title: Protocol for assessing maternal, environmental and epigenetic risk factors for dental caries in children.
abstract: BACKGROUND
  Expenditure on dental and oral health services in Australia is $3.4 billion AUD annually. This is the sixth highest health cost and accounts for 7 % of total national health expenditure. Approximately 49 % of Australian children aged 6 years have caries experience in their deciduous teeth and this is rising. The aetiology of dental caries involves a complex interplay of individual, behavioural, social, economic, political and environmental conditions, and there is increasing interest in genetic predisposition and epigenetic modification.
  
  
  METHODS
  The Oral Health Sub-study; a cross sectional study of a birth cohort began in November 2012 by examining mothers and their children who were six years old by the time of initiation of the study, which is ongoing. Data from detailed questionnaires of families from birth onwards and data on mothers' knowledge, attitudes and practices towards oral health collected at the time of clinical examination are used. Subjects' height, weight and mid-waist circumference are taken and Body Mass Index (BMI) computed, using an electronic Bio-Impedance balance. Dental caries experience is scored using the International Caries Detection and Assessment System (ICDAS). Saliva is collected for physiological measures. Salivary Deoxyribose Nucleic Acid (DNA) is extracted for genetic studies including epigenetics using the SeqCap Epi Enrichment Kit. Targets of interest are being confirmed by pyrosequencing to identify potential epigenetic markers of caries risk.
  
  
  CONCLUSIONS
  This study will examine a wide range of potential determinants for childhood dental caries and evaluate inter-relationships amongst them. The findings will provide an evidence base to plan and implement improved preventive strategies.
authors.affiliation: School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. Surani.fernando@griffith.edu.au.|Population and Social Health Research Program, Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. Surani.fernando@griffith.edu.au.
authors.forename: Surani
authors.initials: S
authors.lastname: Fernando
authors.affiliation: Molecular Basis of Disease Program, Menzies Health Institute Queensland, Griffith Health Institute, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. d.speicher@griffith.edu.au.
authors.forename: David J
authors.initials: DJ
authors.lastname: Speicher
authors.affiliation: School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. m.bakr@griffith.edu.au.|Molecular Basis of Disease Program, Menzies Health Institute Queensland, Griffith Health Institute, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. m.bakr@griffith.edu.au.
authors.forename: Mahmoud M
authors.initials: MM
authors.lastname: Bakr
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, GPO Box 2434, Brisbane, 4001, Queensland, Australia. miles.benton84@gmail.com.
authors.forename: Miles C
authors.initials: MC
authors.lastname: Benton
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, GPO Box 2434, Brisbane, 4001, Queensland, Australia. grccomputationalgenomics@gmail.com.
authors.forename: Rodney A
authors.initials: RA
authors.lastname: Lea
authors.affiliation: Population and Social Health Research Program, Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. p.scuffham@griffith.edu.au.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Scuffham
authors.affiliation: Population and Social Health Research Program, Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. g.mihala@griffith.edu.au.
authors.forename: Gabor
authors.initials: G
authors.lastname: Mihala
authors.affiliation: Population and Social Health Research Program, Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. n.johnson@griffith.edu.au.|Molecular Basis of Disease Program, Menzies Health Institute Queensland, Griffith Health Institute, Gold Coast Campus, Griffith University, Gold Coast, 4222, Queensland, Australia. n.johnson@griffith.edu.au.
authors.forename: Newell W
authors.initials: NW
authors.lastname: Johnson
mesh_terms: D001315:Australia; D002648:Child; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology* / Q000235:genetics*; D044127:Epigenesis, Genetic; D005260:Female; D006801:Humans; D009035:Mothers; D009909:Oral Health; D012307:Risk Factors