Prospective study of oral health in children and adults with cystic fibrosis (CF)

<bold>Introduction:</bold> People with CF (pwCF) have less caries than the general population <age 10 but worse oral health in adulthood. Risk factors may include altered saliva flow, diet and medications affecting pH and the oral microbiota. <bold>Methods:</bold> This longitudinal 3-center study includes pwCF ages 12-30 years. Study measures are dental exam, lung function, respiratory cultures, medications and microbiome by 16S rRNA sequencing of unstimulated saliva and plaque. <bold>Results:</bold> Results from the initial 49 pwCF (32 children ≤21 years and 17 adults) on CFTR modulators show preserved FEV1 (mean 92% predicted, SD 20%). <italic>S. aureus</italic> was the most frequent respiratory pathogen (isolated from 20 participants). Any tooth decay was noted in 38% of pwCF, with a higher % of decayed surfaces in adults (79.5±6.7 vs. 35.2±5.6, p=<0.01) and an overall higher dental disease severity (DMFS index) in adults (5.5±1.3 vs. 2.2±0.9, p=0.04). Enamel defects were noted in 54%, gingivitis in 67% and 20% of surfaces with bleeding in the cohort. These findings, as well as saliva flow and pH did not differ by age group. Oral health did not differ by chronic antibiotic use. Among the 16 most prevalent genera in saliva, the relative abundance of <italic>Streptococcus</italic> was lower and <italic>Haemophilus</italic> higher among those with FEV1 <80% vs. ≥80%, but relative abundance of these genera did not differ by presence of any tooth decay. PwCF on chronic antibiotics had higher relative abundance of <italic>Streptococcus</italic> and <italic>Rothia</italic> compared to those not on antibiotics. <bold>Summary:</bold> This preliminary analysis shows considerable dental disease but no association between oral health and chronic antibiotics but differences in salivary microbiome by lung function. Microbiome analyses are ongoing.