Edelstein Burton L, Ureles Steven D, Smaldone Arlene
Dental Medicine and Health Policy and Management, Columbia University Medical Center, New York, N.Y, USA.
Children's Dental Associates of New London County, New London, Conn., USA; Dental Medicine, Columbia University Medical Center, New York, N.Y, USA.
Pediatr Dent. 2016;38(4):325-30.
Culturing mutans streptococci (MS) from children's saliva has high utility in caries risk assessment. The purpose of this retrospective cohort study was to examine its ability in predicting caries progression and determine sensitivity, specificity, and likelihood ratios of a very high ["too numerous to count (TNTC) MS test result.
200 preschoolers (3.3±1.2 years, 50 percent no recoverable MS, 50 percent TNTC MS at first dental visit) were followed for five or more years. Caries experience of both groups was compared to identify predictors of caries presence and its progression.
Controlling for demographic, oral health, and dental visit factors, TNTC preschoolers had both greater presence and extent of caries at the first dental visit (adjusted odds ratio [aOR] 8.0, 95 percent confidence interval [CI] 2.5 to 25.5) and caries progression at five or more years (aOR 6.0, 95 percent CI 2.4 to 15.0). Fewer TNTC preschoolers remained caries free over five years or longer (13 percent versus 77 percent for no MS). Overall, sensitivities and specificities exceeded 75 percent.
Despite engagement in preventive dental care, children with TNTC MS were six times more likely to experience cavity increments than preschoolers with no recoverable MS at first visit.
从儿童唾液中培养变形链球菌（MS）在龋齿风险评估中具有很高的实用价值。这项回顾性队列研究的目的是检验其预测龋齿进展的能力，并确定极高的[“无法计数（TNTC）MS检测结果”]的敏感性、特异性和似然比。
对200名学龄前儿童（3.3±1.2岁，50%首次就诊时未检出MS，50%首次就诊时TNTC MS）进行了五年或更长时间的随访。比较两组的龋齿经历，以确定龋齿存在及其进展的预测因素。
在控制人口统计学、口腔健康和就诊因素后，TNTC学龄前儿童在首次就诊时龋齿的存在和范围更大（调整后的优势比[aOR]为8.0，95%置信区间[CI]为2.5至25.5），在五年或更长时间内龋齿进展也更快（aOR为6.0，95%CI为2.4至15.0）。在五年或更长时间内仍无龋齿的TNTC学龄前儿童较少（13%，而未检出MS的儿童为77%）。总体而言，敏感性和特异性超过75%。
尽管接受了预防性牙科护理，但首次就诊时TNTC MS的儿童出现龋齿增加的可能性是未检出MS的学龄前儿童的六倍。
