Cytokines, Minerals, Total Antioxidant Capacity, Nitric Oxide, and Salivary Characteristics as Biomarkers Associated With Early Childhood Caries: A Narrative Review

Early childhood caries (ECC) is one of the multifactorial, acute, and progressive types of tooth decay. Some salivary biomarkers are associated with this disease. 

The data we used in our review were searched from articles published between 1950 to 2021 and using early childhood caries (ECC), children, saliva, salivary biomarkers, salivary characteristics, salivary minerals, cytokines, total antioxidant capacity (TAC) and nitric oxide (NO) as keywords, collected from official web pages (Scopus, PubMed, Embase and Google scholar) and documents published from different international institutions. 

The search was limited to articles published in the English language. After the abstract screening, the full text of 194 relevant studies was reviewed. Finally, 101 relevant studies were selected.

Cytokines with the potential to affect ECC include interleukin (IL)-1 (IL-1β), IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-alpha (TNFα), a soluble cluster of differentiation (sCD)14-cluster of differentiation 14 (CD14), CD63 and vascular endothelial growth factor (VEGF). The minerals associated with the ECC are calcium (Ca), phosphate (PO43-), fluoride (F), magnesium (Mg), iron (Fe), and lead (Pb). 

Some characteristics of saliva that seem to concern ECC include salivary pH, salivary total protein, salivary total lipid, salivary buffering capacity, and saliva flow rate. Other vital factors observed to have significant effects on the ECC process involve total antioxidant capacity (TAC) and nitric oxide (NO).