Difference Between Pro- and Anti-Inflammatory Interleukins in Saliva of Children with Early Childhood Caries

Objectives: This study aimed to explore the levels of salivary interleukin-6 (IL-6) in children diagnosed with Early Childhood Caries (ECC) and Rampant Caries (RC). Additionally, it sought to determine whether salivary IL-6 levels vary with the increased activity or number of carious lesions in children with ECC and RC. Methods: A cross-sectional study was conducted at RAK College of Dental Sciences (RAKCODS), Ras Al Khaimah, UAE. Ethical approval was obtained, and 100 children aged 4 to 12 years were selected. Participants were divided into ECC and RC groups, each containing study and control subgroups of 25 children each. The study groups were children who had active carious lesions and the control groups were those children who had no active carious lesions. All of these children were screened and included as a part of the community engagement of the clinics. Saliva samples were collected and analyzed for IL-6 levels using an ELISA kit. Dental examinations and data collection adhered to standardized procedures, including specific clinical criteria for diagnosing ECC and RC and calibrated examiners to ensure consistent clinical assessments. Statistical analyses were conducted to compare salivary IL-6 levels between the study and control groups of each RC and ECC group and a test was also performed to assess the relationship between salivary IL-6 levels and the severity of dental caries. Results: This study found significantly higher mean salivary IL-6 levels in children with ECC (19.023 pg/mL) and RC (21.45 pg/mL) compared to their respective control groups (ECC: 6.42 pg/mL, RC: 11.43 pg/mL), with p-values < 0.0001. Strong positive correlations were observed between IL-6 levels and increased caries activity or severity, with Pearson's correlation coefficients of 0.961 for ECC and 0.954 for RC. Conclusions: This study concludes that significantly elevated salivary IL-6 levels are observed in children with ECC and RC. Furthermore, salivary IL-6 levels were found to rise in correlation with the increase in number of carious lesions. These findings support the potential of salivary IL-6 as a biomarker for assessing caries severity and highlight the need for future research to explore diverse populations and additional clinical parameters.

Introduction: Streptococcus mutans infection has been identified as an important microbial factor for early childhood caries (ECC). Candida species has been shown to enhance the adherence of S. mutans to the oral biofilm and carious tooth substance. However, there is a paucity of the literature regarding the association between S. mutans and Candida albicans related to the ECC. Aim: To assess and compare the levels of S. mutans and C. albicans among 3–5-year-old preschool children with and without ECC and to determine the association between them. Materials and Methods: A cross-sectional study was conducted among 30 children with ECC (ECC group) and 30 children without ECC (non-ECC group). Dental caries was assessed, and unstimulated saliva samples were collected. S. mutans and C. albicans counts were determined using Mutans-Sanguis agar and CHROMagar, respectively. Chi-square test and logistic regression were used. Significance levels were set at 5%. Results: There was a significant difference between ECC group and non-ECC group for S. mutans (P = 0.04) and C. albicans (P = 0.02) levels. There was no significant association between S. mutans and C. albicans in ECC and non-ECC groups. Children with ECC were more likely to have high levels of S. mutans and C. albicans when compared to non-ECC group. Conclusion: Children with ECC presented higher levels of S. mutans and C. albicans compared to children without ECC. High affinity between S. mutans and C. albicans suggests interaction between these diverse species that may mediate cariogenic development.

The study aimed to assess early childhood caries and its correlation with risk variables among school children. 242 children under the age of 5 years were clinically assessed and to ascertain early childhood caries, a validated structured questionnaire was utilized. Demographic data (four questions) and oral health-related activities questions (two questions) were included. To verify visible signs of caries on the occlusal, buccal, and lingual surfaces, the community periodontal index (CPI) probe was used. Caries was diagnosed using the WHO criteria for carious lesions Children's saliva samples (3 mL) were taken, and a digital portable pH meter was used to determine the pH level. All data were gathered and statistically analyzed. The mean age with early childhood caries (ECC) was 4.6 ± 0.4 and 3.8 ± 0.8 without ECC. In both the groups, the highest education of mothers was secondary and less [104 (59%) and 37 (56%), respectively]. In both with and without ECC, the maximum number of mothers Working was 111 (63%) and 41 (62%), respectively. The maximum number of children brushing their teeth once a day in both the groups were139 (79%) and 35 (53%), respectively, and 148 (84%) were using dentifrices to brush their teeth in the ECC group and 37 (56%) were using dentifrices to brush their teeth in without ECC group. The salivary pH is slightly less in with ECC (7.22 ± 0.34) group compared to without ECC group (7.48 ± 0.46). And there was a statistically significant difference found between the groups. The current study demonstrated a significant association between the risk factors under investigation and early childhood caries among school children considered in the present study. Identifying children who are at risk might be aided by early screening for caries development. Both developed and developing nations continue to face a major public health issue with ECC. Despite the extensive knowledge that dental health professionals possess about the variables that lead to the development of ECC, it continues to be the most common and neglected oral healthcare requirement in children. How to cite this article: Chavan S, Chetani H, Yumnam G, et al. Evaluation of Early Childhood Caries and Its Association with Risk Factors among School Children: A Cross-sectional Study. J Contemp Dent Pract 2024;25(8):758-761.

Aim &amp; Background: Limited data exists on infant feeding practices and the prevalence of Early Childhood Caries (ECC) in the Lucknow district of Uttar Pradesh, India. This study aimed to explore the relationship between feeding practices and the occurrence of ECC in preschool children. Materials and Methods: Children aged 24 to 71 months were screened for caries, and based on the presence or absence of caries, they were categorized into ECC and non-ECC groups. Feeding practices, food frequency, and dietary sugar intake were assessed through a parent-completed questionnaire. Results: The average duration of exclusive breastfeeding was significantly longer in the ECC group (13.49±8.59 months) compared to the non-ECC group (10.47±4.23 months) (p=0.007). A higher percentage of parents in the ECC group (94.6%) fed their children at sleep times, including naps, compared to 28.0% in the non-ECC group. Both groups combined breastfeeding with solid/semi-solid foods, feeding both day and night. However, 94.6% of parents in the ECC group put their children to sleep while breastfeeding, compared to 50.7% in the non-ECC group (p&lt;0.001). The average duration of bottle feeding was significantly longer in the ECC group (27.13±12.39 months) than in the non-ECC group (19.27±6.66 months) (p=0.001). Additionally, 94.1% of parents in the ECC group fed their children at bedtime, compared to only 14.3% in the non-ECC group. Most parents in the ECC group (66.7%) added sweeteners to milk, compared to 16.1% in the non-ECC group. Conclusion: Prolonged breastfeeding beyond 12 months and feeding at all bedtimes, including naps, were significantly associated with ECC. Prolonged and frequent bottle feeding with added sugars was also positively correlated with ECC in children in Lucknow.

The study assessed the caries risk in infants and children with and without early childhood caries (ECC) using American Academy of Pediatric Dentistry Caries Risk Assessment Tool (AAPD CRAT) and identified the association between caries risk and mode of birth delivery. This cross-sectional study included 96infants and childrenwith all maxillary and mandibular primary anterior teeth and at least two primary molars erupted clinically in the oral cavity. The details on the mode of birth delivery were noted in a preformed template along with the demographic details, followed by caries risk assessment (CRA) to assess the caries risk of an individual. The outcome assessment for overall caries risk was performed for the ECC and non-ECC group and compared against the mode of birth delivery. Descriptive statistics were performed for all the study variables (gender, overall caries risk, mode of birth delivery, and term of delivery). The Chi-square test was used to compare the categorical variables between the two groups (ECC and non-ECC groups). The high caries risk category contributed to 52.1% and 68.8% in the ECC and non-ECC groups, respectively. The prevalence of vaginal mode of delivery was 41.7% and 52.1% in the ECC and non-ECC groups, respectively. Caries risk increases with increasing age and the non-ECC group shows more risk (68.8%) than the ECC group. In comparison with the variables against the groups (ECC and non-ECC), Chi-square test revealed that only the term of delivery (p value = 0.035) and overall caries risk (p = 0.045) showed statistically significant difference. The proportion of high caries risk subjects was significantly more in the non-ECC groups. Children delivered by the C-section mode showed high caries risk (66.7%) when compared with the vaginal mode of delivery (53.3%). A validated CRAT for predicting caries risk is required.

Objective To discuss the difference of cariogenicity of Candida albicans from children with early childhood caries(ECC) and without caries. Methods Twenty-six strains isolated from children with early childhood caries as the ECC group and 24 strains from children with caries free(CF) as the CF group, were inoculated into Sabouraud liquid medium with different initial pH value (ranging from 4.0 to 7.0 at 0.5 intervals). After cultured at 37℃ for 48 h, the terminal pH value of medium was detected by pH meter to evaluate the acidogenicity, and the A540 was measured by spectrophotometer to assess the aciduricity. Moreover, all the strains were inoculated into the surface of hydroxyapatite(HA) plate, and colony formation unit was used to evaluate the adhesion ability. The ability of acidogenicity, aciduricity and adhesion of Candida albicans in ECC group and CF group were compared. Results There were no statistically significant difference of the acidogenicity in the changes of pH value and A540 value between ECC and CF group at initial pH value between 4.5-7.0(P>0.05), while the change of pH and A540 values of the acidogenicity was significantly higher in ECC group than that of CF group at initial pH value at 4. 0 (P 0.05). Conclusion The difference of Candida albicans from children with early childhood caries and those without caries of cariogenicity; strains of Candida albicans with stronger aciduricity may play an important role in the promoting the process of early childhood caries. Key words: early childhood caries(ECC); cariogenicity; acidogenicity; aciduricity; adhesion; Candida albicans

Early Childhood Caries (ECC) is one of the most common chronic childhood diseases. In spite of the global decrease in dental caries in the past decades, ECC has become a significant problem in many developing countries and also in a few industrialized nations. Saliva as a host factor can play an important role in the process of dental caries. The aim of this study was to compare sIgA and IgG as saliva components between ECC and caries-free groups. In this cross-sectional study, samples of unstimulated saliva of 90 children (45 in ECC group & 45 in caries-free group) were taken with Scully method. Then the concentration levels of sIgA and IgG were measured with Enzyme Linked Immunosorbent Assay and Single Radial Immunodiffusion methods. Mean concentration levels of salivary sIgA and IgG were significantly higher among children with ECC (p<0.05). There was also a weak inverse correlation between sIgA level and DMFT index in ECC group but it was not statistically significant (p=0.056). The high concentration of salivary immunoglobulin in children with ECC may be associated with an increased antigenic load, leading to high production of antibodies.

Early childhood caries (ECC) is characterized by the presence of one or more decayed, missing (due to caries), or filled teeth surfaces in any primary tooth, in a child below 6 years of age. Although ECC is primarily associated with high levels of maternal Streptococcus mutans, there has been an increased interest in finding the relationship between oral fungal flora and dental caries. The aim of the study is to identify and characterize the Candida species and to compare the candidal isolates in children with ECC and without ECC. The study was conducted on children below 6 years of age, who were categorized into ECC and non-ECC groups of fifty children each. Samples were collected using sterile cotton swabs and were inoculated on Sabouraud's Dextrose Agar and incubated at 37°C for 24 h. Candidal colonies were isolated, species identified and virulence factors tested for both ECC and non-ECC groups. The candidal carriage among the ECC children was found to be 84%, which was significantly higher than the non-ECC group of 24%. Candida albicans and non-albicans Candida (NAC) were isolated in both ECC and non-ECC groups. Phospholipase production was significantly high in ECC group whereas hemolysin production and germ tube formation showed no significant difference between the two groups. A significant correlation was found between the presence of Candida and ECC. NAC also plays an important role in the development of ECC. The virulence factors such as phospholipase may be responsible for the pathogenicity of Candida in the development of ECC.

Aim: The aim of this study was to evaluate whether the treated and untreated severe early childhood caries (ECC) in children would make any impact on the Permanent First Molar (PFM) decays.Materials and Methods: Our descriptive epidemiological study was conducted in Ataturk University, Faculty of Dentistry, Department of Pediatric Dentistry/Erzurum-Turkey, between 2011 and 2017. We included a total of 90 children (44 girls, 46 boys), and divided them into 3 equal groups. They were 6–9 years old with a mean age of 7.38 ± 0.89. Group 1 consisted of the patients who had previously been treated under GA, Group 2 included the patients with untreated ECC and with no previous dental treatment, and Group 3 consisted of the patients who had been periodically treated in normal clinical settings. Each patient was processed through; dmft scoring and PFM caries evaluation process in accordance with International Caries Detection and Assessment System (ICDAS), respectively. The obtained data was analyzed with SPSS v20.0. And also, we used One-way ANOVA, Kruskal-Wallis and Mann Whitney U tests.Results: In accordance with ICDAS, we found that Group 3 had the highest mean number of PFMs (2 ± 1.43) and Group 2 had the lowest (1.43 ± 1.45). In Group 2, the number of ICDAS-determined carious PFMs were significantly lower than the other groups (p < 0.05). However, ICDAS score 6 was 0 in Group 1, while it was determined higher as 4.2% in Group 2.Conclusion: In respect to our research outcomes, which revealed that regardless of treated or not severe ECC had a significant impact on the PFMs, we strongly recommend that the parent of the children experiencing ECC should be informed about the risk of future caries in PFMs.

To compare the permeability of the enamel of primary teeth from individuals free of Early Childhood Caries (ECC) with that from individuals affected with ECC by assessment of dye penetration using Laser Scanning Confocal Microscope (LSCM). Experimental in vitro study. Exfoliated primary maxillary anterior teeth (n = 44) were collected and divided into two groups (n=22 per group): samples with ECC (Group 1) and without ECC (Group 2). The samples were immersed in Rhodamine B dye solution for 1 day, cut longitudinally into 3 sections, observed using LSCM. Dye penetration depths in the incisal, middle, cervical thirds and on labial, lingual surfaces were recorded. Data were analyzed by the Mann-Whitney test (α = 5%, p < .005). The overall mean penetration depth for group 1 (100.6 μm ± 58.48 μm) was significantly higher than that of group 2 (31.55 μm ± 23.40 μm, p < .000). Mean penetration depth in the incisal, middle, and cervical thirds and on the labial and lingual surfaces of group 1 also presented significantly higher scores than in group 2 (p < .005). There was significantly more dye penetration in the ECC group than in the non-ECC group. This could be related to a higher level of enamel permeability in teeth affected with ECC.

BackgroundSeveral maternal health determinants during the first period of life of the child, as feeding practice, smoking habit and socio-economic level, are involved in early childhood health problems, as caries development. The potential associations among early childhood caries, feeding practices, maternal and environmental smoking exposure, Socio-Economic Status (SES) and several behavioral determinants were investigated.MethodsItalian toddlers (n = 2395) aged 24–30 months were recruited and information on feeding practices, sweet dietary habit, maternal smoking habit, SES, and fluoride supplementation in the first year of life was obtained throughout a questionnaire administered to mothers. Caries lesions in toddlers were identified in visual/tactile examinations and classified using the International Caries Detection and Assessment System (ICDAS). Associations between toddlers’ caries data and mothers’ questionnaire data were assessed using chi-squared test. Ordinal logistic regression was used to analyze associations among caries severity level (ICDAS score), behavioral factors and SES (using mean housing price per square meter as a proxy).ResultsCaries prevalence and severity levels were significantly lower in toddlers who were exclusively breastfed and those who received mixed feeding with a moderate–high breast milk component, compared with toddlers who received low mixed feeding and those exclusively fed with formula (p < 0.01). No moderate and high caries severity levels were observed in an exclusively breastfed children. High caries severity levels were significantly associated with sweet beverages (p < 0.04) and SES (p < 0.01). Toddlers whose mothers smoked five or more cigarettes/day during pregnancy showed a higher caries severity level (p < 0.01) respect to those whose mothers did not smoke. Environmental exposure to smoke during the first year of life was also significantly associated with caries severity (odds ratio =7.14, 95% confidence interval = 6.07-7.28). No association was observed between caries severity level and fluoride supplementation. More than 50% of toddlers belonging to families with a low SES, showed moderate or high severity caries levels (p < 0.01).ConclusionsHigher caries severity levels were observed in toddlers fed with infant formula and exposed to smoke during pregnancy living in area with a low mean housing price per square meter.

BackgroundIn recent years, the opportunistic fungus C.albicans has been linked to ECC.It is important to investigate the relationship between the distribution of C.albicans and early childhood caries (ECC) in 3–5-year-old Uygur and Han children in Kashgar, and the role of C.albicans of distinct genotypes in caries.MethodsTwo hundred fifty-six Uygur and 141 Han children were enrolled in the study. The identified C.albicans isolates were genotyped based on 25S rDNA Polymerase Chain Reaction(PCR) amplification, and their acidogenicity, aciduricity, and adhesiveness were examined. Moreover, secreted aspartic protease (Sap) activity and SAP1–5 transcriptional levels were compared in the ECC and caries-free (CF) groups of Uygur children.ResultsC.albicans detection rate was significantly higher in Uygur children than in Han children (44. 5% vs. 31. 2%; χ2= 6.739, P = 0.009);the A genotype was dominant in Uygur and Han children with ECC, the C genotype was dominant in Uygur CF children(P = 0.022). C.albicans acidogenicity and growth were more pronounced in the Uygur ECC group than in CF group, especially at pH 4.0 and 4. 5(pH 4.0, P = 0.012; pH 4. 5, P = 0.029); the average ratios of glass-wall adhesion and the Sap activity was higher in ECC group than in CF group(P < 0.01), and SAP2(P < 0.001) and SAP5(P = 0.001) were expressed more robustly in ECC group.ConclusionsThe strong acidogenicity and aciduricity, Sap activity, and high SAP2 and SAP5 expression might be closely associated with ECC. C.albicans potentially plays a key role in the progression of caries, which most readily affects genotype A carriers and could be attributed to person-to-person environmental variation.

Objective To investigate the expression of Interleukin 6 (IL-6) and interleukin 10 (IL-10) in cerebrospinal fluid(CSF) in patients with primary central nervous system lymphoma. Methods Forty cases of primary central nervous system lymphoma (PCNSL) , 11 cases of secondary central nervous system lymphomas(SCNS), 20 cases of brain metastase, 20 cases of central nervous system infection and 16 cases of other nervous system disease(ONSD) were collected during the period from July 2013 to December 2015 in Fudan University Hua Shan Hospital North. Enzyme linked immunosorbent assay was used to detect the levels of IL-6 and IL-10 in serum and cerebrospinal fluid. The overall level of each group was compared using Kruskal-Wallis test. Two independent samples were compared by U Mann-Whitney test. The diagnostic value of IL-6 and IL-10 levels for PCNSL was evaluated by ROC curve. Results In PCNSL group, BM group, SCNSL group, CNSI group and ONSD group, the serum levels of IL-6 and IL-10 were not statistically significant (H values were 4.165 and 5.368, respectively, P>0.05). IL-6 levels in CSF were significantly higher in CNSI[623.73 (1018.77-184.37) pg/ml]than those in other groups (ZPCNSL=51.36, ZSCNSL=28.18, ZBM=51.50, ZCNSI=85.45, ZONSD=42.16, P<0.05). The levels of IL-10 in CSF were significantly higher in CNSI and PCNSL than those in other groups (ZPCNSL=74.50, ZSCNSL=34.68, ZBM=35.35, ZCNSI=72.95, ZONSD=15.66, P<0.05). The levels of IL-10 in CSF in PCNSL group[64.88(20.03-206.14)pg/ml]was significantly higher than in SCNSL group[6.28(2.78-18.87)pg/ml, Z=-3.753, P<0.05], BM group[7.30(3.72-14.49)pg/ml, Z=-5.034, P<0.05]and ONSD group[3.14(2.931-4.20)pg/ml, Z=-5.786, P<0.05]. The area under the ROC curve of IL-6 and IL-10 levels in CSF was 0.461 and 0.806 respectively for the diagnosis of PCNSL. When IL-10 was 19.62 pg/ml, the sensitivity was 77.5% (31/40) and the specificity was 70.1% (47/67). The area under the ROC curve of CSF IL-6 and IL-10 levels was 0.861 and 0.718 respectively for the diagnosis of CNSI. When IL-6 was 155.12 pg/ml, the sensitivity was 80.0% (16/20) and the specificity was 90.8% (79/87). When IL-10 was 26.76 pg/ml, the sensitivity was 80.0% (16/20) and the specificity was 66.7% (58/87). Conclusion The expression levels of IL-6 and IL-10 in CSF can be used as an indicator for the differential diagnosis of primary central nervous system lymphoma.(Chin J Lab Med, 2016, 39: 585-588) Key words: Central nervous system neoplasms; Lymphoma; Interleukin-6; Interleukin-10; Cerebrospinal fluid

Introduction:Dental caries is the most prevalent chronic disease among children worldwide irrespective of the advancements in oral healthcare. The basis of considering dermatoglyphic patterns as marker for dental caries is that the epithelium of finger buds and enamel are both ectodermal in origin and develop during the same period of intrauterine life.Aim and Objective:To record and evaluate the dermatoglyphic patterns, its correlation with early childhood caries (ECC) and to predict its efficacy in assessing the caries risk.Method:The study was carried out on 100 school going children within the age group of 36–71 months. Study population was divided into two groups comprising of 50 individuals each on the basis of def score, experimental group (def ≥ 1) and control group (def score 0). Dermatoglyphic patterns of all ten palmar digits were recorded using Cummins and Midlo method and assessed using a magnifying glass (2×).Results:Statistically significant increase in number of whorls was found in ECC group, whereas higher number of loops was seen in control group. In ECC group, value of both, the mean axial t triradius angle and mean total ridge count was low as compared to the caries-free group.Conclusion:There is definite variation in dermatoglyphics between the ECC and caries-free group, indicating that dermatoglyphic patterns can be used as a non-invasive predictive tool for children with ECC.

The aim of this study is to evaluate the presence of candida, which is one of the etiological factors contributing to early childhood caries (ECC) and severe early childhood caries (S-ECC), in the dental plaque and saliva of children aged 6 years and younger. Our study involved 60 participants who met the inclusion criteria. Based on clinical examinations, we divided them into three groups, each consisting of 20 children: S-ECC, ECC, and caries-free groups. We collected dental plaque and saliva samples from the children during clinic visits. In the laboratory, we assessed these samples for the presence of candida using the Liofilchem® - ChromaticTM Candida (Roseto degli Abruzzi, Italy) medium and identified Candida species. The presence of Candida in the saliva of children with S-ECC (40%) and ECC (30%) was statistically significant compared to children without caries (p<0.05). Observationally, we found a higher presence of candida only in the dental plaque of children with S-ECC (25%) and ECC (15%) compared to children without caries (p>0.05). In the S-ECC group, we detected Candida albicans, Candida glabrata, Candida krusei, and Candida tropicalis in saliva, while Candida albicans was found in dental plaque. In the ECC group, Candida albicans, Candida glabrata, and Candida krusei were detected, whereas Candida was not detected in children without caries. It is important to consider the presence of Candida in both saliva and dental plaque, as it potentially plays a role in the pathogenesis of ECC. These findings suggest that identifying and preventing Candida colonization may be valuable for individual risk assessment and could contribute to reducing ECC.