title: Role of microbiological factors in predicting early childhood caries.
abstract: OBJECTIVE
  Microbiological methods that accurately identify caries-susceptible children may enhance caries control and assist treatment planning. This study's purpose was to evaluate the usefulness of two microbiological indicators (mutans streptococci [MS] and lactobacilli [LB] levels), singly and in combination, for predicting early childhood caries (ECC) and their contributions in multifactorial modeling.
  
  
  METHODS
  A total of 1,782 randomly selected three- to five-year-olds were recruited and underwent oral examination and microbiological tests using commercially available diagnostic kits. A questionnaire was completed by their parents. After 12 months, the caries increment in 1,576 (∼88 percent) children was assessed.
  
  
  RESULTS
  Caries risk increased with the MS and LB levels but plateaued above the LB level of 10(5) CFU/ml saliva. MS, LB, and combined MS+LB models predicted one-year caries increment (Δdmft>0) with a sensitivity/specificity of 79 percent/67 percent, 51 percent/89 percent, and 66 percent/85 percent, respectively. Sensitivity/specificity reached 80 percent/80 percent when baseline caries experience ("past caries") was added to the MS+LB model and up to 85 percent/80 percent and 81 percent/85 percent when psychosociobehavioral factors and oral hygiene status were added to the MS+LB model, without and with "past caries," respectively.
  
  
  CONCLUSIONS
  The combined "mutans streptococci+lactobacilli+past caries" model is useful for identifying at-risk children. Incorporating MS and LB into a biopsychosociobehavioral model slightly improved the prediction, even without "past caries".
authors.affiliation: Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Gao
authors.affiliation: Oral Sciences, Faculty of Dentistry, at the National University of Singapore, Singapore. denhsus@nus.edu.sg.
authors.forename: Chin-Ying Stephen
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Oral Sciences, Faculty of Dentistry, at the National University of Singapore, Singapore.
authors.forename: Teresa
authors.initials: T
authors.lastname: Loh
authors.affiliation: Department of Decision Sciences, School of Business, at the National University of Singapore, Singapore.
authors.forename: Brian
authors.initials: B
authors.lastname: Hwarng
authors.affiliation: PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam; Saw Swee Hock School of Public Health, at the National University of Singapore, Singapore.
authors.forename: David
authors.initials: D
authors.lastname: Koh
mesh_terms: D019540:Area Under Curve; D058491:Bacterial Load; D002652:Child Behavior; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000382:microbiology*; D003733:Dental Caries Susceptibility / Q000502:physiology*; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D015438:Health Behavior; D006801:Humans; D007778:Lactobacillus / Q000502:physiology*; D008297:Male; D009910:Oral Hygiene; D011446:Prospective Studies; D012372:ROC Curve; D011934:Reagent Strips; D018570:Risk Assessment; D012463:Saliva / Q000382:microbiology; D012680:Sensitivity and Specificity; D013295:Streptococcus mutans / Q000502:physiology*
chemical_list: D011934:Reagent Strips