Objectives: One of the groups most severely affected by dental caries is American Indians (AIs). The Toddler Overweight and Tooth decay prevention Study (TOTS) is an overweight/obesity and early childhood caries prevention project targeting AI babies/toddlers, relying on effecting changes in breastfeeding and sugared beverage consumption in the Pacific Northwest. This second interim report presents 24-month follow-up caries experience in control, comparison, and intervention children (May 2003 to June 2005). Materials and Methods: 444 children in the birth cohort and their families are enrolled in the three intervention tribes, with another 112 toddlers (who were already 18-30 months old prior to the beginning of the study) recruited into a control group to supply dental data (one measurement). A further 60 children (25-30 months old) in unrelated AI communities were also evaluated once for dental status (comparison group). Dental personnel trained in the d1d2fs index examined the children in tribal dental clinics when guardians/mothers attended appointments set up by site coordinators. Results: Among children 24 months old and younger, mean (±sd) d1fs in the birth cohort was 0.4±1.6; values for the control group were 1.5±4.1; values for the comparison group were 1.4±2.4. Corresponding d2fs values were 0.2±1.1, 2.2±6.2, and 0.0±0.0. Among children 25 months old and older, d1fs in the birth cohort was 0.7±1.5; in the control group, 1.9±3.2; and in the comparison group 1.7±3.5. Corresponding d2fs values were 0.2±0.6, 3.8±6.4, and 1.5±3.0. Conclusions: Substantial caries burden is reflected in these 24+ months data, with large inequalities in the distribution of disease. The bulk of the d1fs and d2fs indices is made up by untreated disease, with no fillings present. With new funding now available to follow the birth cohort until age 36 months, we will undertake incident caries analyses to contrast caries experience with the comparison and control groups. NIDCR/NARCH1S05GM64122

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