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Peer-reviewedCC BY-NC-NDBMC oral health

The role of salivary lactobacilli in early childhood caries increment.

  • Yu Zhang1,2,3,4,5,6
  • Yating Xu1,2,3,4,5,6
  • Liangzhi Tu1,2,3,4,5,6
  • Minyi Xu1,2,3,4,5,6
  • Jingyu Zhan1,2,3,4,5,6
  • Xiping Feng1,2,3,4,5,6
  • Xi Chen7,8,9,10,11,12
12 affiliations
  1. 1Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
  2. 2College of Stomatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
  3. 3National Center for Stomatology, Shanghai, People's Republic of China.
  4. 4National Clinical Research Center for Oral Diseases, Shanghai, People's Republic of China.
  5. 5Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China.
  6. 6Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China.
  7. 7Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China. [email protected].
  8. 8College of Stomatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China. [email protected].
  9. 9National Center for Stomatology, Shanghai, People's Republic of China. [email protected].
  10. 10National Clinical Research Center for Oral Diseases, Shanghai, People's Republic of China. [email protected].
  11. 11Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China. [email protected].
  12. 12Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China. [email protected].
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Abstract

Background

Although lactobacilli are frequently detected in children with early childhood caries (ECC), the roles of specific lactobacilli species remain unclear. Streptococcus mutans, a well-established cariogenic species, was included as a reference organism. Limosilactobacillus fermentum, Ligilactobacillus salivarius, Lactobacillus acidophilus, and Lacticaseibacillus rhamnosus were selected in the study aiming to investigate the prospective associations between lactobacilli species and caries increment based on machine learning approaches.Methods

A prospective cohort of 282 children aged 3-4 years was established in Shanghai, China. Participants received clinical examinations at baseline and 1-year follow-up. Baseline saliva samples were collected. The detection and quantification of the targeted species in salivary samples were performed by quantitative real-time PCR. Logistic regression and machine-learning analyses were conducted to evaluate associations with caries increment.Results

L. fermentum, L. salivarius, L. rhamnosus, and S. mutans were positively correlated to caries increment. L. fermentum was highly detectable (82.6%) in the saliva and significantly correlated with S. mutans. Furthermore, positive correlations existed between L. fermentum, and L. acidophilus, L. rhamnosus and L. salivarius. The ratio of L. salivarius to S. mutans was significantly correlated to caries increment. In the logistic regression model, caries experience and high levels of caries activity test were significantly associated with caries increment, whereas the associations between salivary bacterial abundance and caries increment were no longer statistically significant after adjustment. SHAP analysis based on light gradient boosting machine identified S. mutans and L. fermentum as the top important bacterial features contributing to the prediction of caries increment.Conclusions

Salivary detection and abundance of specific lactobacilli species were prospectively associated with caries increment in preschool children. Among the species examined, L. fermentum may contribute to the overall microbial predictive profile in machine-learning models rather than acting as an independent predictor of caries increment. The observed association involving L. salivarius and S. mutans suggests a potential ecological relationship that warrants further investigation.

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Cite

BibTeXRIS
BibTeX
@article{zhang2026role,
  title = {{The role of salivary lactobacilli in early childhood caries increment.}},
  author = {Yu Zhang and Yating Xu and Liangzhi Tu and Minyi Xu and Jingyu Zhan and Xiping Feng and Xi Chen},
  journal = {BMC oral health},
  year = {2026},
  month = jul,
  doi = {10.1186/s12903-026-09425-w},
  url = {https://europepmc.org/article/MED/42919233},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - The role of salivary lactobacilli in early childhood caries increment.
AU  - Yu Zhang
AU  - Yating Xu
AU  - Liangzhi Tu
AU  - Minyi Xu
AU  - Jingyu Zhan
AU  - Xiping Feng
AU  - Xi Chen
PY  - 2026
DA  - 2026/07/01
JO  - BMC oral health
DO  - 10.1186/s12903-026-09425-w
UR  - https://europepmc.org/article/MED/42919233
AB  - Background  Although lactobacilli are frequently detected in children with early childhood caries (ECC), the roles of specific lactobacilli species remain unclear. Streptococcus mutans, a well-established cariogenic species, was included as a reference organism. Limosilactobacillus fermentum, Ligilactobacillus salivarius, Lactobacillus acidophilus, and Lacticaseibacillus rhamnosus were selected in the study aiming to investigate the prospective associations between lactobacilli species and caries increment based on machine learning approaches.Methods  A prospective cohort of 282 children aged 3-4 years was established in Shanghai, China. Participants received clinical examinations at baseline and 1-year follow-up. Baseline saliva samples were collected. The detection and quantification of the targeted species in salivary samples were performed by quantitative real-time PCR. Logistic regression and machine-learning analyses were conducted to evaluate associations with caries increment.Results  L. fermentum, L. salivarius, L. rhamnosus, and S. mutans were positively correlated to caries increment. L. fermentum was highly detectable (82.6%) in the saliva and significantly correlated with S. mutans. Furthermore, positive correlations existed between L. fermentum, and L. acidophilus, L. rhamnosus and L. salivarius. The ratio of L. salivarius to S. mutans was significantly correlated to caries increment. In the logistic regression model, caries experience and high levels of caries activity test were significantly associated with caries increment, whereas the associations between salivary bacterial abundance and caries increment were no longer statistically significant after adjustment. SHAP analysis based on light gradient boosting machine identified S. mutans and L. fermentum as the top important bacterial features contributing to the prediction of caries increment.Conclusions  Salivary detection and abundance of specific lactobacilli species were prospectively associated with caries increment in preschool children. Among the species examined, L. fermentum may contribute to the overall microbial predictive profile in machine-learning models rather than acting as an independent predictor of caries increment. The observed association involving L. salivarius and S. mutans suggests a potential ecological relationship that warrants further investigation.
SN  - 1472-6831
ER  -