Hyposalivation, acidic saliva, decayed teeth and oral yeast prevalence in children with mucopolysaccharidosis

Abstract

OBJECTIVE: Patients with mucopolysaccharidosis present several alterations of the stomatognathic complex, however, no data is available on saliva biochemistry and yeast colonization. The aim of the study was to evaluate caries experience as well as saliva biochemistry and microbiology parameters in patients with mucopolysaccharidosis. METHOD: The sample consisted of twelve participants with mucopolysaccharidosis followed in the Metabolic Disease Unit of the Centro Hospitalar de S. João and twelve healthy participants followed at the Faculty of Dental Medicine, University of Porto. To all participants, Decayed, Missing, Filled Teeth (DMFT) index was evaluated. In addition, saliva was collected to evaluate biochemical parameters (flow rate, pH, sodium, potassium, chloride, calcium, phosphate, α-amylase and IgA) and the microbiological profile (total microorganisms, mutans streptococci and yeasts) of all participants. RESULTS: In comparison to controls, the mucoplysacharidosis patients presented a higher prevalence of decayed teeth, lower salivary flow and pH values. They also presented also lower calcium and higher phosphate ions in saliva. No differences were found between groups regarding oral microbial load for total microorganisms, mutans streptococci and yeasts as well as oral prevalence of mutans streptococci. However, MPS patients presented higher prevalence of oral Candida in comparison to controls. CONCLUSION: The higher prevalence of decayed teeth and higher oral yeast colonization in MPS patients may be related to the lower saliva calcium concentration, pH and flow.

Analysis of salivary parameters of mucopolysaccharidosis individuals

“…37 Stimulated salivar y f low < 0.8m l/m in is considered a pathological condition and has been considered a strong indicator of increased caries risk. 37,38,39 In the present study, salivary flow rate and pH of stimulated saliva were reduced in MPS individuals when compared to controls, corroborating previous studies. 38 Eight subjects had salivary flow rate less than or equal to 0.3 ml / min.…”

Oral manifestations in children with mucopolysaccharidosis

“…In MPS patients a greater involvement of dentists is required, in order to arrive at better diagnostics and preventive protocols to improve oral health of these patients. 8,9,13,15,20,21,27,33,34 …”

The biochemistry of saliva throughout pregnancy

“…The formation and mineralization of teeth are greatly influenced by calcium and phosphate metabolism; 36 accordingly, low calcium content in saliva has been associated to dental caries, [37][38][39] due to enhanced enamel demineralization, reduced remineralisation and increased alveolar bone loss. 37,39 It should be noted that higher salivary phosphate levels were found in children with early childhood caries.…”

“…The formation and mineralization of teeth are greatly influenced by calcium and phosphate metabolism; 36 accordingly, low calcium content in saliva has been associated to dental caries, [37][38][39] due to enhanced enamel demineralization, reduced remineralisation and increased alveolar bone loss. 37,39 It should be noted that higher salivary phosphate levels were found in children with early childhood caries. 38 These inverted proportional calcium/phosphate saliva concentrations may be justified by phosphate homeostasis, where the secretion of parathyroid hormone in response to low serum calcium can increase phosphate efflux from bone, kidney and gastrointestinal tract.…”