Oral health status in children with black tooth stain

Black stain (BS) is a frequently observed condition in children and often leads to dental visits due to aesthetic concerns. Despite its association with the risk of caries, comprehensive data on the oral and dental health of children with BS, including the presence of caries, gingival health status, salivary parameters, the presence of halitosis, and nutritional status, are limited. Therefore, this study aimed to evaluate and compare the oral-dental health statuses of children with and without BS.

The cross-sectional study evaluated demographic findings, oral hygiene habits, oral-dental health status, presence of halitosis, and nutritional characteristics. Oral-dental health status was evaluated using the decayed-missing-filled indices (dmft-dmfs-DMFT-DMFS), ICDAS-II index, pufa/PUFA index, plaque index (PI), and gingival index (GI). The presence of halitosis was determined by sulfur monitoring. Salivary pH, salivary buffering capacity, and salivary flow rate were also assessed. Nutritional characteristics were determined using a 3-day food record and a food frequency questionnaire. Statistical analyses were performed using the independent samples t-test, Mann-Whitney U test, and Fisher's exact test. Statistical significance was considered at the 5% level for the results of all analyses. In addition to p-values, effect sizes were calculated to assess the magnitude of differences between groups.

From a total of 1720 patients initially assessed for study inclusion, and BS was observed in 69 patients (4.01%). 23 children with BS (study group) and 27 children without BS (control group), aged 6-13 years, were included in this study. The mean dmft-dmfs-DMFT-DMFS scores were 2.6 ± 2.7, 6.2 ± 7.3, 2.6 ± 2.5, and 2.7 ± 2.4 for children with BS and 3.4 ± 4.1, 9.8 ± 11.6, 4.1 ± 3.1, and 5.4 ± 5 for children without BS, respectively. In the BS group, the level of cavitated caries lesions in permanent teeth, the mean DMFS score, the mean PI score, and mean salivary pH and salivary buffering capacity were significantly higher (p ≤ 0.05 for all). No statistically significant differences were observed between the groups in other evaluated parameters, including volatile sulfur compound levels (p > 0.05). In the BS group, the mean intake of molasses, a food rich in iron, was significantly higher (p ≤ 0.05). Given the relatively small sample size, the generalizability of the findings is limited.

Children with BS have lower rates of dental caries. Low caries levels in children with BS may be related to their low PI values, high salivary pH, and high salivary buffering capacity.