Key Factors Influencing Caries Development in Preschoolers: A Focus on Socio-Demographic, Maternal Health, and Salivary Biomarkers in 3-Year-Olds

BACKGROUND The study examined and compared the significance of sociodemographic, oral health behavior, and maternal factors, as well as salivary pH and salivary levels of human neutrophil peptide 1 (HNP-1), human b defensin 2 (hBD-2), and human cathelicidin (LL-37) as early caries predictors in 3-year-olds. MATERIAL AND METHODS A 1-year observational prospective study was conducted. The study included 165 caries-free children aged 36-48 months and their mothers. At baseline data were collected through a questionnaire for mothers and clinical examination of the children. For certain children (N=35), unstimulated saliva samples were collected to determine salivary pH using a digital portable pH meter and salivary levels of HNP-1, hBD-2, and LL-37 peptides using ELISA. After 12 months, caries incidence was determined. The caries-predictive significance of factors was estimated by logistic regression analysis. RESULTS After 1 year, caries was diagnosed in 29.1% of the children. Univariate logistic regression analysis revealed that the potentially most significant caries predictors in 3-year-olds were debris index >1 (OR 6.324, P<0.001), breastfeeding duration (OR 1.017, P=0.001), lack of a personal dentist (OR 2.454, P=0.012), and poor dental health of the mother (OR 10.521, P<0.001). The multivariate model confirmed that these variables are the potentially most significant caries predictors in 3-year-olds. CONCLUSIONS This 1-year study showed that the most significant early caries predictors in 3-year-olds are debris index, breastfeeding length, lack of a personal dentist, and poor dental health of mothers. The tested salivary parameters did not show caries-predictive significance.