Clinical outcomes for Early Childhood Caries (ECC): the influence of salivary mutans streptococci levels.
OBJECTIVE
To assess the relationship between clinical outcomes for children treated for Early Childhood Caries (ECC) and salivary mutans streptococci (MS) levels.


METHODS
The study cohort consisted of 79 children (42 males, 37 females) treated for ECC, aged from 2.3 to 7.3 years at time of entry. Whole non-stimulated saliva samples were obtained from each subject prior to dental surgery and at 6 mths post dental surgery, by saturating a cotton swab in the saliva pooled in the floor of the mouth. Samples were placed into PBS on ice and processed within 2 hours. Samples were sonicated, serially diluted and plated onto MSB and SBA agar plates, then incubated 48 hours anaerobically; SBA plates were incubated an additional 24 hours aerobically. The MS level in each sample was expressed as a percentage of the total cultivable flora. The cohort was evaluated for new caries lesions at 6 months post dental surgery. Relapse was defined as the presence of new smooth surface caries lesions.


METHODS
Comparisons between Relapse (R) and Non-Relapse (NR) groups with respect to mutans streptococci levels were performed using Wilcoxon tests. Within group comparisons were performed using Wilcoxon signed-rank tests.


RESULTS
57 children (72%) returned for the 6 months examination and 21 of these subjects (37%) relapsed. No statistically significant difference in median salivary MS levels existed between the R (0.20%) and NR (0.033%) groups at baseline (p=0.647) or at 6 months post dental surgery (R=0.03%; NR=0.01%; p=0.273). A statistically significant difference between baseline and 6 months post dental surgery was noted in the median salivary MS level within the R group (p=0.0007) and within the NR group (P<0.0001).


CONCLUSIONS
The relapse rate (37%) was high and rapid for children treated for ECC. Dental surgery resulted in a statistically significant reduction in salivary MS reservoirs for children treated for ECC. However, this did not translate into acceptable clinical outcomes.
Chase
I
I
Department of Pediatric Dentistry, School of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada.
Berkowitz
R J
RJ
Mundorff-Shrestha
S A
SA
Proskin
H M
HM
Weinstein
P
P
Billings
R
R
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015169:Colony Count, Microbial; D003442:Crowns; D003731:Dental Caries / Q000382:microbiology / Q000628:therapy*; D003793:Dental Restoration, Permanent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012463:Saliva / Q000382:microbiology*; D018709:Statistics, Nonparametric; D013295:Streptococcus mutans / Q000302:isolation & purification*; D016986:Streptococcus sobrinus / Q000302:isolation & purification*; D014094:Tooth, Deciduous / Q000473:pathology; D016896:Treatment Outcome