Abstract
Untreated tooth decays affect nearly one third of the world and is the most prevalent disease burden among children. The disease progression of tooth decay is multifactorial and involves a prolonged decrease in pH, resulting in the demineralization of tooth surfaces. Bacterial species that are capable of fermenting carbohydrates contribute to the demineralization process by the production of organic acids. The combined use of machine learning and 16s rRNA sequencing offers the potential to predict tooth decay by identifying the bacterial community that is present in an individual’s oral cavity. A few recent studies have demonstrated machine learning predictive modeling using 16s rRNA sequencing of oral samples, but they lack consideration of the multifactorial nature of tooth decay, as well as the role of fungal species within their models. Here, the oral microbiome of mother–child dyads (both healthy and caries-active) was used in combination with demographic–environmental factors and relevant fungal information to create a multifactorial machine learning model based on the LASSO-penalized logistic regression. For the children, not only were several bacterial species found to be caries-associated (Prevotella histicola, Streptococcus mutans, and Rothia muciloginosa) but also Candida detection and lower toothbrushing frequency were also caries-associated. Mothers enrolled in this study had a higher detection of S. mutans and Candida and a higher plaque index. This proof-of-concept study demonstrates the significant impact machine learning could have in prevention and diagnostic advancements for tooth decay, as well as the importance of considering fungal and demographic–environmental factors.
Highlights
Poor maternal and child oral health is a public health crisis with potential intergenerational health impacts
S. mutans entered the model as the first variable with an increased risk for caries (11.14% in early childhood caries (ECC) and 0.47% in caries-free children)
ML modeling of the oral microbiome has the potential to identify microbial biomarkers and aid in the prediction of dental caries
Summary
Poor maternal and child oral health is a public health crisis with potential intergenerational health impacts. Within dental biofilms/plaque, oral cariogenic bacteria metabolize dietary carbohydrates resulting in acid production and initiating demineralization of tooth enamel (Bowen, 2016). In a healthy (caries-free) mouth, the remineralization and demineralization rates are at equilibrium; when the demineralization rate exceeds the remineralization rate, tooth decay occurs (Takahashi and Nyvad, 2011; Abou Neel et al, 2016). Often, this shift from equilibrium is caused by a disruption in the ecology of the oral microbiome from a largely commensal community to a community dominated by cariogenic bacteria
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