Birth Cohort Study Identifies Candida albicans as a Risk Factor for Dental Caries

Area of Science:

• Oral Microbiology
• Pediatric Dentistry
• Infectious Diseases

Background:

• Severe early childhood caries (S-ECC) poses a significant public health challenge.
• The role of specific microorganisms, particularly fungi like Candida albicans, in S-ECC etiology requires further investigation.
• Prospective longitudinal studies are crucial for understanding the causal relationship between oral microbiota and caries development.

Purpose of the Study:

• To investigate the association between oral Candida albicans colonization and the onset of S-ECC in a low-income infant cohort.
• To identify early microbial predictors of S-ECC.
• To compare the predictive timing of C. albicans versus Streptococcus mutans in S-ECC development.

Main Methods:

• A prospective birth cohort study followed 160 infants from birth to 2 years, with oral samples collected at 7 time points.
• Candida species and Streptococcus mutans were quantified.
• Two-step LASSO penalized logistic regression and standard logistic regression were used to identify S-ECC risk factors.

Main Results:

• Candida albicans colonization increased the risk of S-ECC by 4.47-fold (OR, 1.28-15.58; P=0.02).
• C. albicans predicted S-ECC onset as early as 1 month, while S. mutans predicted it after 1 year.
• Other significant risk factors included plaque score (OR, 5.19) and salivary S. mutans (OR, 9.74).

Conclusions:

• Oral Candida albicans is a significant risk factor for S-ECC.
• C. albicans serves as an early biological marker for predicting S-ECC risk in infancy.
• Targeting fungal pathogens may offer novel strategies for caries prevention in pediatric populations.