In the severe hearing loss group, the activated enriched pathways were: ichiba graft vs. host disease 35 d up, flechner biopsy kidney transplant rejected vs. ok up, wieland up by hbv infection, mclachlan dental caries up, and blanco melo COVID-19 SARS-CoV-2 pos patient lung tissue up (Figure 4A); whereas, the suppressed pathways were: kim all disorders calb1 corr up, mcclung delta fosb targets 2 weeks, mcclung creb1 targets up, reactome translation, and mikkelsen mef hcp with h3 unmenthylated (Figure 4B). This evidence concerns the gene CREB1 and dental caries.