Capability of Biological Characteristics in Caries Prediction for Children

Introduction: Caries-related biological profile of Singapore children remains unclear. Identifying caries-predictive biological tests is of clinical importance. Objective: to profile the salivary/microbiological characteristics and plaque pH of Singapore preschoolers and to evaluate the capability of these biological tests in caries prediction. Methods: 1782 preschoolers (3-5 years of age) in 13 randomly selected kindergartens participated in a questionnaire survey (completed by parents) and biological tests on stimulated saliva flow rate, buffering capacity, level of Streptococcus mutans (SM), level of Lactobacilli (LB), and plaque pH. The 1-year caries increment was calculated. Results: 80% of children had adequate salivary buffering capacity (end-pH°Ý6.0). 53% and 18% were identified with high SM level (°Ý105 CFU/ml saliva) and high LB level (>104 CFU/ml saliva), respectively. Plaque pH was high (>6.5) in 51% and low (<6.0) in 27% of children. Multiple demographic, socio-economic, and behavioral factors affected the biological characteristics. Used as a single predictor, "SM", "LB", and "plaque pH" tests reached the sensitivity/specificity of 79%/67%, 51%/89%, and 75%/84%, respectively, in predicting 1-year caries increment. The sensitivity/specificity were further improved to 66%/85%, 84%/82%, 82%/85%, and 81%/90%, for "SM+LB", "SM+pH", "LB+pH", and "SM+LB+pH", respectively. Conclusion: SM, LB, and plaque pH tests may be promising in caries prediction. (This study was financially supported by National University of Singapore Academic Research Funds R222-000-021-112 and R222-000-022-112.)