Dental plaque pH in predicting caries relapse after general anaesthesia – an exploratory study

Abstract

Objectives Numerous caries risk assessment tools have been proposed in the literature, with few validated in preschool children especially those receiving oral rehabilitation under general anaesthesia (GA). Past caries experience, the best predictor thus far, may not be a reliable indicator after effective clinical intervention. Hence, this longitudinal study was aimed to explore the potential role of plaque pH in predicting future caries incidence after GA among preschool children. Methods Oral examination, plaque pH measurements and questionnaire survey were performed, among pre‐schoolers indicated for GA, at baseline (n = 92), 6‐month (6M; n = 83), 12‐month (12M; n = 79) and 24‐month (24M; n = 66) recall visits after GA. Multivariable logistic regression and receiver‐operating characteristic analysis were performed to evaluate the predictive value of models with plaque pH and past caries experience. Results Individuals with low resting plaque pH at 6M and 12M were shown to be at high risk of 1‐year caries incidence at 12M [relative risk (RR) 1.41, 95% confidence interval (CI) 1.09–1.48] and 24M (RR 1.61, 95% CI 1.22–1.73) recall visit, respectively. Moreover, plaque pH demonstrated a statistically significant predictive value in the 12M and 24M models (12M/24M: 85%/77%) compared with past caries experience, which was not a significant predictor in both models (both P > 0.05). Conclusions Plaque pH may be a promising prognostic and predictive marker for early identification of high‐risk children undergoing oral rehabilitation under GA.

A systematic review of caries risk in children <6 years of age

“…32 The pH level of dental plaque is an indicator of future caries risk in high-risk children for a duration of up to 12 months. 54 Infants' saliva microbiome contains biomarker species whose abundance and presence might be used to predict present clinical status and/or future ECC onset. Streptococcus mutans surpasses most other oral bacteria in the ability to metabolize free sugars, especially sucrose.…”

“…The presence of dental plaque is a reliable and widely recognized sign that can help in the identification of the initial phases of ECC and also in assessing the extent or severity of the condition 32 . The pH level of dental plaque is an indicator of future caries risk in high‐risk children for a duration of up to 12 months 54 . Infants' saliva microbiome contains biomarker species whose abundance and presence might be used to predict present clinical status and/or future ECC onset.…”

“…45,53 The most commonly identified clinical variable associated with caries risk was dental plaque (ORs: 3.58, 5.20, 6.50, 8.90, 9.16). 2,20,22,32,49 One study reported it as a promising predictor of caries development among young children (RR: 1.61), 54 whereas another study also reported it as a significant factor for caries risk (HR: 5.32). 24 According to three studies, there is a connection between enamel hypoplasia and a higher risk of developing caries in the future (ORs: 8.90, 5.20, 12.25-26.92).…”

Factors Affecting Future Caries Occurrence Among Preschoolers in Northern Guangdong: A Longitudinal Study

“…However, individuals without previous caries experience may be at risk for new-onset caries, and baseline dmft may not be an effective predictor of these individuals. 21 In addition, the trajectory of disease in caries patients may not always be linear or static, especially after effective behavioral and clinical interventions. 22 Although the risk of new-onset caries is higher in individuals with more previous caries experience, 16 , 23 the risk is not zero in individuals without previous caries experience.…”