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. 2025 Apr 14:36:e246407.
doi: 10.1590/0103-644020256407. eCollection 2025.

Evaluation of wooden spatula and plastic pipette methods for caries risk assessment in infants and toddlers

Silvina Tineo  1   2 , Paulo Nelson-Filho  3 , Thais Citolino Barbosa  3 , José Maria Alvarez Gimenez  1   2 , Raquel Assed Bezzera da Silva  3 , Lea Assed Bezzera da Silva  3 , Marta Estela Saravia  1   2
Affiliations

Evaluation of wooden spatula and plastic pipette methods for caries risk assessment in infants and toddlers

Silvina Tineo et al. Braz Dent J. .

Abstract
in English, Portuguese

The study aimed to compare two different methods (wooden spatula and plastic pipette) for the collection of unstimulated saliva for colony counting of Mutans Streptococci species (MS) (microbiological caries risk), in infants and toddlers. The children's behavior was favorable (very comfortable or comfortable) and unfavorable (uncomfortable or very uncomfortable), while the saliva collection, was also evaluated. Saliva samples were obtained from 19 children aged 1-29 months, of both sexes and seeded by both methods, obtaining the MS CFU numbers. The ANOVA test was used to statistically analyze the microbiological results, and the Z-test and chi-square test were used to analyze the behavioral assessment (α= 0,05%). 63.1% and 57.9% of children had MS in their saliva, using the saliva collection techniques with a spatula and a pipette, respectively. The number of CFUs was an average of 10.47 for saliva collected with the spatula and 7.32 for saliva collected with the pipette, however, there was no statistical difference between the methods (p=0.696653). Comparing the ages 1-6 months and 18-29 months, the older children showed higher CFU numbers, for both methods (p=0.000383). The clinical assessment of the child's behavior demonstrated a significant statistical difference between the two methods, with more positive behavior for the spatula (p<0.001). In conclusion, the wooden spatula method can be used for saliva collection and quantifying of the MS levels in infants and toddlers, since there was no significant difference in the CFUs count, furthermore is better accepted based on the child's behavior, compared to the plastic pipette technique.

O estudo teve como objetivo comparar dois métodos diferentes (espátula de madeira e pipeta plástica) para coleta de saliva não estimulada para contagem de colônias de espécies de Estreptococos do grupo Mutans (EM) (risco microbiológico de cárie), em bebês e crianças de 1 a 3 anos. O comportamento das crianças, favorável (muito confortável ou confortável) e não favorável (desconfortável ou muito desconfortável), durante a coleta de saliva, também foi avaliado. Amostras de saliva foram obtidas de 19 crianças, de 1 a 29 meses de vida, de ambos os sexos, para obtenção das UFCs de EM. O teste ANOVA foi utilizado para a análise estatística dos resultados microbiológicos, e o teste-Z e o teste qui-quadrado foram utilizados para a análise da avaliação comportamental (α= 0,05%). 63,1% e 57,9% das crianças apresentaram EM na saliva, utilizando as técnicas de coleta de saliva com espátula e pipeta, respectivamente. O número de UFC foi em média 10,47 para a saliva coletada com espátula e 7,32 para a saliva coletada com a pipeta, porém sem diferença estatística entre os métodos (p=0,696653). Comparando as idades de 1 a 6 meses e de 18 a 29 meses, as crianças mais velhas apresentaram maior número de UFCs, para ambos os métodos (p=0,000383). A avaliação clínica do comportamento da criança demonstrou diferença estatística significativa entre os dois métodos, com comportamento mais favorável para a espátula (p<0,001). Concluindo, o método da espátula de madeira pode ser utilizado para a coleta de saliva e quantificação dos níveis de EM em bebês e crianças de 1 a 3 anos, uma vez que não houve diferença significativa na contagem de UFCs, além de ser mais bem aceito, com base no comportamento da criança, em comparação à técnica da pipeta plástica.

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Figures

Figure 1
Figure 1. Collection of saliva samples in infants and toddlers, by wooden spatula technique and seeding in SB-20M culture medium. A - Adapted wooden spatula; B - Collection of saliva sample; C- Spatula breakage with the aid of sterilized tweezer; D - Sample seeding in the SB-20M culture medium.
Figure 2
Figure 2. Collection of saliva samples in infants and toddlers, by disposable plastic pipette technique and seeding in SB-20M culture medium. A - Disposable plastic pipette; B - Collection of saliva sample; C- Saliva sample deposited in sterilized Petri dishes, for the immersion of the wooden spatula; D - Wooden spatula seeding in the SB-20M culture medium.
Figure 3
Figure 3. Boxplot showing the number of CFUs obtained in infants (children aged 1-6 months) and toddlers (children aged 18-29 months), after collecting saliva using a wooden spatula (Sample I) or plastic pipette (Sample II).
Figure 4
Figure 4. Results of the evaluation of infants and toddlers' behavior during unstimulated saliva collection using a wooden spatula or plastic pipette.
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