n Journal of Minimum Intervention in Dentistry - Salivary streptococcus mutans count and caries outcome - a systematic review

Volume 3, Issue 4
  • ISSN : 1998-801X


To answer whether an increased salivary S. mutans count is associated with higher caries.

Six databases were searched for articles (4 February 2009). Inclusion criteria : (i) titles/abstracts relevant to topic; (ii) published in English, Portuguese, Spanish; (iii) prospective cohort study; (iv) at least 2 groups / cohorts are investigated, for which a baseline salivary mutans count and a caries outcome after a period of time is reported; (v) caries outcome reported as computable datasets.
Fifteen from the initial 134 articles were selected. From these, 5 were rejected and 10 articles reporting on 30 separate datasets accepted. Owing to heterogeneity, no meta-analysis was undertaken. Cohorts which differed statistically significantly (p<0.05) in their caries outcomes also differed largely in their salivary SM counts; cohorts with similar (p>0.05) caries outcomes differed little. Cohorts with S. mutans count >105 cfu/ml showed higher caries outcome. The results showed a 55% lower caries risk in subjects with S. mutans <5 x 105 cfu/ml (Relative Risk 0.45 - 95% CI 0.34, 0.59 - p<0.00001). Potential bias may have influenced study results.
Increased S. mutans counts are associated with higher caries outcomes. High quality cohort studies are needed to validate the current evidence.

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