Salivary metabolomics as an early predictor of childhood ECC before lesion formation

Abstract

Early childhood caries (ECC) remains one of the most prevalent chronic oral diseases affecting children worldwide, with conventional diagnostic approaches often detecting disease only after irreversible enamel damage has occurred. Salivary metabolomics has emerged as a promising non-invasive strategy for identifying biochemical alterations associated with ECC susceptibility before visible lesion formation. By analyzing complex metabolic profiles present in saliva, this approach can detect early changes related to microbial activity, carbohydrate metabolism, host responses, inflammation, and oxidative stress. Advanced metabolomic platforms, including mass spectrometry and nuclear magnetic resonance-based techniques, enable the identification of potential biomarker patterns that may predict caries risk and progression. Integration of salivary metabolomics with microbiome analysis, proteomics, and artificial intelligence-driven predictive models may improve early risk assessment and support personalized preventive dental care. This molecular-based approach has the potential to transform ECC management from reactive treatment toward proactive prevention by enabling timely interventions, targeted behavioral modifications, and individualized therapeutic strategies. However, clinical implementation requires standardized protocols, validation of reliable biomarkers, and development of practical chairside diagnostic technologies. Salivary metabolomics represents a promising frontier in precision pediatric dentistry for early ECC prediction and prevention.