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Multimodal Data Integration Reveals Mode of Delivery and Snack Consumption Outrank Salivary Microbiome in Association With Caries Outcome in Thai Children

  • Wu, Tong Tong1
  • Xiao, Jin2
  • Manning, Samantha1
  • Saraithong, Prakaimuk3
  • Pattanaporn, Komkham4
  • Paster, Bruce J.5
  • Chen, Tsute5
  • Vasani, Shruti2
  • Gilbert, Christie6
  • Zeng, Yan2
  • Li, Yihong7
  • 1 Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY , (United States)
  • 2 Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY , (United States)
  • 3 Department of Internal Medicine, Division of Infectious Diseases, Medical School University of Michigan, Ann Arbor, MI , (United States)
  • 4 Mae Fah Luang University School of Dentistry, Chiang Rai , (Thailand)
  • 5 Department of Microbiology, Forsyth Institute, Cambridge, MA , (United States)
  • 6 Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY , (United States)
  • 7 Department of Public and Ecosystem Health, Cornell University Master of Public Health Program, Ithaca, NY , (United States)
Published Article
Frontiers in Cellular and Infection Microbiology
Frontiers Media SA
Publication Date
May 23, 2022
DOI: 10.3389/fcimb.2022.881899
  • Cellular and Infection Microbiology
  • Original Research


Early childhood caries (ECC) is not only the most common chronic childhood disease but also disproportionately affects underserved populations. Of those, children living in Thailand have been found to have high rates of ECC and severe ECC. Frequently, the cause of ECC is blamed on a handful of cariogenic organisms, such as Streptococcus mutans and Streptococcus sobrinus. However, ECC is a multifactorial disease that results from an ecological shift in the oral cavity from a neutral pH (~7.5) to an acidic pH (<5.5) environment influenced by the host individual’s biological, socio-behavioral, and lifestyle factors. Currently, there is a lack of understanding of how risk factors at various levels influence the oral health of children at risk. We applied a statistical machine learning approach for multimodal data integration (parallel and hierarchical) to identify caries-related multiplatform factors in a large cohort of mother-child dyads living in Chiang Mai, Thailand (N=177). Whole saliva (1 mL) was collected from each individual for DNA extraction and 16S rRNA sequencing. A set of maternal and early childhood factors were included in the data analysis. Significantly, vaginal delivery, preterm birth, and frequent sugary snacking were found to increase the risk for ECC. The salivary microbial diversity was significantly different in children with ECC or without ECC. Results of linear discriminant analysis effect size (LEfSe) analysis of the microbial community demonstrated that S. mutans, Prevotella histicola, and Leptotrichia hongkongensis were significantly enriched in ECC children. Whereas Fusobacterium periodonticum was less abundant among caries-free children, suggesting its potential to be a candidate biomarker for good oral health. Based on the multimodal data integration and statistical machine learning models, the study revealed that the mode of delivery and snack consumption outrank salivary microbiome in predicting ECC in Thai children. The biological and behavioral factors may play significant roles in the microbial pathobiology of ECC and warrant further investigation.

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