Tooth Fairy Study- The South Texas Oral Health Network Collaboration

Purpose: This study's purpose was to examine the processes and the potential for dental practitioners to address environmental health exposure risks to their patients through dental practice-based research participation. To explore this, the South Texas Oral Health Network (STOHN) initiated a collaboration with The Tooth Fairy National Study investigating toxicants stored in deciduous teeth as a potential neurodevelopmental risk factor.

Background: Neurodevelopmental disorders (ND), like Autism Spectrum Disorder (ASD), affect 1 in 68 live births. Evidence suggests that environmental chemicals may play a role in ASD risk and/or etiology by acting independently or through interactions with genetic vulnerabilities. Provider awareness of environmental exposure risk during pregnancy and early childhood in South Texas is low. Therefore, it is important to increase provider knowledge and awareness to enable greater communication with patients. STOHN serves as a conduit reaching large numbers of patients. This study also engaged practitioners in an ongoing national study with minimal impact on their practice.

Methods: The goal was to enroll twenty parents with children via ten dental practitioners. STOHN pediatric and general practitioners were recruited for the study. Practitioners were contacted by phone and in person. Upon completion of Human Subject Protection training, each practitioner participated in a study training taught by a public health educator in the department of Family and Community Medicine at University of Texas Health Science Center in San Antonio (UTHSCSA). Training topics included NDs, environmental health exposures, patient engagement, survey administration, and how to collect donated teeth. This collaboration allowed STOHN to gather control teeth as well as demographic and health information for the Tooth Fairy Study repository for future analyses. Participants received a thank you card from the Tooth Fairy and participating providers were highlighted in the monthly STOHN newsletter.

Evaluation results: Evaluation was threefold: Practitioner enrollment and retention; practitioner confidence in educating their patients about potential environmental risk exposures and completed surveys with donated teeth.

Conclusion: The interdisciplinary collaboration between dental practitioners and medical researchers through STOHN provided an opportunity to increase practitioner knowledge and awareness of a novel health concern, while also raising their confidence and willingness to educate their patients about potential environmental exposure risks. UTHSCSA IRB Protocol # HSC20170132E.