Biological Validation of the PSC-MCAT: Analyzing Dental Plaque Microbiota Across Caries Risk Levels in Preschoolers.

OBJECTIVE

Although Caries Risk Assessment (CRA) tools are widely recognised in preventive dentistry for predicting dental caries risk in children, there is a notable lack of studies addressing CRA within the Chinese population. This study aimed to evaluate the biological validity of the modified caries-risk assessment tool for preschool children (PSC-MCAT) by analysing the oral microbiome of children stratified by caries risk.

MATERIALS AND

METHODS

A comprehensive analysis of the oral microbiome was conducted on 72 preschool children categorised into low- (L), moderate- (M), and high-risk (H) groups based on the PSC-MCAT criteria. Next-generation sequencing was employed to assess microbial diversity and structure. Statistical analyses were performed to identify significant differences among the risk groups.

RESULTS

The analysis revealed statistically significant differences in microbial diversity and structure among the caries risk groups (P < .05). Specific caries risk biomarkers, including Scardovia, Prevotella, and Megasphaera, were significantly enriched in the H group (P < .05). Co-occurrence network analysis showed that the M group exhibited a more complex microbial network compared to the H group, while the L group displayed sparse ecological interactions. KEGG pathway analysis identified 8 differentially abundant metabolic pathways among the risk groups. Furthermore, certain biomarkers in the H group, such as Scardovia and Megasphaera, were associated with D-arginine and D-ornithine metabolic pathways (P < .05) and were closely linked to children's oral health behaviours, including sweet food intake frequency and regular fluoride application (P < .05).

CONCLUSION

This study provides the first biological validation of the PSC-MCAT's risk stratification capacity, establishing a mechanistic link between clinical risk tiers and the dynamics of acidogenic pathobionts as well as host-microbe metabolic interactions. These findings offer valuable insights for prognostic predictions and targeted caries management strategies.