Salivary Tumor Necrosis Factor-Alpha and Dental Caries in Children and Adolescents

Abstract

Background: Dental caries is one of the most common diseases during childhood. Saliva can modulate the process of decay, as a rich source of host factors. It has been shown that tumor necrosis factor-alpha (TNF-α) is secreted more in the saliva of individuals with active caries. No study has addressed the relationship between TNF-α levels and age or compared children's immune response at different age groups and during adolescence. Objectives: The present study aimed at evaluating the pro-inflammatory cytokine level of TNF-α in saliva and its association with caries in different age groups of children and adolescents. Methods: In this case-control study, 128 children and adolescents were divided to four age groups of 32. In each group, half of the individuals had no decay (control group) and the other half had > 4 decayed teeth (case group). Overall, 5 mL of non-stimulated saliva was spitted in sterile tubes for 15 minutes. Furthermore, 1 mL of each sample was centrifuged for five minutes at 12000 rpm. Salivary level of TNF-α was measured using the Enzyme Linked Immunosorbent Assay (ELISA) standard kit. Results: A total of 79 children were studied. The mean TNF-α levels in the case group was 35.20 ± 16.23 Pg/mL and in the control group, this was 26.20 ± 6.25 Pg/mL (P value = 0.001). The mean TNF-α level was significantly higher in the age group of six to 12 years than the age group of 13 to 18 years (P value = 0.01). Conclusions: The results of this study indicated that decay plays an important role in increasing cytokine TNF-α in non-stimulatory saliva, there is no confirming evidence of the direct effect of age on immune function yet.

Insights on the role of cytokines in carious lesions

“…This cytokine has an important role in host defense and inflammatory responses with multiple biologic effects. TNF-α acts on the growth, differentiation, and function of all cell types and seems to be an integral part of inflammatory and immunological events [45,48].…”

“…Sharma et al [6] evaluated salivary levels of inflammatory cytokines in children with early childhood caries and found an elevated level of TNF-α and, that the presence of this cytokine is correlated with the severe stage of the caries disease. The study conducted by Nazemisalman et al [48] concluded that tooth decay plays an important role in increasing cytokine TNF-α in non-stimulatory saliva. In contrary, Hussein et al [50] observed that the level of TNF-α in the saliva of smokers with dental caries were not significant in comparison to control.…”

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“…Dental and oral disease is an essential issue of the health sector in general; however, in developing countries, there is a tendency to increase dental and oral diseases, one of which is dental caries, which, if untreated, can lead to tooth necrosis [1][2][3][4][5][6][7][8][9][10]. Treatment of tooth decay, such as caries or pulp necrosis, necessitates crown restoration and the creation of a post [11].…”