European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2026
Salivary biomarkers and their association with dental caries and oral health status in children with β-thalassaemia: a case-control study.
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Gawand Rutika Rajkumar, Padmawar Neeta, Mopagar Viddyasagar, Patil Chetan, Dumbre Sakshi Prashant, Pawar Anushka
Аннотация
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.
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.