Cohort Profile: ZOE 2.0—A Community-Based Genetic Epidemiologic Study of Early Childhood Oral Health

• Main Authors: Kimon Divaris, Gary D. Slade, Andrea G. Ferreira Zandona, John S. Preisser, Jeannie Ginnis, Miguel A. Simancas-Pallares, Cary S. Agler, Poojan Shrestha, Deepti S. Karhade, Apoena de Aguiar Ribeiro, Hunyong Cho, Yu Gu, Beau D. Meyer, Ashwini R. Joshi, M. Andrea Azcarate-Peril, Patricia V. Basta, Di Wu, Kari E. North
• Format: Article
• Language: English
• Published: MDPI AG 2020-11-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: children; early childhood caries; community-based studies; oral health; genomics
• Online Access: https://www.mdpi.com/1660-4601/17/21/8056

Early childhood caries (ECC) is an aggressive form of dental caries occurring in the first five years of life. Despite its prevalence and consequences, little progress has been made in its prevention and even less is known about individuals’ susceptibility or genomic risk factors. The genome-wide association study (GWAS) of ECC (“ZOE 2.0”) is a community-based, multi-ethnic, cross-sectional, genetic epidemiologic study seeking to address this knowledge gap. This paper describes the study’s design, the cohort’s demographic profile, data domains, and key oral health outcomes. Between 2016 and 2019, the study enrolled 8059 3–5-year-old children attending public preschools in North Carolina, United States. Participants resided in 86 of the state’s 100 counties and racial/ethnic minorities predominated—for example, 48% (<i>n</i> = 3872) were African American, 22% white, and 20% (<i>n</i> = 1611) were Hispanic/Latino. Seventy-nine percent (<i>n</i> = 6404) of participants underwent clinical dental examinations yielding ECC outcome measures—ECC (defined at the established caries lesion threshold) prevalence was 54% and the mean number of decayed, missing, filled surfaces due to caries was eight. Nearly all (98%) examined children provided sufficient DNA from saliva for genotyping. The cohort’s community-based nature and rich data offer excellent opportunities for addressing important clinical, epidemiologic, and biological questions in early childhood.