Unstimulated salivary flow and oral streptococci in pediatric patients with hematological tumors: A longitudinal study

• Published in: Special care in dentistry Vol. 42; no. 1; pp. 49 - 59
• Main Authors: Araújo, Elza Cristina Farias, Costa, Raphael Cavalcante, Ribeiro, Isabella Lima Arrais, Almeida, Leopoldina de Fátima Dantas de, Serpa, Eliane Batista de Medeiros, Valença, Ana Maria Gondim
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-01-2022
• Subjects: Blood cancer; Chemotherapy; Child; children; Dental Caries; DMF Index; Hematologic Neoplasms; Hematology; Humans; Longitudinal Studies; Patients; Pediatrics; Saliva; Selective media; Streptococcus; Streptococcus mutans; Tumors; saliva; hematologic neoplasms; streptococcus; children; chemotherapy
• ISSN: 0275-1879; 1754-4505
• DOI: 10.1111/scd.12628

Aims
To evaluate the unstimulated salivary flow (USF) and salivary colonization of total Streptococcus spp. (TS) and mutans‐group (MS) in pediatric patients with hematological tumors. Correlations of salivary and microbiological changes with chemotherapy and patient‐related factors were also verified.
Methods and Results
Eligible children (n = 31) were evaluated before (control) and after (2, 5, and 10‐weeks) the chemotherapy protocol was applied. Saliva samples were collected by the traditional spitting method to determine the USF (ml/min). Salivary TS and MS were determined by colony‐forming units (CFU ) counts in a selective medium. The caries experience was evaluated by DMFT/dmft indexes. Data were submitted to Student's t‐test, one‐way ANOVA, and correlation tests (α = 0.05). The USF rate at baseline was 0.89 (±0.73) ml/min with up to 20% reduction during the follow‐up and did not differ statistically during chemotherapy (p  > .05). Chemotherapy did not modify the salivary TS load (p > .05), but induced a dysbiotic shift with higher MS counts (∼ 5 fold‐increase) at 10‐weeks (p < .05). There is a correlation of USF with age (r = .390) and SM load with caries experience (rs = −.540) at 5‐weeks.
Conclusion
Chemotherapy may promote a specific increase of mutans‐group streptococci without changing the Streptococcus spp. load and unstimulated saliva flow. Correlation reinforced the need for further enlightenment about the chemotherapy mechanisms in the salivary and microbiological parameters.