Abstract
Early childhood caries (ECC) is an aggressive form of dental caries occurring in the first five years of life. Despite its prevalence and consequences, little progress has been made in its prevention and even less is known about individuals’ susceptibility or genomic risk factors. The genome-wide association study (GWAS) of ECC (“ZOE 2.0”) is a community-based, multi-ethnic, cross-sectional, genetic epidemiologic study seeking to address this knowledge gap. This paper describes the study’s design, the cohort’s demographic profile, data domains, and key oral health outcomes. Between 2016 and 2019, the study enrolled 8059 3–5-year-old children attending public preschools in North Carolina, United States. Participants resided in 86 of the state’s 100 counties and racial/ethnic minorities predominated—for example, 48% (n = 3872) were African American, 22% white, and 20% (n = 1611) were Hispanic/Latino. Seventy-nine percent (n = 6404) of participants underwent clinical dental examinations yielding ECC outcome measures—ECC (defined at the established caries lesion threshold) prevalence was 54% and the mean number of decayed, missing, filled surfaces due to caries was eight. Nearly all (98%) examined children provided sufficient DNA from saliva for genotyping. The cohort’s community-based nature and rich data offer excellent opportunities for addressing important clinical, epidemiologic, and biological questions in early childhood.
Highlights
Dental caries is the most common chronic childhood disease worldwide
Children were eligible to participate in ZOE 2.0 if they were between the ages of
There were approximately 20,000 children enrolled in the North Carolina public preschool (Head Start) system, the target population
Summary
Dental caries is the most common chronic childhood disease worldwide. Childhood caries (ECC) is an early-onset, aggressive form of the disease that affects an estimated 600 million children worldwide. Management of ECC is challenging—it frequently requires restorative care under sedation or general anesthesia, and there are populations wherein it remains largely untreated [1]. The disease imposes substantial human and economic costs on children, their families, and the public health care infrastructure [2]. This burden falls disproportionately on poor families, whose children are more likely to develop ECC compared to their non-poor counterparts, and who are frequently unable to access the requisite dental care [3,4]. Despite a general decrease in caries prevalence in permanent teeth of older children and adults, the proportion of preschool children with
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