Association of unstimulated salivary parameters with dental caries in socioeconomically diverse Pakistani school children: a cross-sectional study

Background: Saliva plays a vital role in maintaining oral health by facilitating mechanical cleansing, buffering acids, and providing essential minerals for remineralization. Alterations in salivary properties such as flow rate, pH, and buffering capacity are known to influence the development of dental caries. This study aimed to assess the association between unstimulated salivary parameters and dental caries in school-aged children in a sample of Pakistani population. Methods: An analytical cross-sectional study was conducted on 516 schoolchildren aged 9–16 years, selected using multistage stratified random sampling from public and private schools in Karachi. Participants were categorized into caries-free (CF) and caries-active (CA) groups based on their dmft/DMFT scores. Unstimulated whole saliva was collected using the passive drool method. Salivary flow rate, pH, and buffering capacity were measured and categorized as low, normal, or high. Statistical analysis was performed using SPSS v26.0, and comparisons were made using the Mann-Whitney U and Krusskal walis test. Logistic regression analysis was performed to find the risk predictor. A p-value < 0.05 was considered statistically significant. Results: Mean salivary flow rate, pH, and buffering capacity were significantly higher in the CF group compared to the CA group (p < 0.05). Girls in both groups showed higher mean values for all parameters than boys. Socioeconomic status was significantly associated with salivary pH and buffering capacity, particularly in the middle and lower SES groups. Conclusion: Unstimulated salivary parameters are significantly associated with dental caries status in school-aged children. These findings support the potential use of salivary diagnostics as a non-invasive tool for early identification of high-risk individuals and formulation of targeted preventive strategies. Further longitudinal studies are recommended to validate these findings.