Atraumatic restorative treatment induces transient changes in salivary total protein and redox biomarkers in children with caries: A non-randomized clinical study

•ART temporarily alters salivary protein levels and redox biomarkers in children with caries.•The severity of the lesion influences variations in protein and redox biomarkers.•The greatest variation in biomarkers was observed in children with dentin lesions. This study aimed to evaluate if dental atraumatic restorative treatment (ART) impacts salivary total protein and redox biomarkers in children with caries. The study included 30 children (aged 4 to 6 years) with caries on posterior deciduous teeth, classified by ICCMS, attending a basic education school. Participants were divided into enamel (n = 15) and dentin (n = 15) lesion groups. Unstimulated saliva samples were collected before (B), immediately after (A), and seven days after (A7) ART. Analyses included total protein concentration, lipid peroxidation (TBARS), total antioxidant capacity (TAC), and uric acid (UA). The results obtained at different time points (B, A, A7) were compared between children with caries and between those with enamel or dentin lesions using a paired repeated-measures ANOVA, followed by Tukey's post-hoc test (p < 0.05). ART caused significant decreases in total protein concentration (p = 0.0146), which rebounded by the 7th day. TBARS levels increased (p = 0.0215) immediately after ART and remained unchanged until the 7th day. TAC (p = 0.0032) and UA (p = 0.0006) levels decreased in the saliva of children 7 days after ART. These changes were significant only in children with dentin lesions, not enamel lesions. ART temporarily alters salivary protein levels and redox biomarkers in children with caries, returning to baseline after 7 days. These findings highlight the importance of complementing restorative treatments with dietary advice and oral hygiene to ensure comprehensive caries management.