Comparative Evaluation of Salivary Nitric Oxide in Caries-free and Affected Children before and after Total Oral Rehabilitation

In various global contexts, the prevalence of ECC varies widely.For instance, in India, studies have reported ECC prevalence rates ranging from 44 to 49% among children aged 8-48 months, with boys being more commonly affected than girls.6,7 This variability underscores the need for targeted interventions and research to address the specific challenges posed by ECC in different populations.Saliva, as a diagnostic medium, offers a promising avenue for exploring biomarkers related to oral health.Salivary biomarkers, IntroductIonDental caries, commonly known as tooth decay, represents a pervasive microbial disease characterized by the demineralization and destruction of tooth structure, often leading to cavities. 1 Among its various forms, early childhood caries (ECC) and severe early childhood caries (S-ECC) are particularly concerning due to their impact on young children's oral health.ECC is defined as the occurrence of one or more decayed (either noncavitated or cavitated), missing (due to caries), or filled tooth surfaces in any primary tooth of a child younger than 6 years of age.S-ECC refers to the presence of any carious lesion on smooth surfaces in children under 3 years of age.For children aged 3-5, S-ECC is diagnosed when there is at least one cavitated, missing, or filled smooth surface on the primary maxillary anterior teeth, or when the number of decayed, missing, or filled teeth (dmft score) is equal to or exceeds 4 at age 3, 5 at age 4, or 6 at age 5. 2 The importance of ECC and S-ECC lies not only in their prevalence but also in their profound impact on children's overall health and development.Dental caries at a young age can lead to pain, infection, difficulty eating, and impaired speech development.3 Moreover, untreated ECC can result in systemic health issues and even compromise a child's academic performance due to missed school days.4 The development of dental caries is influenced by multiple interconnected factors, 5 including the presence of cariogenic microorganisms-especially Streptococcus mutans-frequent intake of fermentable carbohydrates, poor oral hygiene habits, and individual host-related vulnerabilities.Other factors that contribute to the occurrence and severity of ECC and S-ECC are socioeconomic conditions, accessibility to dental services, and cultural practices.