Primary Caregiver Retention and Perceptions of Retention Strategies in a 36-Month Prospective Childhood Caries Study.

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.

The effect of periodontal therapy on TNF-alpha, IL-6 and metabolic control in type 2 diabetics.

PURPOSE: This pilot study investigated if scaling and root planing (S&RP) was an effective intervention in reducing levels of inflammatory markers TNF-alpha and IL-6 in a type 2 diabetic population. METHODS: Twenty-five patients with type 2 diabetes, 18-64 years of age were enrolled having 4 or more sites with pocket depths > or = 5mm and 2 or more sites with attachment loss > or = 3mm. Participants received S&RP following collection of gingival crevicular fluid and serum which were analyzed for TNF-alpha and IL-6. After 3 months post-treatment levels were collected. Serum pre-and post-treatment levels were analyzed using a paired t test at a significance level of p < or = 0.05. Mean TNF-alpha was 1.7 pg/ml at baseline and post-treatment was 4.0 pg/ml. Mean IL-6 was 2.8 pg/ml at baseline and post-treatment 6.0 pg/ml. RESULTS: Both mean TNF-alpha and IL-6 were increased following S&RP ; however, the observed increases were not statistically significant. While participants improved on periodontal measures following therapy, systemic measures of inflammation (TNF-alpha and IL-6) did not show the hypothesized reductions. CONCLUSION: Further studies are needed to determine effectiveness of S&RP on inflammatory mediators in a population with type 2 diabetes.