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From 2007-2011: We have conducted a community based clinical trial testing the effectiveness of xylitol in preventing dental caries in kindergarten children followed until the second grade. The kindergarten children were given xylitol or fiber gummy bears together with other currently available best prevention practices such as oral health education, tooth brush and paste, fluoride varnish, and dental sealants. Other data such as caregiver and child oral health behavior, access, and dietary information have been collected. From this project, we found out that individual level prevention is not sufficient to reduce caries in low-income populations, and that family level prevention is also necessary. We received an R34 pilot study to plan for family-level theory-based behavioral interventions. This study has led to a larger U01 clinical trial of family-level interventions in school districts in Ohio and Washington states.

From 2007-2014: An R01 level NIDCR study investigated the oral health problems of preterm very low birth weight (VLBW) and NBW infants. Assessments included dental caries, tooth enamel problems, S. mutans bacteria, oral hygiene behavior, diet, and DNA samples of infants. Approximately 300 VLBW infants, and 300 normal birth weight controls were recruited from two hospitals in the Cleveland area. The participating infants receive a visual dental exam to determine oral health at three ages -8, 18, and 36 months. This longitudinal cohort study is aimed to understand the mechanism of early childhood caries in VLBW infants. The long term goal of this study is to study the permanent dentition and develop interventions that are appropriate for this group of special needs children.

Our studies also include developing an illness perception measure for older adults using the Common-Sense Model of Self-Regulation. This measure will be instrumental in assessing the oral health beliefs of older adults that would be conducive for developing behavioral interventions in the future.