Preventive Interventions Impact Salivary Physiology in a Remote Indigenous Community
Objectives: Assess the impact of preventative interventions on children’s salivary physiology in a remote Indigenous community in Australia.
Methods: This is part of a longitudinal study of cost-effectiveness of annual preventative interventions. Children aged 4-17 years of Northern Peninsula Area, Queensland, participated: almost all were Aboriginal/Torres Strait Islander. Those with parent’s consent comprised experimental groups, those without became controls. Active disease was treated before a “Big Bang” caries intervention: fissure-sealing; reducing bacterial load with Povidone Iodine; strengthening tooth structure/inhibiting plaque with Fluoride Varnish. Prior to intervention stimulated saliva was collected for flow rate, pH, buffering capacity and reserved for microbiomics using NGS. It was cultured on-site for mutans Streptococci (MS), Lactobacilli (LB) and Yeast at baseline and one year follow-up. Salivary hydration/consistency were visually inspected.
Results: At baseline 408 children participated, only 278 a year later. Mean pH, buffering and salivary flow increased significantly from 7.05±0.44, 9.39±2.13, and 1.13±0.6ml/min at baseline to 7.63±0.27, 11.00±1.75, and 1.37±0.66ml/min respectively after one year in experimental group. Corresponding figures in controls were, 7.06±0.50, 8.9±2.05, 1.1±0.47ml/min at baseline and 7.59±0.24, 11.15±1.3, 1.18±0.58ml/min at one year: not significantly different between experimental and controls. 48/109 subjects in the experimental group (44%) demonstrated a decrease in MS CFU (p=0.004) while there was no change in controls. There was no change in LB count in both groups, but 48% and 55% children in experimental and control groups respectively experienced decrease in Yeast counts at one year.
Conclusions: Children in both groups showed an increase in salivary pH, buffering capacity and stimulated flow, perhaps due to our oral health promotion advice. Salivary MS levels decreased in experimental but not in control group, indicating a sustained healthier oral environment. Yeasts are low and do not differentiate risk groups. The “Big Bang” has created a healthier oral environment one year later.