Integrating Salivary Cystatin S with Cariogram Risk Assessment Tool for Early Detection of Early Childhood Caries: A Case-Control Study

Aim: To evaluate the link between salivary cystatin S levels and early childhood caries, exploring its potential as a biomarker due to its role in enamel remineralization and demineralization inhibition. It also utilizes the Cariogram mobile app to assess caries risk, aiming to improve early detection and prevention in high-risk children.Methodology: A case-control study was conducted on 30 children (15 cases, and 15 controls). Unstimulated whole saliva was collected using spitting method, and cystatin S levels were measured using a human Cystatin S ELISA kit. Caries risk was assessed using the Cariogram mobile app.Results: Cystatin S concentrations were higher in the control group (10.28 ± 9.17 ng/ml) compared to the case group (8.41 ± 4.97 ng/ml), though the difference was not statistically significant (p = 0.852).. In the case group, 80% of children exhibited very high caries risk, whereas the control group showed a broader distribution, from very low (13.3%) to very high risk (26.7%). A statistically significant difference in caries risk was observed between the groups (p = 0.005)Conclusion: Cystatin S concentration was slightly higher in the control group than in the case group, however the difference was not statistically significant. This suggests that while cystatin S may have a protective role against dental caries, other factors likely contribute to caries development. Caries risk assessment is recommended for all children, including those who are caries-free, as our study revealed that even some caries-free children exhibited both high and very high caries risk.