Early childhood caries and candida albicans
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ABSTRACT DATA SOURCES Seven electronic databases including PubMed, Web of Science, Scopus, Embase, Cochrane Library, LILACS and ClinicalTrials.gov and grey literature were searched. There
was no information regarding the restriction of language or publication date. STUDY SELECTION Four reviewers included both epidemiological and experimental clinical studies that investigated
the presence of oral _C. albicans_ in children (age < 6 years), with or without ECC. Studies including children with severe systematic diseases were excluded. DATA EXTRACTION AND
SYNTHESIS Data were abstracted independently by four reviewers. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.
Meta-analysis was performed. The overall odds ratio of associations between the presence of _C. albicans_ and ECC was calculated. Subgroup analysis on the different sample collection sites
(plaque, swab and saliva) was performed. RESULTS Fifteen cross-sectional studies were included for the qualitative assessment and nine studies for meta-analysis. Regarding the quality
assessment, all included studies were rated as ‘fair’ or ‘good’. Children with the presence of oral _C. albicans_ had 6.51 times as likely, to have ECC experience, compared to those without
_C. albicans_ (95% CI: 4.948.57, p<0.01). The odds of experiencing ECC in children with _C. albicans_ versus those without _C. albicans_ were 6.69 for plaque, 6.3 for oral swab, and 5.26
for salivary samples. CONCLUSIONS Children with oral _C. albicans_ have higher odds of experiencing ECC, compared to children without _C. albicans_. You have full access to this article via
your institution. Download PDF SIMILAR CONTENT BEING VIEWED BY OTHERS IRANIAN EARLY CHILDHOOD DENTAL CARIES: A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS OF PREVALENCE AND ASSOCIATED
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CARIES IN INDIAN POPULATION – A SYSTEMATIC REVIEW AND META-ANALYSIS Article 03 August 2023 COMMENTARY Early childhood caries (ECC) is the most common childhood oral disease that affects
young children worldwide, particularly in disadvantaged communities or developing countries.1 The aetiology of ECC has been related to multi-species bacterial infection. _Streptococcus
mutans_ and _Lactobacillus_ species are commonly studied in the literature. In recent years, microbiological data have revealed that fungal organisms were also associated with dental caries
in childhood. In particular, _Candida albicans_ was frequently detected at higher levels in children with severe ECC, compared with children without ECC.2 However, no positive correlation
was found between ECC experience and _C. albicans_, while implying it may be regarded as a cornerstone commensal organism.3 The role of Candida in the pathogenesis of ECC remains ambiguous.4
The authors of the present study endeavoured to evaluate the association between oral _C. albicans_ and caries experience in young children through a meta-analysis and systematic review. An
extensive database search was conducted by four reviewers. Restriction on language or publication date were not clearly stated. Almost all of the included studies were published in English,
except one in Chinese. The publication year of the included studies ranged from 2000 to 2016. After retrieving the full texts, reasons for exclusions were not clearly described. There was
no restriction on study designs (including all experimental and epidemiological studies), nevertheless, there were no cohort or randomised clinical studies found, with only cross-sectional
studies included. Quality assessment of the studies was carried out and none of them was graded as ‘low’ quality. Although the magnitude of pooled odds ratio estimates highly supported the
relationship of the presence of _C. albicans_ and caries experience, potential biases may have occurred. The authors recognised the study limitations due to the types of studies included and
small sample size of most studies. Another concern was the heterogeneity of the study designs regarding the different sample collection sources, various types of fungal identifications and
caries diagnostic criteria. However, the generalisability or external validity was not mentioned. Since the majority of the included studies recruited their participants from clinics or
unspecified places, there is uncertainty if these groups would be representative of the general child population. Publication bias, in which positive findings have a higher chance of being
published in the early stages of discovery, may be also a threat, possibly leading to invalid conclusions. Registered prospective studies may be helpful to prevent biases associated with
nonpublication. Despite a strong association between _C. albicans_ and ECC, these results should be interpreted with caution, as the quality of the available evidence is likely to be low due
to the high risk of biases derived from the cross-sectional studies. A statistical association does not mean that one variable inevitably causes the other. Nevertheless, this summary paper
provides insightful information regarding the potential role of _C. albicans_ in ECC development, and enhances interest among paediatric dentists and general practitioners. In summary, there
is limited evidence that the presence of oral _C. albicans_ is significantly associated with ECC. Prospective cohort studies are needed to clarify whether _C. albicans_ is a causative
factor of dental caries in young children or in other age groups of populations. The complex fungal-bacterial ecology and host response mechanisms during the caries process should be further
studied. REFERENCES * Duangthip D, Gao SS, Lo EC, Chu CH . Early childhood caries among 5- to 6-year-old children in Southeast Asia. _Int Dent J_ 2017; 67:98–106. Article Google Scholar *
Xiao J, Moon Y, Li L, _et al_. Candida albicans carriage in children with severe early childhood caries (S-ECC) and maternal relatedness. _PLoS One_ 2016; 11: e0164242. Article Google
Scholar * Janus MM, Willems HM, Krom BP . Candida albicans in multispecies oral communities: a keystone commensal? _Adv Exp Med Biol_ 2016; 931:13–20. Article Google Scholar * Neves AB,
Lobo LA . Pinto KC _et al_. Comparison between clinical aspects and salivary microbial profile of children with and without early childhood caries: A Preliminary Study. _J Clin Pediatr Dent_
2015; 39:209–214. Article Google Scholar * Duangthip D, Gao SS, Lo EC, Chu CH . Early childhood caries among 5- to 6-year-old children in Southeast Asia. _Int Dent J_ 2017; 67:98–106.
Article Google Scholar * Xiao J, Moon Y . Li L _et al_. Candida albicans carriage in children with severe early childhood caries (S-ECC) and maternal relatedness. _PLoS One_ 2016; 11:
e0164242. Article Google Scholar * Janus MM, Willems HM, Krom BP . Candida albicans in multispecies oral communities: a keystone commensal? _Adv Exp Med Biol_ 2016; 931:13–20. Article
Google Scholar * Neves AB, Lobo LA . Pinto KC _et al_. Comparison between clinical aspects and salivary microbial profile of children with and without early childhood caries: A Preliminary
Study. _J Clin Pediatr Dent_ 2015; 39:209–214. Article Google Scholar Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Faculty of Dentistry, The University of Hong Kong,
Hong Kong Duangthip D Authors * Duangthip D View author publications You can also search for this author inPubMed Google Scholar ADDITIONAL INFORMATION Address for correspondence: Jin Xiao,
625 Elmwood Ave. Rochester, NY 14618 (USA). E-Mail: [email protected] XIAO J, HUANG X, ALKHERS N _ET AL_. Candida albicans and early childhood caries: A Systematic Review and
Meta-Analysis. _Caries Res_ 2018; 52: 102-112. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE D, D. Early childhood caries and candida albicans. _Evid
Based Dent_ 19, 100–101 (2018). https://doi.org/10.1038/sj.ebd.6401337 Download citation * Published: 21 December 2018 * Issue Date: December 2018 * DOI:
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