 6-mo period (hazard ratio, 1.08; P = 0.01). Other risk factors in the model did not reach statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our results provide prospective evidence that an increase in salivary MS predicts ECC onset in young, initially caries-free children, confirming that a high salivary MS count likely plays a causal role in ECC onset, independent of covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Knowledge Transfer Statement:<\/jats:title>\n                    <jats:p>These results suggest that we must focus on reducing salivary MS counts in young children and preventing or delaying MS colonization in infants and young children determined to be at risk for ECC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23800844221101800","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T03:26:22Z","timestamp":1654745182000},"page":"394-401","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["A Prospective Longitudinal Study of Early Childhood Caries Onset in Initially Caries-Free Children"],"prefix":"10.1177","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0798-6805","authenticated-orcid":false,"given":"D.T.","family":"Kopycka-Kedzierawski","sequence":"first","affiliation":[{"name":"Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.J.","family":"Billings","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Feng","sequence":"additional","affiliation":[{"name":"Departments of Biostatistics and Computational Biology and Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.G.","family":"Ragusa","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Flint","sequence":"additional","affiliation":[{"name":"Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.E.","family":"Watson","sequence":"additional","affiliation":[{"name":"Departments of Dentistry, Pharmacology and Physiology, and Environmental Medicine, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.L.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry and Pediatrics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0836-2842","authenticated-orcid":false,"given":"S.","family":"Manning","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.R.","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.G.","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"bibr1-23800844221101800","doi-asserted-by":"publisher","DOI":"10.1159\/000261176"},{"key":"bibr2-23800844221101800","unstructured":"Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. 2001. 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