Wpływ wybranych parametrów przebiegu ciąży i porodu na intensywność próchnicy dzieci w wieku przedszkolnym w aspekcie poziomu wydzielniczej IgA w ślinie

Tomasz Kowalik¹, *Joanna Szczepańska²

Summary
Introduction. There are a number of factors affecting caries development in children. Some of them are a consequence of bad dietary and hygiene habits of their mothers before becoming pregnant or during and after the course of pregnancy, which may affect the development of the child’s immune system. The presence of secretory IgA in saliva provides protection for oral cavity against, among others, Streptococcus mutans, thus performing protective and preventive cariogenic function.
Aim. The aim of the study is to evaluate the effect of pregnancy, type of delivery, choice of feeding and the time of children teething on carious process progression in children at pre-school age in relation to secretory IgA concentration in saliva.
Material and methods. Medical history and clinical examination were undertaken on a group of 121 children at the age of 4-6 years. The studied children were divided into 3 groups based on DMFT index: group I included children who were caries-free (DMFT index = 0), group II – children with small number of carious lesions (DMFT ≥ 1 and ≤ 2) and group III included children with high caries rates (DMFT ≥ 3). Secretory immunoglobulin A concentration and data obtained from questionnaires directed to children’s parents were subjected to evaluation.
Results. Higher levels of secretory IgA were noted in children with higher caries rates; statistically significant difference was observed with then second saliva test between groups I and III (p = 0.03). The duration of the child delivery significantly affected both caries rates (p = 0.005) and sIgA levels (p = 0.02). Children who were breast-fed had higher levels of saliva antibodies compared to children who received mixed feeding (p = 0.03). Additionally, higher levels of sIgA were observed in children teething at the right time than in those whose teeth erupted before the age of 6 months.
Conclusions. Pregnancy and childbirth, breast-feeding, the time of eruption of primary teeth have an impact on the intensity of caries, which is correlated with the concentration of secretory immunoglobulin A in saliva.

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