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. 2019 Jan 17;19(1):21.
doi: 10.1186/s12903-018-0692-2.

Salivary characteristics and dental caries experience in remote Indigenous children in Australia: a cross-sectional study

R Lalloo  1 , S K Tadakamadla  2 , J Kroon  2   3 , O Tut  2 , S Kularatna  4 , R Boase  5 , K Kapellas  6 , D Gilchrist  5 , E Cobbledick  2 , J Rogers  2 , N W Johnson  7   8   9
Affiliations

Salivary characteristics and dental caries experience in remote Indigenous children in Australia: a cross-sectional study

R Lalloo et al. BMC Oral Health. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Trial registration: Australian New Zealand Clinical Trials Registry ( ANZCTR ), No: ACTRN12615000693527; date of registration: 3rd July 2015.

Keywords: Australia; Bacteria; Children; Dental caries; Fluoridation; Indigenous; Remote; Saliva.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Griffith University Human Research Ethics Committee (GU Ref No: DOH/05/15/HREC) and the Far North Queensland Human Research Ethics Committee (FNQ HREC/15QCH/39–970). The Department of Education and Training (Queensland Government) also provided formal permission for us to approach potential research participants. Site Specific Approval was authorised by the Torres and Cape Hospital and Health Service. We have obtained written, signed informed consent from parents of all children in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Number of children approached and those that consented, and complied, with particular aspects of the study
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