title: Clinical, salivary, and bacterial markers for caries risk  assessment in schoolchildren: a 4-year follow-up.
abstract: BACKGROUND
  In Mexico, there is a high prevalence of dental caries and large groups of children still show extensive untreated dental damage.
  
  
  OBJECTIVE
  This study aims to evaluate, in a cohort of 6-year-old Mexican children, the relationship between caries increment at 4 years and the following caries risk markers: fissure morphology, caries experience, salivary flow rate, Snyder test results, and mutans and lactobacilli counts.
  
  
  METHODS
  To predict new caries lesions in 110 schoolchildren, clinical, salivary, and bacteriological caries risk markers were used, including fissure morphology, caries experience, salivary flow rate, Snyder test, and Streptococcus mutans and lactobacilli counts. To determine the validity of these markers, the baseline data were compared with the caries increment after 4 years.
  
  
  RESULTS
  The risk model's capacity to predict caries was moderate (specificity 79.6% and sensitivity 78.6%). Caries experience (P = 0.0001), Snyder test (P = 0.002), and fissure morphology (P = 0.024) had the strongest association with caries increment. Salivary flow rate, lactobacilli, and S. mutans counts did not contribute significantly to the prediction of caries lesions in these children.
  
  
  CONCLUSIONS
  In addition to the initial caries experience, tooth morphology and Snyder test proved to be useful predictors for caries. These three risk markers may be particularly useful in targeting caries prevention efforts in developing countries.
authors.affiliation: Area for Research in Clinical Sciences, Health Care Department, Metropolitan Autonomous University, Mexico. tlsperez@correo.xoc.uam.mx
authors.forename: Leonor
authors.initials: L
authors.lastname: Sánchez-Pérez
authors.forename: Jordan
authors.initials: J
authors.lastname: Golubov
authors.forename: M Esther
authors.initials: ME
authors.lastname: Irigoyen-Camacho
authors.forename: Patricia Alfaro
authors.initials: PA
authors.lastname: Moctezuma
authors.forename: Enrique
authors.initials: E
authors.lastname: Acosta-Gio
mesh_terms: D015415:Biomarkers / Q000032:analysis; D002648:Child; D015331:Cohort Studies; D015169:Colony Count, Microbial; D004245:DMF Index; D003732:Dental Caries Activity Tests; D003733:Dental Caries Susceptibility / Q000502:physiology*; D003750:Dental Fissures / Q000473:pathology*; D003773:Dental Plaque / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification*; D008297:Male; D008800:Mexico; D015203:Reproducibility of Results; D018570:Risk Assessment; D012463:Saliva / Q000378:metabolism* / Q000382:microbiology; D012636:Secretory Rate; D012680:Sensitivity and Specificity; D013295:Streptococcus mutans / Q000302:isolation & purification*
chemical_list: D015415:Biomarkers