# The role of salivary biochemical markers and dental indices in the assessment of oral health of Egyptian children with cystic fibrosis: an exploratory study

## TL;DR

This study explores how cystic fibrosis affects oral health in Egyptian children by analyzing saliva and dental indicators.

## Contribution

The study is the first to explore salivary biochemical markers and dental indices in Egyptian children with cystic fibrosis.

## Key findings

- CF children showed higher levels of α-amylase, TNF-α, and IL-6, and lower SOD and catalase in saliva.
- Klebsiella and Pseudomonas bacteria were more prevalent in CF children.
- Dental caries did not increase despite elevated α-amylase due to a low-carbohydrate diet.

## Abstract

Although several studies have proven that cystic fibrosis (CF) does have a definite impact on oral and dental health, others have demonstrated that it does not. Here, we evaluated children with CF in the Egyptian population based on dental indices, salivary biochemical markers, and lifestyle factors, including diet/medications, in addition to routine bacteriological assays of plaque and caries specimens. Thirty-three children were classified into two groups: CF children (n = 18) and non-CF children (n = 15). Dental indices included DMFT and dmft indices to assess caries prevalence, plaque index (PI), and gingival index (GI) to evaluate periodontal health, along with developmental defects of enamel (DDE). Salivary biochemical markers, such as α-amylase enzyme, SOD, catalase, TNF-α, and IL-6, are used to assess oxidative/inflammatory status. Bacteriological analysis was conducted on oral samples. On comparing CF and non-CF children, salivary biochemical markers showed a significant increase in α-Amylase (p < 0.001), TNF-α (p < 0.001), and IL-6 (p < 0.001), and a significant decrease in SOD (p = 0.027) and catalase (p < 0.001). However, dental indices did not show any significant increase. Klebsiella spp. and Pseudomonas spp. were significantly higher (p = 0.026 and p < 0.001, respectively), whereas Streptococcus spp. and Moraxella catarrhalis levels did not differ. In conclusion, oxidative stress and inflammatory response in CF children extend to the oral cavity via saliva. However, routine medications appear to mitigate these effects, preventing periodontal alteration development.  Despite the elevated α-amylase activities, dental caries did not develop because of a low-carbohydrate diet.