title: Dental caries in American Indian toddlers after a community-based beverage intervention.
abstract: OBJECTIVE
  The Toddler Overweight and Tooth Decay Prevention Study (TOTS) was an overweight and early childhood caries (ECC) project in the Pacific Northwest. It targeted American Indian (AI) toddlers from birth, to effect changes in breastfeeding and sweetened beverage consumption.
  The intervention cohort was children born in three communities during 12 months; expectant mothers were identified through prenatal visits, and recruited by tribal coordinators. The local comparison cohorts were children in those communities who were aged 18-30 months at study start. A control longitudinal cohort consisted of annual samples of children aged 18-30 months in a fourth community, supplying secular trends.
  
  
  METHODS
  d1-2mfs was used to identify incident caries in intervention, comparison, and control cohorts after 18-to-30 months of follow-up in 2006.
  
  
  RESULTS
  No missing or filled teeth were found. For d1t, all three intervention cohorts showed statistically significant downward intervention effects, decreases of between 0.300 and 0.631 in terms of the fraction of affected mouths. The results for d2t were similar but of smaller magnitudes, decreases of between 0.342 and 0.449; these results met the .05 level for significance in two of three cases. In light of an estimated secular increase in dental caries in the control site, all three intervention cohorts showed improvements in both d1t and d1t.
  
  
  CONCLUSIONS
  Simple interventions targeting sweetened beverage availability (in combination with related measures) reduced high tooth decay trends, and were both feasible and acceptable to the AI communities we studied.
authors.affiliation: Department of Preventive and Community Dentistry, Indiana University School of Dentistry, 415 Lansing Street, Indianapolis, IN 46202-2876, USA. gmaupome@iupui.edu
authors.forename: Gerardo
authors.initials: G
authors.lastname: Maupomé
authors.forename: Njeri
authors.initials: N
authors.lastname: Karanja
authors.forename: Cheryl
authors.initials: C
authors.lastname: Ritenbaugh
authors.forename: Tam
authors.initials: T
authors.lastname: Lutz
authors.forename: Mikel
authors.initials: M
authors.lastname: Aickin
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
mesh_terms: D002253:Carbonated Beverages / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003731:Dental Caries / Q000208:ethnology* / Q000517:prevention & control; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007198:Indians, North American; D007223:Infant; D008297:Male