Clinical outcomes for Early Childhood Caries (ECC): the influence of salivary mutans streptococci levels

Authors:

ABSTRACT

Aim

To assess the relationship between clinical outcomes for children treated for Early Childhood Caries (ECC) and salivary
mutans streptococci (MS) levels. STUDY DESIGN AND

Methods

The study cohort consisted of 79 children (42 males, 37 females)
treated for ECC, aged from 2.3 to 7.3 years at time of entry. Whole non-stimulated saliva samples were obtained from each subject prior
to dental surgery and at 6 mths post dental surgery, by saturating a cotton swab in the saliva pooled in the floor of the mouth. Samples
were placed into PBS on ice and processed within 2 hours. Samples were sonicated, serially diluted and plated onto MSB and SBA
agar plates, then incubated 48 hours anaerobically; SBA plates were incubated an additional 24 hours aerobically. The MS level in each
sample was expressed as a percentage of the total cultivable flora. The cohort was evaluated for new caries lesions at 6 months post
dental surgery. Relapse was defined as the presence of new smooth surface caries lesions. STATISTICS: Comparisons between
Relapse (R) and Non-Relapse (NR) groups with respect to mutans streptococci levels were performed using Wilcoxon tests. Within
group comparisons were performed using Wilcoxon signed-rank tests.

Results

57 children (72) returned for the 6 months
examination and 21 of these subjects (37) relapsed. No statistically significant difference in median salivary MS levels existed
between the R (0.20) and NR (0.033) groups at baseline (p=0.647) or at 6 months post dental surgery
(R=0.03; NR=0.01; p=0.273). A statistically significant difference between baseline and 6 months post dental surgery
was noted in the median salivary MS level within the R group (p=0.0007) and within the NR group (P<0.0001). CONCLUSIONS: The relapse rate (37) was high and rapid for children treated for ECC. Dental surgery resulted in a statistically significant reduction in salivary MS reservoirs for children treated for ECC. However, this did not translate into acceptable clinical outcomes.

PLUMX METRICS