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Purpose <p>This study compared oral health status, dental caries, and salivary biomarkers (flow rate, pH, sialic acid, and total antioxidant capacity [TAC]) in children with β-thalassaemia and healthy controls and examined their associations and predictive value for caries risk.</p> Methods <p>This analytical case–control study involved 80 children aged 5–12&#xa0;years (40 with β-thalassaemia major and 40 age- and sex-matched controls). The unstimulated saliva was analysed for flow rate, pH, sialic acid (acidic ninhydrin method), and TAC (phosphomolybdenum method). Clinical indices included DMFT/dmft, gingival bleeding, periodontal scores, and probing depths. Statistical analyses included <i>t</i>-tests/Mann–Whitney <i>U</i> tests, Spearman correlations, multivariable logistic regression, and ROC curves (SPSS v26.0; <i>p</i> &lt; 0.05).</p> Results <p>Thalassaemic children had significantly higher DMFT/dmft (median 4.5 vs. 2, <i>p</i> &lt; 0.001), worse periodontal health, reduced flow rate (0.68 ± 0.26 vs. 1.7 ± 0.43&#xa0;mL/min), lower pH (6.47 ± 0.17 vs. 7.21 ± 0.54), elevated sialic acid (51.23 ± 12.38 vs. 20.97 ± 3.48&#xa0;μg/mL), and lower TAC (303.32 ± 88.36 vs. 888.33 ± 319.16&#xa0;μmol/L; all <i>p</i> &lt; 0.001). Biomarker–DMFT correlations were present in controls but absent in the thalassaemia group. Multivariable regression showed that elevated sialic acid level was the strongest predictor of high caries risk (DMFT/dmft &gt; 3; OR = 2.50, 95% CI 1.45, 4.32, <i>p</i> = 0.001), whilst higher flow rate, pH, and TAC were protective.</p> Conclusion <p>β-Thalassaemia major is linked to poor oral health and disrupted salivary profiles due to iron overload and oxidative stress. Salivary sialic acid and TAC have emerged as promising non-invasive biomarkers for caries risk assessment, advocating for the integration of preventive dental care within multidisciplinary management.</p>

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Salivary biomarkers and their association with dental caries and oral health status in children with β-thalassaemia: a case–control study

  • 期刊论文

  • 发表日期：

    2026年5月23日

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  • Rutika Rajkumar Gawand,
  • Neeta Padmawar,
  • Viddyasagar Mopagar,
  • Chetan Patil,
  • Sakshi Prashant Dumbre,
  • Anushka Pawar

摘要

Purpose

This study compared oral health status, dental caries, and salivary biomarkers (flow rate, pH, sialic acid, and total antioxidant capacity [TAC]) in children with β-thalassaemia and healthy controls and examined their associations and predictive value for caries risk.

Methods

This analytical case–control study involved 80 children aged 5–12 years (40 with β-thalassaemia major and 40 age- and sex-matched controls). The unstimulated saliva was analysed for flow rate, pH, sialic acid (acidic ninhydrin method), and TAC (phosphomolybdenum method). Clinical indices included DMFT/dmft, gingival bleeding, periodontal scores, and probing depths. Statistical analyses included t-tests/Mann–Whitney U tests, Spearman correlations, multivariable logistic regression, and ROC curves (SPSS v26.0; p < 0.05).

Results

Thalassaemic children had significantly higher DMFT/dmft (median 4.5 vs. 2, p < 0.001), worse periodontal health, reduced flow rate (0.68 ± 0.26 vs. 1.7 ± 0.43 mL/min), lower pH (6.47 ± 0.17 vs. 7.21 ± 0.54), elevated sialic acid (51.23 ± 12.38 vs. 20.97 ± 3.48 μg/mL), and lower TAC (303.32 ± 88.36 vs. 888.33 ± 319.16 μmol/L; all p < 0.001). Biomarker–DMFT correlations were present in controls but absent in the thalassaemia group. Multivariable regression showed that elevated sialic acid level was the strongest predictor of high caries risk (DMFT/dmft > 3; OR = 2.50, 95% CI 1.45, 4.32, p = 0.001), whilst higher flow rate, pH, and TAC were protective.

Conclusion

β-Thalassaemia major is linked to poor oral health and disrupted salivary profiles due to iron overload and oxidative stress. Salivary sialic acid and TAC have emerged as promising non-invasive biomarkers for caries risk assessment, advocating for the integration of preventive dental care within multidisciplinary management.