Salivary microbial counts and buffer capacity in children with acute lymphoblastic leukemia
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Published on: October 17, 2025
Li-Wei Ou-Yang1, Pei-Ching Chang, Aileen I Tsai
1Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan (Republic of China).
Insights
Children with acute lymphoblastic leukemia (ALL) undergoing chemotherapy had lower salivary Streptococcus mutans but also reduced salivary buffer capacity. Oral prevention strategies are crucial for these patients, especially those with diminished buffer capacity.
Area of Science:
- Pediatric Oncology
- Oral Health
- Immunocompromised Patients
Background:
- Children undergoing chemotherapy for acute lymphoblastic leukemia (ALL) face unique oral health challenges.
- Maintaining oral health is critical during cancer treatment to prevent complications.
Purpose of the Study:
- To assess caries activity in children with ALL during maintenance chemotherapy.
- To compare oral health parameters between ALL patients and healthy controls.
Main Methods:
- Examined 46 children with ALL (age 3-12) undergoing maintenance chemotherapy.
- Clinical dental examination (DMF/DEFTS) and salivary analysis (Streptococcus mutans, lactobacilli, buffer capacity) were performed.
- A control group of age and sex-matched healthy children was included for comparison.
Main Results:
- Salivary Streptococcus mutans counts were significantly lower in ALL children (P<.001).
- Salivary lactobacilli counts were similar between groups (P=.47).
- ALL children exhibited significantly lower salivary buffer capacity (P=.002) and a trend towards higher caries scores (DEFTS/DMFTS).
Conclusions:
- Children with ALL undergoing chemotherapy present with altered salivary parameters, notably reduced buffer capacity.
- Targeted oral prevention strategies are recommended for ALL patients, particularly those with low salivary buffer capacity.
Purpose:
The aim of this study was to evaluate the caries activity in children undergoing maintenance stage chemotherapy courses.
Methods:
Forty-six children with acute lymphoblastic leukemia (ALL) were examined, the age ranged from 3 to 12 years with a mean age of 7(1/2) years. They were under maintenance stage chemotherapy at the Department of Pediatric Hematology of Chang-Gung Memorial Hospital, Taoyuan, Taiwan. A control group of healthy children was recruited by age and sex-matching criteria. The children received only a clinical dental examination without radiographs. Decayed (D), Missing (M), and Filled (F) Tooth surfaces (S) scores were recorded following the WHO criteria. After oral examination, stimulated saliva samples were collected from the subjects to exam the salivary Streptococcus mutans counts, salivary lactobacilli counts and salivary buffer capacity.
Result:
The Wilcoxon signed-rank test shows that the salivary Streptococcus mutans counts in ALL children were significantly lower than healthy subjects (P<.001) and lactobacilli counts were similar on both groups (P=.47). However, the ALL group tended to have lower salivary buffer capacity than the control group (P=.002). The mean DEFTS/DMFTS scores of the ALL group were higher than the control group, but the differences did not reach statistical significance.
Conclusions:
Specific oral prevention regimens for ALL children undergoing chemotherapy should be planned for patients with unusually low salivary buffer capacity.
