The Associations between Snack Intake and Cariogenic Oral Microorganism Colonization in Young Children of a Low Socioeconomic Status

Abstract

Cariogenic microorganisms are crucial pathogens contributing to the development of early childhood caries. Snacks provide fermentable carbohydrates, altering oral pH levels and potentially affecting microorganism colonization. However, the relationship between snack intake and cariogenic microorganisms like Candida and Streptococcus mutans in young children is still unclear. This study aimed to assess this association in a prospective underserved birth cohort. Data from children aged 12 to 24 months, including oral microbial assays and snack intake information, were analyzed. Sweet and non-sweet indices based on the cariogenic potential of 15 snacks/drinks were created. Mixed-effects models were used to assess the associations between sweet and non-sweet indices and S. mutans and Candida carriage. Random forest identified predictive factors of microorganism carriage. Higher non-sweet index scores were linked to increased S. mutans carriage in plaques (OR = 1.67, p = 0.01), potentially strengthening with age. Higher sweet index scores at 12 months were associated with increased Candida carriage, reversing at 24 months. Both indices were top predictors of S. mutans and Candida carriage. These findings underscore the associations between snack intake and cariogenic microorganism carriage and highlight the importance of dietary factors in oral health management for underserved young children with limited access to dental care and healthy foods.

Keywords: Candida albicans; Streptococcus mutans; oral health; snack intake.

Figure 1

Participant flow diagram of the study.

Figure 2

(A) The relationship between sweet index scores and predicted probability of Candida carriage in saliva at 12, 18, and 24 months. (B) The relationship between sweet index scores and predicted probability of Candida carriage in plaques at 12, 18, and 24 months. (C) The relationship between non-sweet index scores and predicted probability of S. mutans carriage in saliva at 12, 18, and 24 months. (D) The relationship between non-sweet index scores and predicted probability of S. mutans carriage in plaques at 12, 18, and 24 months. The blue line represents the relationship at 12 months and the blue area represents the confidence interval; the red line represents the relationship at 18 months and the red area represents the confidence interval; and the green line represents the relationship at 24 months and the green area represents the confidence interval.