THE SIGNIFICANCE OF ORAL MUCOSAL DISEASES IN DENTAL CARIES OF PRIMARY TEETH: BIDIRECTIONAL RELATIONSHIPS, PATHOGENETIC MECHANISMS, AND CLINICAL IMPLICATIONS

Dental caries of primary teeth, particularly early childhood caries, remains one of the most common chronic diseases of childhood, while diseases of the oral mucosa, including oral candidiasis, primary herpetic gingivostomatitis, recurrent aphthous stomatitis, gingivitis, traumatic ulceration, and odontogenic mucosal lesions, are among the most frequent reasons for pediatric dental consultation. These two groups of conditions are usually studied separately, although they develop in the same oral environment, share several risk factors, and influence each other. This literature-based analytical article examines the epidemiology of caries of primary teeth and of oral mucosal diseases in children, analyzes the mechanisms through which mucosal diseases contribute to the onset and progression of caries, and describes the mucosal complications of untreated caries. A narrative synthesis of systematic reviews, meta-analyses, epidemiological surveys, experimental studies, and clinical guidelines was performed. The analysis shows that early childhood caries affects approximately 48% of preschool children worldwide and that caries of primary teeth affects about 514 million children. Children with oral Candida albicans have approximately six times higher odds of early childhood caries, and experimental studies have demonstrated a synergistic interaction between Candida albicans and Streptococcus mutans in cariogenic biofilms. Painful mucosal conditions interrupt toothbrushing, shift the diet toward soft and sweetened foods, and are often treated with sugar-containing liquid medicines, while untreated caries causes traumatic ulcers, odontogenic sinus tracts, and abscesses. The relationship between oral mucosal diseases and caries of primary teeth is therefore bidirectional. Comprehensive examination of the oral mucosa, prevention of caries during and after mucosal illness, use of sugar-free medicines, and timely treatment of carious teeth are essential components of pediatric dental care.