Association of salivary proteins with dental caries in children with mixed dentition: a systematic review

Purpose: To review the current evidence on the association between salivary protein profile and dental caries in children during mixed dentition stage.

Methods: This systematic review followed the PRISMA 2020 guidelines. Searches were run in PubMed, Scopus and Embase along with gray literature. The searches were limited to studies on humans, published from inception to February 2024. Observational studies exploring correlations between salivary proteins and caries in children during mixed dentition (6-13 years) were included. The methodological quality of included studies was analyzed independently by two reviewers using the Joanna Briggs checklist and Newcastle-Ottawa scale, respectively followed by a qualitative synthesis.

Results: A total of 17 primary studies were included. The studies recruited 1,330 subjects including 612 caries-active and 505 caries-free subjects. The total protein content was higher in caries-active subjects. Among the glycoproteins, IgA and MUC5B were higher in caries-free subjects while the levels of MUC7 were lower in the caries-free group. Antimicrobial peptides and proteinase-3 levels were also higher in caries-free subjects. Contradictory findings were reported for the association of α- amylase and carbonic anhydrase with caries status. The included studies were categorized as good quality (n = 4), fair quality (n = 12) and poor quality (n = 1).

Conclusion: Based on fair-quality studies included in this review and within its limitations, the findings revealed that salivary proteins may be associated with susceptibility to dental caries in mixed dentition. Total salivary proteins are upregulated in caries-active subjects while salivary IgA, antimicrobial peptides and proteinase-3 are increased in caries-free subjects.

Systematic review registration: The study protocol was registered in PROSPERO (registration number CRD42024517374).