ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Salivary Bacteria Levels Of Lactobacillus and Streptococcus Mutans Is Not A Reliable Indicator Of Caries Risk Of An Individual Patient
Clinical Question Is salivary bacteria level a reliable predictor of caries activity or caries risk?
Clinical Bottom Line Salivary bacteria levels (Lactobacillus and Streptococcus mutans) cannot reliably be used to predict the caries activities or caries risk in all groups of people.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 8260016Van Houte/1993At-risk children and adultsReview (diagnostic)
Key resultsThis is a review of studies that investigated the best factor or combination of factors for prediction of caries risk both children and adults. The main conclusion from the review is that the use of the counts of Lactobacillus and Streptococcus mutans for the prediction of caries risk of individuals is not possible but is more promising for that of the caries risk of groups (e.g., identification of high-caries-risk subjects); further, the prediction of low caries risk may be more reliable than that of high caries risk. Due to the multifactorial nature of caries, it is expected that multivariate approaches rather than the use of single parameters may improve caries risk prediction for individuals as well as groups of subjects.
#2) 21695390Leroy/20121057 childrenCohort, longitudinal
Key resultsThis study concluded that visible plaque, not salivary bacteria levels, as well as previous caries experienced are confirmed as significant risk factors for visible caries in preschool children.
Evidence Search Children: ((("Dental Caries"[Mesh]) AND "Saliva"[Mesh]) AND "Streptococcus mutans"[Mesh]) AND "Lactobacillus"[Mesh] Adults: (("Dental Caries Activity Tests"[Mesh] AND "Adult"[Mesh]) AND "Lactobacillus"[Mesh]) AND "Streptococcus mutans"[Mesh]
Comments on
The Evidence
Both articles are indicating that bacteria count cannot reliably be used to predict the caries activities or caries risk in all group of people. It may predict individuals at low risk or a population/community at high risk.
Applicability Salivary bacteria level tests do not pose any relative risk to the patient, but can be used to help determine patients who may be experiencing dental caries. Salivary bacteria level tests may be of better use as a primary caries risk diagnostic tool; i.e., used to determine patients with high cariogenic bacteria levels, who will then receive oral exams or bitewings for definitive diagnosis.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry)
Keywords Dental caries, risk assessment, adults, children, salivary cariogenic bacteria levels, Lactobacillus, Streptococcus mutans
ID# 2367
Date of submission: 03/11/2013spacer
E-mail kmclark3@gmail.com
Author Kevin Clark
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Bennett Amaechi, BDS, MSc, PhD
Faculty mentor/Co-author e-mail amaechi@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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