Mutans Streptococci and Dental Caries: A New Statistical Modeling Approach

Area of Science:

• Oral epidemiology
• Biostatistics
• Pediatric dentistry

Background:

• Dental caries is a prevalent disease in preschool children.
• Mutans streptococci (MS) are key pathogens in caries development.
• Limited research exists on the time-dependent relationship between MS acquisition and caries onset.

Purpose of the Study:

• To assess the relationship between mutans streptococci (MS) acquisition and the time to dental caries occurrence.
• To utilize extended Cox hazard modeling with time-dependent covariates for this analysis.

Main Methods:

• Secondary analysis of a prospective study of 95 low socioeconomic status, African-American preschool children.
• Dental examinations and salivary MS tests were conducted annually from age 1 to 6 years.
• Extended Cox hazard modeling was employed to analyze MS acquisition (time-dependent) and caries experience (outcome).

Main Results:

• The median time to MS acquisition was 2 years; 79% tested positive by age 4.
• The median time to caries experience was 4 years; 68.4% developed caries.
• Extended Cox modeling showed a significant global relationship (HR=2.25) between MS acquisition and caries experience.

Conclusions:

• Extended Cox hazard modeling demonstrated a significant association between mutans streptococci acquisition and dental caries.
• This statistical approach was novel for analyzing this specific oral health relationship.
• Further research using causal mediation analysis with time-dependent variables is recommended.