School of Dentistry, The University of Queensland, Brisbane, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia.
BMC Oral Health. 2019 Jan 17;19(1):21. doi: 10.1186/s12903-018-0692-2.
While associations between salivary characteristics and dental caries have been well studied, we are not aware of this being assessed in a remote Indigenous child population, where lifestyles may be different from urban children. Our aim was to assess associations between caries experience and putative biomarkers in saliva, accounting for oral hygiene and dietary habits.
Children attending schools in an Indigenous community in remote north Queensland, Australia were invited to an oral examination by qualified and calibrated examiners. Salivary flow rate, pH, buffering capacity and loads of mutans streptococci (MS), lactobacilli (LB) and yeasts were determined. Also, data on tooth brushing frequency and soft drinks consumption were obtained via a questionnaire. Caries experience was recorded by the International Caries Detection and Assessment System (ICDAS-II), and quantified as decayed, missing and filled surfaces. Relationships between the salivary variables and the cumulative caries experience (dmfs+DMFS) in the deciduous and permanent dentitions were examined by multivariate analyses to control the effect of confounders.
The mean cumulative decayed (DS + ds), missing (MS + ms) and filled (FS + fs) surfaces were 3.64 (SD: 4.97), 1.08 (4.38) and 0.79 (1.84) respectively. Higher salivary MS and LB counts, low tooth brushing frequency and daily soft drink consumption were significantly related to greater caries experience. Caries experience was about twice in those with ≥10^5 CFU/ml saliva counts of MS (mean = 6.33, SD: 8.40 vs 3.11, 5.77) and LB (7.03, 7.49 vs 4.41, 8.00). In the fully-adjusted multivariate model, caries experience in those with higher counts of MS and LB were 51 and 52% more than those with lower counts.
As with studies in other populations, childhood salivary counts of MS and LB were significantly associated with greater caries experience in this remote Indigenous community. To address the serious burden of oral disease, we are researching ways to promote a healthy oral environment by encouraging good dietary habits, and emphasising the importance of daily tooth brushing with a fluoridated toothpaste. Our ongoing longitudinal studies will indicate the success of measures employed to reduce the counts of bacteria closely associated with cariogenesis and their impact on caries increment.
Australian New Zealand Clinical Trials Registry ( ANZCTR ), No: ACTRN12615000693527; date of registration: 3rd July 2015.
虽然唾液特性与龋齿之间的关联已得到充分研究，但我们尚不清楚在偏远的土著儿童人群中进行了这种评估，这些人群的生活方式可能与城市儿童不同。我们的目的是评估龋齿经历与唾液中假定生物标志物之间的关联，同时考虑口腔卫生和饮食习惯。
邀请澳大利亚北部偏远地区一个土著社区的学校的儿童由合格且经过校准的检查者进行口腔检查。确定唾液流量、pH 值、缓冲能力以及变形链球菌（MS）、乳杆菌（LB）和酵母菌的载量。还通过问卷获得了关于刷牙频率和软饮料消费的数据。使用国际龋齿检测和评估系统（ICDAS-II）记录龋齿经历，并量化为龋齿、缺失和填补的表面。通过多元分析检查唾液变量与乳牙和恒牙累积龋齿经历（dmfs+DMFS）之间的关系，以控制混杂因素的影响。
累积的龋齿（DS+ds）、缺失（MS+ms）和填补（FS+fs）表面的平均值分别为 3.64（标准差：4.97）、1.08（4.38）和 0.79（1.84）。较高的唾液 MS 和 LB 计数、较低的刷牙频率和每日软饮料消费与更高的龋齿经历显著相关。那些唾液中 MS 计数≥10^5 CFU/ml（平均值=6.33，标准差：8.40 与 3.11、5.77）和 LB（7.03、7.49 与 4.41、8.00）的儿童龋齿经历约为两倍。在完全调整的多元模型中，MS 和 LB 计数较高的儿童的龋齿经历比计数较低的儿童多 51%和 52%。
与其他人群的研究一样，在这个偏远的土著社区，儿童唾液中 MS 和 LB 的计数与更高的龋齿经历显著相关。为了应对口腔疾病的严重负担，我们正在研究通过鼓励良好的饮食习惯和强调每天使用含氟牙膏刷牙来促进健康口腔环境的方法。我们正在进行的纵向研究将表明，为减少与龋病密切相关的细菌计数并降低其对龋齿进展的影响而采取的措施的成功。
澳大利亚新西兰临床试验注册中心（ANZCTR），编号：ACTRN12615000693527；注册日期：2015 年 7 月 3 日。
