Kopycka-Kedzierawski D T, Scott-Anne K, Ragusa P G, Cvetanovska M, Flint K, Feng C, Watson G E, Wong C L, Billings R J, Quivey R J, O'Connor T G
Department of Dentistry and Center for Oral Biology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
Center for Oral Biology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
JDR Clin Trans Res. 2022 Apr;7(2):163-173. doi: 10.1177/2380084421999365. Epub 2021 Mar 10.
Early childhood caries (ECC) is a complex, multifactorial oral disease that is a major public health concern because it is prevalent, profoundly alters a child's quality of life, is difficult to treat effectively, and has a distressing tendency to recur following treatment.
The purpose of the study was to examine social, psychological, and behavioral predictors of salivary bacteria and yeast in young children at risk for ECC.
A sample of 189 initially caries-free preschool children was assessed for child stress physiology from salivary cortisol, child and family stress exposure, diet, oral health behaviors, and sociodemographic risks. Multiple logistic regression analysis was implemented to examine the associations between these risk factors and cariogenic microorganisms: mutans streptococci (MS), lactobacilli (LB), and species.
Higher baseline salivary cortisol (odds ratio [OR] = 6.26; 95% confidence level [CL], 1.69-23.16) and a blunted response to an acute laboratory stressor (OR = .56; 95% CL, .37-.83) were associated with an increased likelihood of elevated salivary MS (≥10 colony-forming units/mL) in caries-free children. Sociodemographic risk for cariogenic microorganisms was also found. Specifically, lower education attainment of the parent/primary caregiver was associated with children being more likely to carry salivary species and elevated salivary MS; in addition, children from households with an unemployed parent/primary caregiver were more likely (OR = 3.13; 95% CL, 1.2-8.05) to carry salivary species and more likely (OR = 3.03; 95% CL, 1.25-7.33) to carry elevated levels of MS and/or salivary and/or LB.
The impact of sociodemographic risk and stress physiology on cariogenic disease processes are evident prior to ECC onset. The findings provide novel data on the early onset of cariogenic processes in children and the importance of considering sociodemographic, psychosocial, and behavioral factors when judging ECC risk.
The findings provide valuable and novel findings that, pre-ECC onset, the caries disease process is explicable from a detailed assessment of behavioral, sociodemographic, and psychosocial stress variables.
幼儿龋齿（ECC）是一种复杂的多因素口腔疾病，是一个重大的公共卫生问题，因为它很普遍，会严重改变儿童的生活质量，难以有效治疗，并且在治疗后有令人苦恼的复发倾向。
本研究的目的是检查有患ECC风险的幼儿唾液中细菌和酵母菌的社会、心理和行为预测因素。
对189名最初无龋齿的学龄前儿童样本进行了评估，包括唾液皮质醇测定的儿童应激生理学、儿童和家庭应激暴露、饮食、口腔健康行为以及社会人口统计学风险。采用多元逻辑回归分析来检验这些风险因素与致龋微生物之间的关联：变形链球菌（MS）、乳酸杆菌（LB）和 菌种。
基线唾液皮质醇水平较高（优势比[OR]=6.26；95%置信区间[CL]，1.69 - 23.16）以及对急性实验室应激源反应迟钝（OR=.56；95%CL，.37 -.83）与无龋齿儿童唾液中MS水平升高（≥10菌落形成单位/毫升）的可能性增加相关。还发现了致龋微生物的社会人口统计学风险。具体而言，父母/主要照顾者的教育程度较低与儿童携带唾液 菌种以及唾液中MS水平升高的可能性更大相关；此外，父母/主要照顾者失业家庭的儿童携带唾液 菌种的可能性更大（OR = 3.13；95%CL，1.2 - 8.05），携带MS和/或唾液 和/或LB水平升高的可能性也更大（OR = 3.03；95%CL，1.25 - 7.33）。
在ECC发病之前，社会人口统计学风险和应激生理学对致龋疾病过程的影响就很明显。这些发现为儿童致龋过程的早期发病以及在判断ECC风险时考虑社会人口统计学、心理社会和行为因素的重要性提供了新的数据。
这些发现提供了有价值的新发现，即在ECC发病前，通过对行为、社会人口统计学和心理社会应激变量的详细评估可以解释龋齿疾病过程。
