Educational strategies and atraumatic restorative treatment effect on salivary characteristics: A controlled clinical trial

Objective: To evaluate educational strategies and atraumatic restorative treatment (ART)-restoration impact on salivary physicochemical and microbiological characteristics. Design: Two groups of 6- to 7-year-old children were included: GART, with at least one decayed primary molar (n = 36), submitted to four sessions of oral health educational strategy (OHES) and ART restoration; GC, a paired caries-free group (n = 36), submitted to four sessions of OHES. Three evaluations were carried out: baseline, 1 week after OHES, and 1 month after OHES or ART, when biofilm and gingivitis frequencies, salivary flow, pH, buffer capacity, calcium and phosphorus concentrations were assessed. Total bacteria and Streptococcus mutans were quantified in unstimulated saliva (qPCR). Results: Improvement in biofilm and gingivitis scores, salivary pH, and buffering capacity after OHES was observed in GC, with a decrease in total bacteria and S. mutans counts. GART also showed changes in salivary parameters, even before ART restoration was delivered, and total bacteria count remained lower than baseline 1 month after ART restoration, although a trend to increase the proportion of S. mutans was observed. Conclusion: Improvements in salivary physicochemical and microbiological characteristics were observed after educational strategies, thus reducing the caries risk of children with decayed teeth, although a trend to increase the S. mutans percentage was observed 1 month after ART restoration.