Evaluating Preventive Health Strategies: Salivary Biomarkers as Non-Invasive Indicators of Caries Risk in School Children
Salivary Biomarkers for Caries Risk in Children
DOI:
https://doi.org/10.54393/pjhs.v5i10.2012Keywords:
Salivary Biomarkers, Caries Risk, School Children, Oral Health, Non-Invasive TestingAbstract
Dental caries, a prevalent oral health condition affecting 514 million children aged <6 years, globally, was a significant public health concern. Salivary biomarkers offer a non-invasive approach to assessing caries risk. However, research on the specific role of salivary components in caries progression and prevention was limited. This systematic review aimed to evaluate the potential of salivary biomarkers as a valuable tool for predicting caries risk in school children. Objective: To evaluate the role of Salivary Biomarkers in risk assessment of caries in school children. Methods: A systematic review of literature published between January 2009 and February 2024 focused on studies investigating the association between salivary biomarkers and caries risk in school-aged children. PubMed, Google Scholar, Cochrane Library, Springer, and Science Direct were searched, and the PRISMA guidelines were followed. 500 full-text papers were screened for eligibility, and 43 studies meeting the inclusion criteria were evaluated, relevant information was extracted, and a systematic review was conducted with 43 included studies. Results: Salivary biomarkers, including proteomics, microbiota, sugar metabolization, IgA levels, and salivary metabolic profiles, were significantly correlated with the risk of developing caries. Salivary samples demonstrated superior sensitivity, specificity, cost-effectiveness, and patient acceptance compared to blood samples for predicting caries risk. Conclusions: The findings suggested that salivary biomarkers hold promise as valuable non-invasive tools for stratifying caries risk in school children. Further research was needed to validate these biomarkers and integrate them into routine dental care to improve preventive strategies.
References
Sathiyakumar T, Vasireddy D, Mondal S. Impact of sociodemographic factors on dental caries in children and availing fluoride treatment: a study based on National Survey of Children's Health (NSCH) data 2016-2019. Cureus. 2021 Sep; 13(9). doi: 10.7759/cureus.18395.
Siddiqui AA, Alshammary F, Mulla M, Al-Zubaidi SM, Afroze E, Amin J et al. Prevalence of dental caries in Pakistan: a systematic review and meta-analysis. BioMed Central Oral Health. 2021 Dec; 21: 1-2. doi: 10.1186/s12903-021-01802-x.
Javaid MA, Ahmed AS, Durand R, Tran SD. Saliva as a diagnostic tool for oral and systemic diseases. Journal of Oral Biology and Craniofacial Research. 2016 Jan; 6(1): 67-76. doi: 10.1016/j.jobcr.2015.08.006.
Lukacs JR and Largaespada LL. Explaining sex differences in dental caries prevalence: Saliva, hormones, and "life‐history" etiologies. American Journal of Human Biology: The Official Journal of the Human Biology Association. 2006 Jul; 18(4): 540-55. doi: 10.1002/ajhb.20530.
Acharya S, Mathur MR, Tadakamadla SK, Brand A. Assessing the status of oral health integration in South East Asian Regional Office countries' Universal Health Coverage-A scoping review. The International Journal of Health Planning and Management. 2024 Mar; 39(2): 262-77. doi: 10.1002/hpm.3751.
Sun X, Huang X, Tan X, Si Y, Wang X, Chen F et al. Salivary peptidome profiling for diagnosis of severe early childhood caries. Journal of Translational Medicine. 2016 Dec; 14: 1-1. doi: 10.1186/s12967-016-0996-4.
Hemadi AS, Huang R, Zhou Y, Zou J. Salivary proteins and microbiota as biomarkers for early childhood caries risk assessment. International Journal of Oral Science. 2017 Nov; 9(11): e1-. doi: 10.1038/ijos.2017.35.
Featherstone JD, Crystal YO, Alston P, Chaffee BW, Doméjean S, Rechmann P et al. A comparison of four caries risk assessment methods. Frontiers in Oral Health. 2021 Apr; 2: 656558. doi: 10.3389/froh.2021.656558.
Adams AB. Caries risk assessment. The Chronicle. 1995 Jan; 58(1): 10-3. doi: 10.1111/j.1875-595x.1999.tb00503.x.
Ribeiro CC, Pachêco CD, Costa EL, Ladeira LL, Costa JF, da Silva RA et al. Proinflammatory cytokines in early childhood caries: Salivary analysis in the mother/children pair. Cytokine. 2018 Jul; 107: 113-7. doi: 10.1016/j.cyto.2017.12.009.
Tvarijonaviciute A, Martinez-Lozano N, Rios R, de Teruel MC, Garaulet M, Cerón JJ. Saliva as a non-invasive tool for assessment of metabolic and inflammatory biomarkers in children. Clinical Nutrition. 2020 Aug; 39(8): 2471-8. doi: 10.1016/j.clnu.2019.10.034.
Martins JR, Diaz-Fabregat B, Ramirez-Carmona W, Monteiro DR, Pessan JP, Antoniali C. Salivary biomarkers of oxidative stress in children with dental caries: Systematic review and meta-analysis. Archives of Oral Biology. 2022 Jul; 139: 105432. doi: 10.1016/j.archoralbio.2022.105432.
Hajishengallis E, Forrest CB, Koo H. Early childhood caries: Future perspectives in risk assessment. Journal of Dental Research Clinical and Translational Research. 2016 Jul; 1(2): 110. doi: 10.1177/2380084416637577.
Martins C, Buczynski AK, Maia LC, Siqueira WL, de Araujo Castro GF. Salivary proteins as a biomarker for dental caries-a systematic review. Journal of Dentistry. 2013 Jan; 41(1): 2-8. doi: 10.1016/j.jdent.2012.10.015.
Hegde MN, Attavar SH, Shetty N, Hegde ND, Hegde NN. Saliva as a biomarker for dental caries: A systematic review. Journal of Conservative Dentistry and Endodontics. 2019 Jan; 22(1): 2-6. doi: 10.4103/JCD.JCD_531_18.
Wang K, Zhou X, Li W, Zhang L. Human salivary proteins and their peptidomimetics: Values of function, early diagnosis, and therapeutic potential in combating dental caries. Archives of Oral Biology. 2019 Mar; 99: 31-42. doi: 10.1016/j.archoralbio.2018.12.009.
Yoshizawa JM, Schafer CA, Schafer JJ, Farrell JJ, Paster BJ, Wong DT. Salivary biomarkers: toward future clinical and diagnostic utilities. Clinical Microbiology Reviews. 2013 Oct; 26(4): 781-91. doi: 10.1128/CMR.00021-13.
Mira A, Artacho A, Camelo-Castillo A, Garcia-Esteban S, Simon-Soro A. Salivary immune and metabolic marker analysis (SIMMA): a diagnostic test to predict caries risk. Diagnostics. 2017 Jun; 7(3): 38. doi: 10.3390/diagnostics7030038.
Fernando S, Tadakamadla S, Kroon J, Lalloo R, Johnson NW. Predicting dental caries increment using salivary biomarkers in a remote Indigenous Australian child population. BioMed Central Oral Health. 2021 Dec; 21: 1-0. doi: 10.1186/s12903-021-01702-0.
Lalloo R, Tadakamadla SK, Kroon J, Tut O, Kularatna S, Boase R et al. Salivary characteristics and dental caries experience in remote Indigenous children in Australia: a cross-sectional study. BioMed Central Oral Health. 2019 Dec; 19: 1-9. doi: 10.1186/s12903-018-0692-2.
Lin X, Wang Y, Ma Z, Xie M, Liu Z, Cheng J et al. Correlation between caries activity and salivary microbiota in preschool children. Frontiers in Cellular and Infection Microbiology. 2023 Apr; 13: 1141474. doi: 10.3389/fcimb.2023.1141474.
Manzoor M, Lommi S, Furuholm J, Sarkkola C, Engberg E, Raju S et al. High abundance of sugar metabolisers in saliva of children with caries. Scientific Reports. 2021 Feb; 11(1): 4424. doi: 10.1038/s41598-021-83846-1.
Divaris K. Predicting dental caries outcomes in children: a "risky" concept. Journal of Dental Research. 2016 Mar; 95(3): 248-54. doi: 10.1177/0022034515620779.
Hamalaw SJ, Kareem FA, Gul SS. Association of dental and gingival health status with level of salivary characteristics and Streptococcus mutans in children. Journal of Dental Sciences. 2021 Mar; 16(2): 744-50. doi: 10.1016/j.jds.2020.08.006.
Menon I and Bhat N. Association of passive smoking with dental caries and salivary biomarkers among 5-10 years old children of Muradnagar, Ghaziabad. Journal of Family Medicine and Primary Care. 2019 Aug; 8(8): 2633-9. doi: 10.4103/jfmpc.jfmpc_369_19.
Nomura Y, Shimada Y, Hanada N, Numabe Y, Kamoi K, Sato T et al. Salivary biomarkers for predicting the progression of chronic periodontitis. Archives of Oral Biology. 2012 Apr; 57(4): 413-20. doi: 10.1016/j.archoralbio.2011.09.011.
Sánchez-Pérez L and Acosta-Gı́o AE. Caries risk assessment from dental plaque and salivary Streptococcus mutans counts on two culture media. Archives of Oral Biology. 2001 Jan; 46(1): 49-55. doi: 10.1016/S0003-9969(00)00095-9.
Angarita-Díaz MP, Simon-Soro A, Forero D, Balcázar F, Sarmiento L, Romero E et al. Evaluation of possible biomarkers for caries risk in children 6 to 12 years of age. Journal of Oral Microbiology. 2021 Jan; 13(1): 1956219. doi: 10.1080/20002297.2021.1956219.
Rudney JD, Staikov RK, Johnson JD. Potential biomarkers of human salivary function: a modified proteomic approach. Archives of Oral Biology. 2009 Jan; 54(1): 91-100. doi: 10.1016/j.archoralbio.2008.08.007.
Stojković B, Igić M, Stoimenov TJ, Janjić OT, Ignjatović A, Kostić M et al. Can salivary biomarkers be used as predictors of dental caries in young adolescents?. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2020 Jun; 26: e923471-1. doi: 10.12659/MSM.923471.
Alamoudi A, Alamoudi R, Gazzaz Y, Alqahtani AM. Role of salivary biomarkers in diagnosis and detection of dental caries: a systematic review. Diagnostics. 2022 Dec; 12(12): 3080. doi: 10.3390/diagnostics12123080.
Salman BN, Darvish S, Goriuc A, Mazloomzadeh S, Hossein Poor Tehrani M, Luchian I. Salivary oxidative stress markers' relation to oral diseases in children and adolescents. Antioxidants. 2021 Sep; 10(10): 1540. doi: 10.3390/antiox10101540.
Jayaraj D and Ganesan S. Salivary pH and buffering capacity as risk markers for early childhood caries: A clinical study. International Journal of Clinical Pediatric Dentistry. 2015 Sep; 8(3): 167. doi: 10.5005/jp-journals-10005-1307.
Petrović B, Stilinović N, Tomas A, Kojić S, Stojanović GM. Determination of salivary concentrations of leptin and adiponectin, ability to reduce ferric ions and total antioxidant capacity of saliva in patients with severe early childhood caries. Frontiers in Pediatrics. 2022 Aug; 10: 969372. doi: 10.3389/fped.2022.969372.
Rajkumaar J and Mathew MG. Association of severe early childhood caries with salivary ferritin. Journal of Family Medicine and Primary Care. 2020 Aug; 9(8): 3991-3. doi: 10.4103/jfmpc.jfmpc_9_20.
Pani SC, Abuthuraya D, AlShammery HM, AlShammery D, AlShehri H. Salivary cortisol as a biomarker to explore the role of maternal stress in early childhood caries. International Journal of Dentistry. 2013 May; 2013(1): 565102. doi: 10.1155/2013/565102.
Pappa E, Vougas K, Zoidakis J, Papaioannou W, Rahiotis C, Vastardis H. Downregulation of salivary proteins, protective against dental caries, in type 1 diabetes. Proteomes. 2021 Jul; 9(3): 33. doi: 10.3390/proteomes9030033.
Idowu OS, Duckworth RM, Valentine RA, Zohoori FV. Biomarkers for the assessment of fluoride exposure in children. Caries Research. 2020 Aug; 54(2): 134-43. doi: 10.1159/000504166.
Laputková G, Schwartzová V, Bánovčin J, Alexovič M, Sabo J. Salivary protein roles in oral health and as predictors of caries risk. Open Life Sciences. 2018 May; 13(1): 174-200. doi: 10.1515/biol-2018-0023.
Guo L and Wenyuan S. Salivary biomarkers for caries risk assessment. Journal of the California Dental Association. 2013 Feb; 41(2): 107-18. doi: 10.1080/19424396.2013.12222284.
Zhou X, Li H, Zhu C, Yuan C, Meng C, Feng S et al. Analysis of salivary proteomic biomarkers for the surveillance of changes in high-risk status of early childhood caries. BioMed Central Oral Health. 2021 Dec; 21: 1-0. doi: 10.1186/s12903-021-01930-4.
Choudhary A, Bhat M, Choudhary H, Joshi V, Walia SS, Soni RK. Prevalence of Dental Caries with Salivary Assessment in Six to Twelve Years Old School-Going Children in Shahpura Tehsil, Jaipur. Cureus. 2022 Aug; 14(8). doi: 10.7759/cureus.27802.
George S, Soman A, Jo S, Beegum F, Habibullah MA. Salivary Proteinase 3 as a Biomarker for Caries Severity in Children: A Cross-sectional Study. The Journal of Contemporary Dental Practice. 2024 Mar; 25(3): 236-40. doi: 10.5005/jp-journals-10024-3648.
Sánchez‐Pérez L, Golubov J, Irigoyen‐Camacho ME, Moctezuma PA, Acosta‐Gio E. Clinical, salivary, and bacterial markers for caries risk assessment in schoolchildren: a 4‐year follow‐up. International Journal of Paediatric Dentistry. 2009 May; 19(3): 186-92. doi: 10.1111/j.1365-263X.2008.00941.x.
Seredin P, Goloshchapov D, Ippolitov Y, Vongsvivut P. Pathology-specific molecular profiles of saliva in patients with multiple dental caries-potential application for predictive, preventive and personalised medical services. The European Powder Metallurgy Association Journal. 2018 Jun; 9: 195-203. doi: 10.1007/s13167-018-0135-9.
Diaz-Fabregat B, Ramirez-Carmona W, Cannon ML, Monteiro DR, Pessan JP, Antoniali C. Are salivary NO2−/NO2− and NO3− levels biomarkers for dental caries in children? Systematic review and meta-analysis. Nitric Oxide. 2024 Jan. doi: 10.1016/j.niox.2024.01.001.
Syed M, Sachdev V, Chopra R. Intercomparison of salivary nitric oxide as a biomarker of dental caries risk between caries-active and caries-free children. European Archives of Paediatric Dentistry. 2016 Aug; 17: 239-43. doi: 10.1007/s40368-016-0234-z.
Faheem S, Maqsood S, Hasan A, Imtiaz F, Shaikh F, Farooqui WA. Associations of early childhood caries with salivary beta defensin-3 and childhood anemia: a case-control study. BioMed Central Oral Health. 2021 Dec; 21: 1-7. doi: 10.1186/s12903-021-01810-x.
Børsting T, Venkatraman V, Fagerhaug TN, Skeie MS, Stafne SN, Feuerherm AJ et al. Systematic assessment of salivary inflammatory markers and dental caries in children: an exploratory study. Acta Odontologica Scandinavica. 2022 Jul; 80(5): 338-45. doi: 10.1080/00016357.2021.2011400.
Wu Z, Gong Y, Wang C, Lin J, Zhao J. Association between salivary s-IgA concentration and dental caries: an updated meta-analysis. Bioscience Reports. 2020 Dec; 40(12): BSR20203208. doi: 10.1042/BSR20203208.
Zhao A, Blackburn C, Chin J, Srinivasan M. Soluble toll like receptor 2 (TLR-2) is increased in saliva of children with dental caries. BioMed Central Oral Health. 2014 Dec; 14: 1-5. doi: 10.1186/1472-6831-14-108.
Hamid H, Adanir N, Asiri FY, Abid K, Zafar MS, Khurshid Z. Salivary IgA as a Useful Biomarker for Dental Caries in Down Syndrome Patients: A Systematic Review and Meta-analysis. European Journal of Dentistry. 2020 Oct; 14(04): 665-71. doi: 10.1055/s-0040-1716443.
Antonelli R, Massei V, Ferrari E, Gallo M, Pertinhez TA, Vescovi P et al. Salivary Diagnosis of Dental Caries: A Systematic Review. Current Issues in Molecular Biology. 2024 May; 46(5): 4234-50. doi: 10.3390/cimb46050258.
Musalem-Dominguez O, Montiel-Company JM, Ausina-Márquez V, Morales-Tatay JM, Almerich-Silla JM. Salivary metabolomic profile associated with cariogenic risk in children. Journal of Dentistry. 2023 Sep; 136: 104645. doi: 10.1016/j.jdent.2023.104645.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments