Early Childhood Caries (ECC) is a widespread public health concern, characterised by the rapid progression of dental decay in the primary teeth of young children. Its multifactorial aetiology encompasses dietary habits, oral hygiene practices, the presence of cariogenic microorganisms, and, increasingly, the role of oxidative stress in oral disease development. Oxidative stress occurs when there is an imbalance between reactive oxygen species (ROS) and the body’s ability to neutralise these harmful molecules through antioxidants, which has been identified as a contributing factor in dental caries progression. 

Saliva, an essential physiological fluid, contains a complex mix of enzymes, proteins, and antioxidants that contribute to the maintenance of oral health. Among these, catalase (CAT) plays a critical role in mitigating oxidative damage by breaking down hydrogen peroxide—a byproduct of oxidative metabolism—into water and oxygen. Elevated levels of catalase activity have been observed in the presence of inflammatory processes in the oral cavity, and it serves as an early marker of oxidative stress. In children, the antioxidant defence mechanisms present in saliva, including CAT, are essential for protecting against oral disease, particularly in environments prone to oxidative stress, such as carious lesions.

Oxidative stress, primarily initiated by an overproduction of ROS, has been identified as a predisposing factor in the development and progression of dental caries. By impairing the balance between demineralization and remineralization of tooth enamel, oxidative stress can significantly impact the oral environment, leading to caries activity. Saliva’s antioxidant system, including CAT, serves as a first line of defence, reducing the harmful effects of ROS and supporting tissue health.

Recent studies have highlighted the importance of exploring saliva as a diagnostic tool due to its rich composition of enzymes and antioxidants. Catalase, in particular, has garnered attention for its ability to neutralise hydrogen peroxide and protect oral tissues from oxidative damage. Variations in catalase production and activity in saliva can be influenced by several factors, including genetics, age, health status, and environmental exposures.

Despite the growing body of research on oxidative stress and its role in various oral diseases, limited studies have focused on its contribution to ECC, especially in children. Understanding the relationship between catalase activity and ECC could provide valuable insights into the antioxidant defence mechanisms in children and help identify early biomarkers for the disease. This information could be crucial in developing preventive strategies aimed at reducing the burden of ECC through early detection and intervention.

This randomized controlled trial (RCT) aims to compare catalase enzyme production in children with and without ECC. By examining the differences in CAT activity between these two groups, this study seeks to provide a better understanding of the role of oxidative stress in the development of ECC and its potential implications for preventive care.