Correlating dental caries with oral bacteria and the buffering capacity of saliva in children in Madinah, Saudi Arabia

Introduction: Caries is associated with high counts of mutans streptococci (MS), lactobacillus (LB), and a low saliva buffering capacity (BC). No study using odds ratios (OR) has correlated caries and these factors and no similar study has been done in Saudi Arabia before. Objectives: To determine: The prevalence of caries, the number of colony forming units (CFUs) of MS and LB, the saliva buffering capacity (BC) and the relationship between these factors. Materials and Methods: This was an analytical cross sectional study on children from Madinah. Caries was recorded using dmft/DMFT (decayed, missing, filled teeth). The scores for MS and LB and the BC of saliva was calculated using the Caries Risk Test (CRT)®. Results: A total of 316 students were examined; two-thirds (62%) were female and 25% were caries free. Saliva was collected from 235 participants and the majority had high MS and LB scores (66 and 71%, respectively) while 25% had a low saliva BC. The odds for those who had high LB and MS CFUs, were 9 and 4 times more at risk to developing dental caries and those with a low BC had significantly more caries (P = 0.03). The likelihood for those having severe caries and high counts of LB and MS was 25 (P < 0.01) and 6 (P = 0.042) times greater, respectively, compared to those with no or mild caries. Those with multiple risk factors were more likely to have caries compared to those with single or no risk factors present. Conclusions: The prevalence of caries was relatively high and many respondents had greater than 105 CFUs/ml of MS and LB. Almost all with a low BC had severe caries. There was a strong correlation between high MS, high LB, and low BC and the high prevalence of caries; hence the combination of these factors could be confidently used to predict caries in this population.