Evaluation of wooden spatula and plastic pipette methods for caries risk assessment in infants and toddlers

The study aimed to compare two different methods (wooden spatula and plastic pipette) for the collection of unstimulated saliva for colony counting of Mutans Streptococci species (MS) (microbiological caries risk), in infants and toddlers. The children's behavior was favorable (very comfortable or comfortable) and unfavorable (uncomfortable or very uncomfortable), while the saliva collection, was also evaluated. Saliva samples were obtained from 19 children aged 1-29 months, of both sexes and seeded by both methods, obtaining the MS CFU numbers. The ANOVA test was used to statistically analyze the microbiological results, and the Z-test and chi-square test were used to analyze the behavioral assessment (α= 0,05%). 63.1% and 57.9% of children had MS in their saliva, using the saliva collection techniques with a spatula and a pipette, respectively. The number of CFUs was an average of 10.47 for saliva collected with the spatula and 7.32 for saliva collected with the pipette, however, there was no statistical difference between the methods (p=0.696653). Comparing the ages 1-6 months and 18-29 months, the older children showed higher CFU numbers, for both methods (p=0.000383). The clinical assessment of the child's behavior demonstrated a significant statistical difference between the two methods, with more positive behavior for the spatula (p<0.001). In conclusion, the wooden spatula method can be used for saliva collection and quantifying of the MS levels in infants and toddlers, since there was no significant difference in the CFUs count, furthermore is better accepted based on the child's behavior, compared to the plastic pipette technique.