COMPARISON OF STREPTOCOCCUS MUTANS AND STREPTOCOCCUS SOBRINUS LEVELS AND DENTAL HEALTH BEFORE AND FOR 1 YEAR AFTER COMPREHENSIVE DENTAL TREATMENT UNDER GENERAL ANESTHESIA AMONG CHILDREN WITH SEVERE DENTAL CARIES

Abstract

Dental caries is a major health problem among young children and can be challenging to treat. In this study we aimed to compare Streptococcus mutans and Streptococcus sobrinus levels and dental health before and for 1 year after comprehensive dental treatment under general anesthesia among children with severe dental caries in order to determine the immediate and long-term benefits of this procedure. Study subjects were recruited from the Pediatric Dental Clinic, Faculty of Dentistry, Mahidol University, Bangkok, Thailand. Inclusion criteria for study subjects were: being Thai, aged 1-5 years and having severe early childhood caries (S-ECC) requiring comprehensive dental treatment under general anesthesia. At the time of the dental treatment and at 1 week, 3 months, 6 months and 1 year following treatment, each study subject was examined and the number of caries and levels of S. mutans and S. sobrinus DNA using quantitative real-time PCR with fluorescent dye (SYBR green) were determined and recorded. A total of 27 subjects were included in the study, 82% male. The mean (±standard deviation) age of subjects was 3 (±1) years. The mean S. mutans levels pre-treatment, 1 week, 3 months, 6 months and 1 year post-treatment were: 10,451, 706, 1,152, 10,515 and 1,623 colony forming units (CFU), respectively. The only time the S. mutans level was significantly lower than pre-treatment, was at 1-week post-treatment (p<0.014). The mean S. sobrinus levels pre-treatment, 1 week, 3 months, 6 months and 1 year post-treatment were: 24, 0, 0, 0 and 0 CFU, respectively. The only time the S. sobrinus level was significantly lower than pre-treatment was at 3 months post-treatment (p<0.0001). Forty-eight percent of subjects developed new dental caries 3-12 months post-treatment. Among those with new caries, 31% had both S. mutans and S. sobrinus, 54% had S. mutans, 8% had S. sobrinus and 8% had no bacteria detected. In summary, there was a temporary significant decrease in pathogenic bacteria post-treatment but by 6 months the pathogenic bacterial levels were no longer significantly different from pre-treatment levels and nearly half of subjects developed new caries during the one-year post-treatment period. Our results show dental treatment under general anesthesia is not beneficial for long term control of dental caries or control of pathogenic bacterial levels.