Oral health status, salivary pH status, and Streptococcus mutans counts in dental plaques and saliva of children with acute lymphoblastic leukemia

Abstract

Background: Acute lymphoblastic leukemia (ALL), accounting for 23% of all malignancies in children,is the most prevalent pediatric malignancy. This study compared dental caries, oral hygiene status,salivary pH, and Streptococcus mutans counts in dental plaques and saliva of children with leukemiawith those of healthy controls.Materials and Methods: This case–control cross‑sectional study assessed 32 children withALL and 32 healthy children (4–9‑year‑old) for gingival bleeding index (GBI), decayed, missing, andfilled/decayed, missing, and filled surfaces (DMF/dmfs), and plaque index (PI). Sampling was performedto determine salivary pH and S. mutans counts of the participants. The two groups matched interms of age, gender, and socioeconomic status. The groups were compared using independentt‑test, Mann–Whitney test, Chi‑square test, and Spearman’s and Pearson’s correlation analyses.Results: The mean DMF/dmfs and GBI were significantly higher in the ALL group (PDMF/dmfs = 0.03;PGBI = 0.04). However, the two groups were not significantly different in the mean PI values (P = 0.47).The mean S. mutans counts in dental plaques and saliva of the children with leukemia were significantlylower than the healthy controls (P < 0.01). Moreover, the mean salivary pH was significantly lowerin the ALL group compared to the control group (P < 0.01).Conclusion: Higher caries and gingival bleeding rates, higher dental plaque accumulation inchildren with ALL, decreased salivary pH, and cumulative effects of other risk factors highlight thesignificance of oral hygiene training programs (for the parents of these children) and regular dentalexaminations for these children.Key Words: Acute lymphoblastic leukemia, caries, children, dental plaque, gingival health,Streptococcus mutans