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Mutans Streptococci and Dental Caries: A New Statistical Modeling Approach
Journal article   Open access   Peer reviewed

Mutans Streptococci and Dental Caries: A New Statistical Modeling Approach

Tariq S Ghazal, Steven M Levy, Noel K Childers, Knute D Carter, Daniel J Caplan, John J Warren, Joseph E Cavanaugh and Justine Kolker
Caries research, Vol.52(3), pp.246-252
2018
DOI: 10.1159/000486103
PMID: 29393143
url
https://doi.org/10.1159/000486103View
Published (Version of record) Open Access

Abstract

Survival analyses have been used to overcome some of the limitations encountered with other statistical analyses. Although extended Cox hazard modeling with time-dependent variables has been utilized in several medical studies, it has never been utilized in assessing the complex relationship between mutans streptococci (MS) acquisition (time-dependent covariate) and time to having dental caries (outcome). This study involved secondary analyses of data from a prospective study conducted at the University of Alabama at Birmingham. Low socioeconomic status, African-American preschool children from Perry County, AL, USA (n = 95) had dental examinations at age 1 year and annually thereafter until age 6 years by three calibrated dentists. Salivary MS tests were done at ages 1, 1.5, 2, 2.5, 3, and 4 years. The patterns of and relationship between initial MS detection (time-dependent covariate) and dental caries experience occurrence were assessed, using extended Cox hazard modeling. The median time without MS acquisition (50% of the children not having positive MS test) was 2 years. Approximately 79% of the children had positive salivary MS tests by the age of 4 years. The median caries experience survival (50% of the children not having dental caries) was 4 years. During the follow-up period, 65 of the children (68.4%) had their initial primary caries experience. Results of the extended Cox hazard modeling showed a significant overall/global relationship between initial caries experience event at any given time during the follow-up period and having a positive salivary MS test at any time during the follow-up period (hazard ratio = 2.25, 95% CI 1.06-4.75). In conclusion, the extended Cox modeling was used for the first time and its results showed a significant global/overall relationship between MS acquisition and dental caries. Further research using causal mediation analysis with survival data is necessary, where the mediator "presence of MS" is treated as a time-dependent variable.
 Dental Caries - microbiology Age Factors Dental Caries - etiology Humans Kaplan-Meier Estimate Proportional Hazards Models Child, Preschool Infant Models, Statistical Streptococcus mutans Saliva - microbiology Child Longitudinal Studies

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