Journal of International Dental and Medical Research ISSN 1309-100X Secretory IgA, pH and Salivary Flow Rate http://www.jidmr.com Basma Ezzat Mustafa Al-Ahmad and et al Volume ∙ 13 ∙ Number ∙ 4 ∙ 2020 Page 1455 The Relationship between the Secretory IgA, pH and Salivary Flow Rate with the Occurrence of Early Childhood Caries Basma Ezzat Mustafa Al-Ahmad 1 *, Omar Abdul Jabbar Abdul Qader 2 , Yunita Dewi Ardini 3 ,Muhammad Hazim Mohd Jefri 4 , Amarul Firdaus Alias 4 1. Department of Fundamental Dental-Medical Sciences, Kulliyyah of Dentistry, IIUM. 2. Department of Oral Maxillofacial Surgery and Oral Diagnosis, Kulliyyah of Dentistry, IIUM. 3. Department of Pediatric Dentistry and Dental Public Health, Kulliyyah of Dentistry, IIUM. 4. Kulliyyah of Dentistry, IIUM. Abstract Salivary secretory immunoglobulin A (SIgA) has immunological control over dental caries and presumably prevents the adherence of cariogenic microorganisms to the hard surfaces, relation between SIgA and dental caries still in controversy. This study aims to investigate the relationship of SIgA, salivary flow rate and pH with the occurrence of Early Childhood Caries (ECC). A total of 36 patients aged 2-5 years old were divided into 3 groups, according to their caries status (caries-free, ECC and Severe ECC). The subjects were selected based on inclusive and exclusive criteria needed. ECC and Severe ECC were diagnosed based on AAPD guidelines. Score of dmft was recorded. Unstimulated salivary flow rate and pH were measured. The samples were analyzed for determining the SIgA level. Mean value of IgA levels in ECC group (2404.6516 ng/mL ± 395.03208 ng/mL) was higher compared to other caries status group, although there was no significant relationship as the p-value is 0.404. Median values of salivary flow rate & salivary pH showed no significant difference between 3 caries status groups which p-value is 0.701 & 0.227 respectively. The result for this study showed higher level of secretory Immunoglobulin A (SIgA) in Early Childhood Caries (ECC) group although the result was not significant. Salivary flow rate and pH have not significant effects on the occurrence of ECC. However, the highest median value for flow rate and pH are seen in the Severe-ECC group. Clinical article (J Int Dent Med Res 2020; 13(4): 1455-1460) Keywords: Secretory Immunoglobulin A, Salivary Flow rate, pH, Early Childhood Caries. Received date: 14 August 2020 Accept date: 15 October 2020 Introduction Early Childhood Caries (ECC) is defined as any presence of decayed (non cavitated or cavitated lesions), missing (due to caries) or filled tooth in any primary tooth in a child 71 months or younger. 1 While, Severe- Early Childhood Caries (S-ECC) is defined by any signs of smooth–surface caries in child age younger than 3 years of age, dmft score more or equal to 4 for age 3, dmft score more or equal to 5 for age 4, and dmft score more or equal to 6 for age 5. 2,3 Secretory Immunoglobulin A (S-IgA) is a subclass of IgA, an antibody that play an active defence role against pathogens. It also prevent attachment of microbial, neutralizing the enzymes, toxins and also act synergistically with lactoferrins and lysozymes. It is predominantly found in mucous secretions from glands, such as salivary glands. 4 Hemadi et. al. (2017) mentioned the roles of saliva in protecting human body specifically the teeth by remineralisation process, buffering the low ph oral environment, cleanse food debris and plaque and acts as antibacterial properties. 5 Most of previous studies provided the evidence of higher levels of Immunoglobulin A (IgA) in children with ECC, and suggest its *Corresponding author: Basma Ezzat Mustafa Alahmad , Fundamental Dental and Medical Sciences Department, Faculty of Dentistry ,international Islamic University, Indera Mahkota Campus, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang, Malaysia. E-mail:alahmadbasma970@gmail.com, drbasma@iium.edu.my