Long-term predictive value of salivary microbial diagnostic tests in children

Summary

Aim: To investigate in a group of children (n=183) the predictive value of early colonization of salivary lactobacilli and candida on caries development in primary molars and permanent first molars in 7 years of follow-up time by applying a longitudinal survival analysis method. Study design: Longitudinal cohort study of clinical outcomes based on dental records. Methods: The Kaplan-Meier survival analysis method was used to compare survival times to caries onset in primary molars and permanent first molars for children colonized by salivary lactobacilli and candida and children who were not colonized by those microbes at baseline when children’s mean age was 2.5 years. The survival time was the time elapsing between the birth of a child and the first restoration as a result of dental caries, that is the time when caries has progressed to a stage when a dentist has made a decision to restore the affected tooth. Results: The survival curves for primary and permanent molars were consistently lower for those children whose mouths were colonized by salivary lactobacilli at baseline. A statistically significant relationship was found with onset of caries in both primary and permanent molars and colonization by salivary lactobacilli. The survival of primary second molars was 60% at the age of 9 years in the group colonized by lactobacilli and 80% in those children whose mouths were not colonized. Colonization by candida was also a significant risk factor for caries onset in primary molars but not in permanent first molars. Conclusion: Children whose mouths were colonized by salivary lactobacilli at baseline were more susceptible to caries onset in both primary and permanent molars at any given time during follow-up of seven years than children who were not colonized by those caries associated microorganisms.