Exploring the effect of dentition, dental decay and familiality on oral health using metabolomics.

As a proof of principle, we used an untargeted global metabolic profiling of saliva to understand the biochemical processes associated with dental decay, dentition (primary and secondary tooth eruption) and familiality in a sample of 25 sibling pairs. Pairs were selected to represent four different combinations of dentition and tooth health: (1) both siblings with primary teeth and no decay (n=5); (2) both siblings with primary teeth and discordant for dental decay (n=6); (3) both siblings with primary teeth and dental decay (n=4); and (4) one sibling with primary teeth the other with mixed dentition and both with no dental decay (n=10). There was a strong effect of sibship on the metabolite profiles identified; this may reflect the effects of common genes, environment and behaviors, and shared oral microbial communities. Nested in the familial effects were associations of metabolite profile with dentition and with dental decay. Using three different analyses (Euclidean distance, hierarchical clustering and PCA using selected biochemicals) metabolite profiles of saliva from children with decayed teeth were more similar than the metabolite profiles of saliva from children with healthy (sound) teeth. Larger studies that include host behaviors, environmental factors, oral microbiota composition and structure, and host genetic predisposition are required to identify biomarkers for decay, and to estimate the relative contribution of host factors and oral microbes on risk of dental decay.