Oral microbiota in preschoolers with rampant caries: a matched case–control study

Rampant caries is identified by rapid onset, severe decay affecting multiple surfaces, and early pulp infection. This case-control study was conducted to investigate the disparities in oral microbiota between children affected by rampant caries and their caries-free counterparts. A total of 88 preschool children, with matched distribution of sex and age in both the case and control groups, participated in this study. Children's oral health-related behaviors were reported by parents, salivary pH levels were assessed using a portable pen-type pH meter, and supragingival dental plaque was analyzed by 16S rRNA gene sequencing. Children with rampant caries exhibited lower salivary pH levels, poorer toothbrushing habits, and more frequent consumption of sugary snacks. Veillonella, enriched in caries-free children, showed a positive correlation with salivary pH levels and a negative correlation with candy consumption. Conversely, Fusobacterium and Neisseria, more abundant in children with rampant caries, positively correlated with the frequency of candy consumption. Furthermore, Streptococcus mutans, Porphyromonas gingivalis, and Bacteroides acidifaciens were identified as potential oral microbiome markers for differentiating preschoolers with rampant caries from their caries-free peers. B. acidifaciens, typically found in the gut, has been rarely reported in the field of oral health. More well-designed cohort studies are recommended to elucidate the mechanisms through which gut microbiota influences rampant caries in pediatric patients and offer insights into effective strategies for caries management in young children. KEY POINTS: • Lower salivary pH levels in children with rampant caries. • Biomarkers for predicting rampant caries. • Impact of oral health-related behaviors on oral microbiota.