Background: Dental caries in children has been explored not only as a local oral condition but also in relation to potential systemic inflammatory changes. This study evaluated systemic inflammatory biomarkers and hematologic indices in children with dental caries and examined their association with caries severity, as assessed by the DMFT index. Methods: In this exploratory cross-sectional sibling-controlled study, 114 participants were included: 75 children with dental caries and 39 unaffected siblings serving as controls. All participants underwent blood testing, including inflammatory biomarkers (TNF-α, NGAL) and hematologic indices (NLR, LMR, PLR, IIC, MCVL, SII, SIRI, AISI). Group comparisons were performed using parametric or nonparametric tests, depending on data distribution. Correlation analyses were conducted within the caries group. Age- and sex-adjusted univariate and multivariable linear regression models were used to identify predictors of DMFT, and logistic regression was applied to evaluate associations with high caries burden (DMFT ≥ 6). Results: Children with caries showed higher NGAL, PLR, and MCVL, and lower LMR than controls, while IIC showed a non-significant upward trend. Correlation analysis revealed strong associations among several inflammatory indices, largely reflecting shared computational components. DMFT showed a modest positive correlation with LMR, whereas associations with classical inflammatory biomarkers such as TNF-α and NGAL were weak or absent. In age- and sex-adjusted models, several markers showed borderline associations with DMFT, but none remained independently significant in multivariable analyses. Age was the strongest predictor of DMFT, while sex showed no significant effect. Logistic regression for high DMFT confirmed age as the only significant determinant. Conclusions: In this exploratory pediatric cohort, children with dental caries showed differences in selected systemic inflammatory and hematologic biomarkers compared with unaffected siblings. However, most biomarkers showed only limited independent associations with caries severity after adjustment, with age emerging as the primary determinant of DMFT. These findings suggest that systemic inflammatory markers have limited independent explanatory value for caries severity and should be interpreted as exploratory rather than clinically definitive.

Background: Early childhood caries (ECC) is a biofilm-mediated and sugar-driven disease associated with local and systemic inflammatory responses. This study evaluated serum Interleukin-6 (IL-6) and IL-10 concentrations, hematologic inflammatory indices, and oral inflammatory parameters in children with ECC compared with caries-free sibling controls. Methods: This sibling-controlled case–control study included 155 children aged 2.5–6 years, comprising 120 children with active ECC and 35 caries-free siblings. Serum IL-6 and IL-10 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Complete blood count parameters and derived inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), cumulative inflammatory index (IIC), and mean corpuscular volume-to-lymphocyte ratio (MCVL), were calculated. Plaque Index (PI) and Gingival Index (GI) were recorded in children with ECC. Group comparisons, correlation analyses, ROC analysis, and multivariable logistic regression were performed. Results: Children with ECC exhibited significantly higher serum IL-6 and IL-10 concentrations than sibling controls. MCVL values were significantly lower in the ECC group, whereas several inflammatory indices indicated an increased systemic inflammatory burden. Stratification by PI tertiles showed progressively higher values for WBC, NEU, NLR, SII, SIRI, AISI, and IIC with increasing plaque accumulation (all p < 0.05). PI was strongly correlated with GI (r = 0.811, p < 0.001) and moderately correlated with NLR (r = 0.536), SII (r = 0.536), SIRI (r = 0.654), AISI (r = 0.648), and IIC (r = 0.546) (all p < 0.01). Serum IL-6 and IL-10 were strongly correlated with each other (r = 0.804, p < 0.001) but not with PI or GI. ROC analysis demonstrated moderate discriminatory performance for IL-6 (AUC = 0.701) and IL-10 (AUC = 0.696). Multivariable logistic regression identified elevated IL-6 (OR = 1.32, 95% CI: 1.08–1.62, p = 0.007) and lower MCVL (OR = 0.95, 95% CI: 0.90–1.00, p = 0.048) as independent predictors of ECC. Conclusions: ECC is associated with systemic cytokine alterations and increased hematologic inflammatory burden. While IL-6 and IL-10 distinguish children with ECC from sibling controls, plaque accumulation severity is better reflected by composite hematologic inflammatory indices than by isolated cytokine concentrations. IL-6 and MCVL may be promising adjunctive biomarkers for ECC.

Background/Objectives: Dental caries in primary dentition is strongly related to daily oral hygiene routines and sugar-related dietary behavior. This study assessed oral hygiene and dietary behaviors associated with the clinical severity of carious lesions in primary dentition. Methods: This observational, cross-sectional, clinical-record-based study assessed 448 pediatric dental records from children examined in Craiova, Romania. After applying predefined eligibility criteria, 400 parent–child pairs were included. Children were aged 3–6 years and had primary or early mixed dentition with predominant primary teeth. Carious lesions were classified as absent, incipient, cavitated non-complicated caries, or advanced caries with pulpal/periapical involvement. The primary analysis focused on toothbrushing onset and frequency, toothbrush and toothpaste type, night feeding duration, sweets intake, and sweetened or carbonated beverage intake. Logistic regression was used to identify factors associated with higher odds of major carious lesions. Secondary clinical-record variables were analyzed exploratorily. Results: Carious lesions were recorded in 331 children, while 69 children were caries-free. Incipient caries, cavitated non-complicated caries, and advanced caries with pulpal/periapical involvement were recorded in 99, 116, and 116 children, respectively. Child age and sex were not significantly associated with caries severity. In the adjusted model, delayed toothbrushing onset (OR = 1.464; 95% CI: 1.148–1.866; p = 0.002) and sweetened beverage consumption (OR = 2.488; 95% CI: 1.561–3.963; p < 0.0005) remained independently associated with major carious lesions after Bonferroni correction. Conclusions: In this sample, major carious lesions in primary dentition were associated mainly with modifiable postnatal behaviors, particularly delayed initiation of toothbrushing and sweetened beverage intake. Due to the cross-sectional design, the findings should be interpreted as associations, not causal relationships.

Background: Early childhood caries (ECC) is a biofilm-mediated and sugar-driven disease associated with local and systemic inflammatory responses. This study evaluated serum Interleukin-6 (IL-6) and IL-10 concentrations, hematologic inflammatory indices, and oral inflammatory parameters in children with ECC compared with caries-free sibling controls. Methods: This sibling-controlled case–control study included 155 children aged 2.5–6 years, comprising 120 children with active ECC and 35 caries-free siblings. Serum IL-6 and IL-10 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Complete blood count parameters and derived inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), cumulative inflammatory index (IIC), and mean corpuscular volume-to-lymphocyte ratio (MCVL), were calculated. Plaque Index (PI) and Gingival Index (GI) were recorded in children with ECC. Group comparisons, correlation analyses, ROC analysis, and multivariable logistic regression were performed. Results: Children with ECC exhibited significantly higher serum IL-6 and IL-10 concentrations than sibling controls. MCVL values were significantly lower in the ECC group, whereas several inflammatory indices indicated an increased systemic inflammatory burden. Stratification by PI tertiles showed progressively higher values for WBC, NEU, NLR, SII, SIRI, AISI, and IIC as plaque accumulation increased (all p < 0.05). PI was strongly correlated with GI (r = 0.811, p < 0.001) and moderately correlated with NLR (r = 0.536), SII (r = 0.536), SIRI (r = 0.654), AISI (r = 0.648), and IIC (r = 0.546) (all p < 0.01). Serum IL-6 and IL-10 were strongly correlated (r = 0.804, p < 0.001) but not with PI or GI. ROC analysis demonstrated moderate discriminatory performance for IL-6 (AUC = 0.701) and IL-10 (AUC = 0.696). Age- and sex-adjusted multivariable logistic regression demonstrated that elevated IL-6 concentrations (adjusted OR = 1.36; 95% CI, 1.10–1.68; p = 0.005) remained independently associated with ECC, whereas increasing MCVL values (adjusted OR = 0.92; 95% CI, 0.86–0.98; p = 0.010) were associated with reduced odds of ECC. Conclusions: ECC is associated with systemic cytokine alterations and increased hematologic inflammatory burden. While IL-6 and IL-10 distinguish children with ECC from sibling controls, plaque accumulation severity is better reflected by composite hematologic inflammatory indices than by isolated cytokine concentrations. IL-6 and MCVL may be promising adjunctive biomarkers for ECC.