Social, Psychological, and Behavioral Predictors of Salivary Bacteria, Yeast in Caries-Free Children

Abstract

Introduction: Early childhood caries (ECC) is a complex, multifactorial oral disease that is a major public health concern because it is prevalent, profoundly alters a child’s quality of life, is difficult to treat effectively, and has a distressing tendency to recur following treatment. Objectives: The purpose of the study was to examine social, psychological, and behavioral predictors of salivary bacteria and yeast in young children at risk for ECC. Methods: A sample of 189 initially caries-free preschool children was assessed for child stress physiology from salivary cortisol, child and family stress exposure, diet, oral health behaviors, and sociodemographic risks. Multiple logistic regression analysis was implemented to examine the associations between these risk factors and cariogenic microorganisms: mutans streptococci (MS), lactobacilli (LB), and Candida species. Results: Higher baseline salivary cortisol (odds ratio [OR] = 6.26; 95% confidence level [CL], 1.69–23.16) and a blunted response to an acute laboratory stressor (OR = .56; 95% CL, .37–.83) were associated with an increased likelihood of elevated salivary MS (≥105 colony-forming units/mL) in caries-free children. Sociodemographic risk for cariogenic microorganisms was also found. Specifically, lower education attainment of the parent/primary caregiver was associated with children being more likely to carry salivary Candida species and elevated salivary MS; in addition, children from households with an unemployed parent/primary caregiver were more likely (OR = 3.13; 95% CL, 1.2–8.05) to carry salivary Candida species and more likely (OR = 3.03; 95% CL, 1.25–7.33) to carry elevated levels of MS and/or salivary Candida and/or LB. Conclusions: The impact of sociodemographic risk and stress physiology on cariogenic disease processes are evident prior to ECC onset. The findings provide novel data on the early onset of cariogenic processes in children and the importance of considering sociodemographic, psychosocial, and behavioral factors when judging ECC risk. Knowledge Transfer Statement: The findings provide valuable and novel findings that, pre-ECC onset, the caries disease process is explicable from a detailed assessment of behavioral, sociodemographic, and psychosocial stress variables.

A Prospective Longitudinal Study of Early Childhood Caries Onset in Initially Caries-Free Children

“…Oral microbiology was assessed from a sample of approximately 2 mL of saliva, which was collected from children at baseline assessment and 6, 12, 18, and 24 mo afterward. Microbiological profiles included MS, LB, and Candida species; details related to the microbiological procedures are described elsewhere (Kopycka-Kedzierawski et al 2021).…”

“…The demographic characteristics of the cohort of 189 caries-free children at baseline are presented elsewhere (Kopycka-Kedzierawski et al 2021). The mean age of the children upon enrollment was 29.5 mo (SD, 9.1).…”

Effect of psychological stress on the oral-gut microbiota and the potential oral-gut-brain axis

“…Various preclinical ( Table 1 ) [60] , [61] and clinical studies ( Table 2 ) [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] have demonstrated the effect of psychological stress on the oral microbiome via alterations in the diversity and taxonomic abundance of the bacteria. The alpha diversity measures the richness or evenness of the species within a sample, which is commonly determined by 16 S rRNA sequencing.…”

“… [69] Examining the social, psychological, and behavioral predictors of salivary bacteria in children at risk for Early Childhood Caries High baseline salivary cortisol was associated with increased salivary Streptococcus mutans . [70] Examining the role of stress and bacteria in childhood dental caries Low socioeconomic status, high salivary cortisol, and high cariogenic bacteria ( S. mutans and Lactobacillus ) were each significantly associated with dental caries. [71] Investigating the associations among salivary bacteria, oral emanations of volatile sulfur compounds, and academic-related chronic stress Academic-related chronic stress in students increased salivary Solobacterium moorei levels.…”

“…The relationship between psychological stress and cariogenic bacteria has been demonstrated previously. A study comprising children with early childhood caries reported that high baseline salivary cortisol was associated with increased salivary Streptococcus mutans [70] . In another study, low socioeconomic status, high salivary cortisol, and high amounts of cariogenic bacteria ( S. mutans and Lactobacillus ) were found to be significantly associated with dental caries [71] .…”