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Mother-to-child transmission of Streptococcus mutans: A systematic review and meta-analysis
... The AAPD recommended avoiding saliva-sharing behaviors between mothers and their infants, as MS can be transmitted from mother to child. 24 In the current study, just one-third of pediatricians knew this fact, which was less than the reports of previous studies. 18,22 Around two-thirds of participants do not take the information about mother's oral health, which is in agreement with the results of similar studies. ...
... 6,8 Therefore, pediatricians should be up-to-date regarding this topic, as it was recommended that pediatricians have to educate the parents about the saliva-sharing behaviors, and maintain a good maternal oral health by providing oral health education. 24 In the current study, 84% of participants stated that F administration is important in preventing ECC. However, the majority (94-96%) wrongly answered the questions about the optimal concentrations of F for prevention of dental caries. ...
... Appendix 1: Pediatricians' knowledge of risk factors and prevention of ECC (24) Do you think dental caries causing bacteria can be transmitted from mother/ caregiver to child? 17 (34) 33 (66) What is the concentration of fluoride , in ppm, in drinking water in Ajdabiya? 2 (4) 48 (96) What is the optimal concentration of fluoride, in ppm, in drinking water for prevention of dental caries? 3 (6) 47 (94) What is the optimal concentration of fluoride, in ppm, in toothpaste for prevention of dental caries?3 (6) 47 (94) What is the minimum concentration of fluoride in toothpaste, in ppm, should child use from age 0-3? ...
Abstract
Objectives: This study aimed to assess pediatricians’ knowledge, attitudes, and practices (KAP) toward early childhood caries (ECC) in the governorate of Ajdabiya, Libya.
Materials and methods: A cross-sectional study of a random sample of 50 pediatricians, who work at primary healthcare centers in the governorate of Ajdabiya (in 2021). Data were collected by a self-administered questionnaire that was developed using the KAP study construction guides. Pretests of the questionnaire were performed with five pediatricians, who did not participate in the study. The collected data were analyzed using SPSS for Windows, version 25.0 (SPSS Inc). The alpha value was 0.05.
Results: The overall scores of knowledge ranged from 2 to 12, with a mean of 6.1 (SD, 1.6). For attitudes, the overall scores ranged from 7 to 14, with a mean of 12.1 (SD, 1.5). And the overall scores of practices ranged from 1 to 24, with a mean of 10.0 (SD, 4.7). There were positive correlations between the KAP overall scores. The findings showed weak associations, except between knowledge and practices, it was medium.
Conclusion: Libyan pediatricians demonstrated positive attitudes toward oral health. Nevertheless, their knowledge and practices appeared to be deficient regarding the early dental visits, the cariogenic effect of ad libitum breastfeeding, transmission of cariogenic bacteria from mothers/caregiver to the child, and the role and uses of F in preventive dentistry.
Keywords: Dental caries, Oral health, Professional attitudes, Professional behavior, Professional education.
Journal of Oral Health and Community Dentistry (2022): 10.5005/jp-journals-10062-0065A
... [10][11][12][13] Research has further shown that the mother's oral condition and behaviors significantly influence the offspring's oral health outcomes, particularly the risk of experiencing early childhood caries (ECC). 10,[15][16] Considering the inherent oral implications of pregnancy and the potential systemic consequences, timely monitoring and early intervention are extremely important. Therefore, monitoring oral health in pregnant women should be an integral part of the approach to their general healthcare. ...
... This finding possibly reveals an unawareness that early acquisition of Mutans Streptococci is a key risk factor for developing ECC. [14][15][16]29,34,35 The fact that mother-to-child (or caregiver-to-child) transmission constitutes the major pathway for Mutans Streptococci initial acquisition underlines the importance of education and prenatal oral health care in reducing maternal carriage of Mutans Streptococci and limiting saliva-sharing activities, as highlighted by recent studies. [14][15][16]33 A substantial number of pregnant women stated that nocturnal breastfeeding was not associated with the etiology of ECC. ...
... [14][15][16]29,34,35 The fact that mother-to-child (or caregiver-to-child) transmission constitutes the major pathway for Mutans Streptococci initial acquisition underlines the importance of education and prenatal oral health care in reducing maternal carriage of Mutans Streptococci and limiting saliva-sharing activities, as highlighted by recent studies. [14][15][16]33 A substantial number of pregnant women stated that nocturnal breastfeeding was not associated with the etiology of ECC. In fact, although multiple studies have explored the potential impact of prolonged and ad libitum breastfeeding on ECC's development, recent evidence from a systematic review suggests that breastfeeding does not increase ECC risk. ...
Objectives:
To assess the level of knowledge and attitudes regarding prenatal and infant oral health in a sample of pregnant women from Coimbra, Portugal.
Methods:
A self-applied questionnaire was administered to randomly selected pregnant women who attended prenatal check-ups at two public health institutions in Coimbra. Collected data included sociodemographic information, oral health knowledge and practices in pregnancy, and knowledge on oral health in children. All ethical requirements were met. Statistical analysis was conducted using descriptive and inferential methods. Variables were tested for independence using a chi-square test with a 95% confidence interval.
Results:
A total of 120 women enrolled in the study. Although 68.9% of participants brushed their teeth twice daily, 36.4% reported not using floss, with a statistically significant association with age (p=0.004). Half of the respondents had not attended a dental appointment before pregnancy, and 59.2% believed pregnancy could be harmful to oral health. Findings showed limited knowledge of the possible consequences of gingivitis and periodontitis to the course of pregnancy and the importance of diet in oral health. Moreover, a low level of understanding was noted regarding the existence and prevention of early childhood caries.
Conclusions:
Oral health-related knowledge and practices of surveyed women were in general deficient. Considering pregnancy is a period of particular interest for acquiring knowledge and good oral health practices, which are decisive for both the expectant mother na the child, our results highlight an urgent need to implement prenatal oral health care programs in this study population.
... Patients perceived tooth decay, tooth loss, swollen gums and tooth ache were normal events associated with pregnancy. Tooth ache Morning sickness [18] AJDHS.COM ...
... S. mutans load reduction in the mothers oral cavity diminishes the vertical transmission to the infant which reduces the probability of caries among infants, as evidence based research suggested. 13,18 ...
Aim: To evaluate the attitude, behaviour, experience and knowledge of pregnant females regarding perinatal oral health in rural population of Faridabad. Methodology: Data was collected through personal interview. Eleven questions related to knowledge, attitude, experience and behaviour were asked. Data was analysed using IBM SPSS version 21. Results: About one- fourth of the study population experienced adverse effects on oral health during pregnancy and their knowledge was also found to be poor with respect to perinatal oral health maintenance. They also reported ill behaviours to manage morning sickness. Despite this, their attitude towards maintenance of perinatal oral health was found to be positive. Conclusion: The dental status of the child is a direct reflection of maternal oral condition in pregnancy. Thus, there is a need for educational oral health interventions in pregnant women to improve their own and children oral health status. Keywords: Perinatal, Oral health, Pregnancy, Rural population
... [83]. According to a meta-analysis by da Silva Bastos Vde et al. (2015) [84], the transmission rate does not seem to be statistically different according to the type of technique used to assess transmission. Due to the limitations of 16 S rRNA gene sequencing in identifying microorganisms at strain-level, culturedependent methods followed by molecular identification are still relevant for oral streptococci identification. ...
... Regarding dental caries, there is plenty of evidence suggesting that the vertical transmission of S. mutans between mother and child increases the risk of developing early childhood caries [82,84,112]. The transmission of bacteria typically associated with periodontal disease it may also happen, although there is less robust evidence on this topic [89,90,113]. ...
The mother represents one of the earliest sources of microorganisms to the child, influencing the acquisition and establishment of its microbiota in early life. However, the impact of the mother on the oral microbiota of the child from early life until adulthood remains to unveil. This narrative review aims to: i) explore the maternal influence on the oral microbiota of the child, ii) summarize the similarity between the oral microbiota of mother and child over time, iii) understand possible routes for vertical transmission, and iv) comprehend the clinical significance of this process for the child. We first describe the acquisition of the oral microbiota of the child and maternal factors related to this process. We compare the similarity between the oral microbiota of mother and child throughout time, while presenting possible routes for vertical transmission. Finally, we discuss the clinical relevance of the mother in the pathophysiological outcome of the child. Overall, maternal and non-maternal factors impact the oral microbiota of the child through several mechanisms, although the consequences in the long term are still unclear. More longitudinal research is needed to unveil the importance of early-life microbiota on the future health of the infant.
... 21 Strong evidence demonstrates that mothers are a primary source of S. mutans colonization for their children (eg, utensil sharing, cleaning pacifier with mouth). 22 Thus, an important factor associated with caries risk in young children is the recent or current presence of active dental decay in the primary parent/ caregiver. Because it is likely that bacteria will be vertically transmitted, prevention, diagnosis, and treatment of oral diseases in the child's parent/caregiver are highly beneficial, especially during pregnancy. ...
... It is important to remember that pathogenic bacteria can be passed from parent/caregiver to child. 22 Thus, anticipatory guidance for both parent/caregiver and child is important. Pediatricians can encourage parents/caregivers to model and maintain good oral hygiene, including regular brushing, flossing, and having a relationship with their own dental provider. ...
Oral health is an integral part of the overall health of children. Dental caries is a common and chronic disease process with significant short- and long-term consequences. The prevalence of dental caries remains greater than 40% among children 2 to 19 years of age. Although dental visits have increased in all age, race, and geographic categories in the United States, disparities continue to exist, and a significant portion of children have difficulty accessing dental care. As health care professionals responsible for the overall health of children, pediatricians frequently confront morbidity associated with dental caries. Because the youngest children visit the pediatrician more often than they visit the dentist, it is important that pediatricians be knowledgeable about the disease process of dental caries, prevention of disease, interventions to maintain and restore health, and the social determinants of children’s oral health.
... If the caries in children are not treated at its initial stage it can lead to caries in the primary and permanent teeth which leads to infections, discomfort, and delayed schoolwork, emergency procedures, limited growth and development of the teeth [3]. As a result, neglected caries and improper use of dental treatments are more significant community health issues impacting young children in emerging and developing countries [4]. Silver diamine fluoride (AgF(NH3)2) is a promising substance with clinical dental applications. ...
... When SDF was applied to particular teeth to arrest or prevent dental decay in several investigations, the only adverse effect was a minor, moderately painful white patch in the mucosa that resolved after 2 days without any therapy after 3 years. There was no evidence of a negative pulpal reaction [4,5]. ...
Various studies published in the literature around the world indicate a significant prevalence of early childhood caries (ECC). Treatment of early childhood caries (ECC) using silver diamine fluoride (SDF) has become a viable alternative, particularly for young and anxious children, because traditional restorative treatments is unlikely to combat this prevalent condition. Arrested caries is identified by the hardening of teeth and it changes its color from dark brown to black. More restorative treatments can be performed if necessary. Traditional ECC restorative treatments are not always inexpensive or feasible, as they involve patient cooperation to achieve a satisfactory result. Japan was the first country to promote silver diamine fluoride in 1960. SDF has been used to prevent the spread of caries in various Asian nations, including Japan and China. It was enacted as a fluoride to treat sensitive teeth in the United States by Food and Drug Administration ( FDA). For young children or individuals with specific needs, it is painless and simple to use .The fluoride in SDF stimulates remineralization while the silver ions act as an antimicrobial agent when applied to carious lesions and stop cariogenic biofilms from growing. SDF also prevents future degradation of the dentin's collagen. With a 38 percent use rate, SDF has been utilized in a number of nations. According to a review, SDF is a harmless, economical caries control agent with a wide utilisation in dentistry, and it may meet the WHO Millennium Development Goal (MDG) as well as the United States Institute of Medicine's criteria. The applications of SDF in dental treatment are discussed in this article.
... The major reservoirs from which the infants acquire MS is their mother. 15 A study by Berkowitz concluded that the frequency of infant infection reduced 9 times when the colony-forming units reduced from 10 5 to 10 3 . 16 Presence of other risk factors such as crowding, low immunity, or hyposalivation further increases the caries risk. ...
... 16 Presence of other risk factors such as crowding, low immunity, or hyposalivation further increases the caries risk. [17][18][19] The mean Alban's score was 8.26 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Frequent snacking in between meals, existing untreated caries, hyposalivation, reduced immunity, and absence of regular use of topical fluorides may have resulted in high mean Alban's score. ...
... A systematic review showed scientific evidence about the transmission of S. mutans from mother to child [18], based on studies including serotype classification, bacteriocin activity profiles, chromosomal DNA fingerprinting, ribotyping, arbitrarily primed PCR method and multilocus sequence typing. The results of most studies using these techniques have demonstrated mother to child transmission. ...
... According to the authors the intergenic region between GtfB and GtfC are known to be unstable and to undergo homologous recombination during caries developments. In this way, the knowledge of the S. mutans strains is important because the virulence of the microorganisms is varied and the virulence affects the dental caries evolution rat [18]. ...
OBJECTIVE: Caries is a multifactorial infectious disease and the main etiological agent is the bacteria Streptococcus mutans due to its virulence factors, which enable the adherence to dental enamel and favours the formation of dental biofilm through the production of extracellular polysaccharides. The transmission of S. mutans can occur between people, often within families. The present study aimed to evaluate the intrafamily genetic pattern of S. mutans through partial sequencing of the gene that encodes the glucosyltransferase β (gtfB) enzyme.METHODS: We previously analyzed saliva samples from 40 individuals from nine families, and it was obtained 64 isolates biochemically characterized as S. mutans. The isolates were evaluated by random amplification of polymorphic DNA (RAPD). Those with greater similarity were characterized by partial sequence 16S rRNA gene and the gtfB gene sequencing.RESULTS: It was observed genetic similarity among strains isolated from individuals with caries activity; while isolates from individual without caries showed that they are genetically distinct, suggesting a different virulence pattern.CONCLUSION: The present results demonstrated that partial sequencing of the gtfB gene showed to be a potential marker to investigate genetic pattern and virulence of S. mutans, deserving further investigation in order to identify families at risk of caries.
... The Decayed, Missing, and Filled Teeth (DMFT) index is the predominant populationbased measure of caries experiences worldwide. This index gives the sum of an individual's decayed, missing, and filled permanent teeth or surfaces (DMFS) [68]. ...
The antibacterial and anti-inflammatory effect of thioglycosides has already been established. This study investigates the effects of thioglycosides extracted from white mustard, specifically the “Bamberka” variety, in the context of oral hygiene. The aim of the study is to clarify an evidence-based link between the documented antibacterial and anti-inflammatory effects attributed to thioglycosides and their practical application in oral care. A randomized, single-blinded (patient-blinded) clinical study was performed on 66 patients using mustard-based toothpaste for oral hygiene. The patients were examined at baseline and after 6 and 12 months. The values of the Approximal Plaque Index (API), the Plaque Index (PI), and Bleeding on probing (BOP) were taken into consideration. The results show a significant reduction in plaque accumulation, especially after 6 months of using mustard-based toothpaste in all examined parameters. This suggests that thioglycosides from mustard contribute to a considerable decrease in dental plaque accumulation, confirming their potential in natural oral care solutions, which is indicated in the main conclusions or interpretations.
... The transmission of oral microbes from mothers to children of different ages was also supported by several previous papers. 18,42,43 Possible reasons for the interconnection of oral health between family members are genetic factors, vertical transmission of bacteria, and common lifestyle and hygiene habits within the family. 44, 45 We did not assess the genetic factor in our study, but it is plausible that children and their mothers might share similar functional gene polymorphisms. ...
Background
Gingivitis is the most common form of periodontal disease among children and adolescents and is associated with disrupted host–microbiome homeostasis. Family is an important factor influencing the prevalence of gingivitis. In the present study, we investigated the salivary microbiome, oral hygiene habits, and the salivary level of myeloid‐related protein (MRP)‐8/14 in children aged 7–12 years with gingivitis, periodontally healthy children, and their mothers.
Methods
This study included 24 children with gingivitis (including four sibling pairs) and 22 periodontally healthy children (including two sibling pairs) and their mothers. The whole saliva was collected, DNA was extracted, the variable V3–V4 region of the eubacterial 16S ribosomal RNA gene was amplified, and sample library preparation was performed according to the Illumina protocol. The salivary levels of MRP‐8/14 were analyzed by ELISA.
Results
Alpha diversity of the salivary microbiome was considerably higher in gingivitis children and mothers of gingivitis children compared to healthy children and their mothers, respectively. Significant differences in beta diversity between healthy and gingivitis children, healthy children and their mothers, and gingivitis children and their mothers were detected. Overall, the number of common core amplicon sequence variants between children and their own mothers was significantly higher than between children and other mothers. The salivary MRP‐8/14 levels in children with gingivitis were significantly higher compared to healthy children; a similar tendency was also mentioned for mothers.
Conclusion
Our study underlines the importance of family as an essential factor influencing oral health.
... In Pakistan, oral health trends reflect alarming statistics, with dental caries emerging as the most widespread childhood ailment, surpassing conditions like asthma by fivefold and hay fever by sevenfold [2]. Left untreated, dental decay in preschoolers escalates the risk of future caries in both primary and permanent dentition, along with associated consequences such as pain, infections, costly emergency room visits, hospitalizations, extensive treatment requirements necessitating general anesthesia, hindered growth and development, and increased absenteeism from school [3]. The term "early childhood caries" (ECC) is now used to define decayed, missing, or restored teeth in the primary dentition of children [4]. ...
Background/objectives: Dental caries, a prevalent issue among children, often leads to discomfort and potential complications. Utilizing caries-arresting treatments to slow down its progression offers a practical alternative. Previous research indicates that topical fluorides can deactivate and remineralize enamel caries. This study aims to evaluate the efficacy of 38% silver diamine fluoride (SDF) in halting active dental caries lesions in children.
Materials and methods: This descriptive case series was conducted at the Operative Dentistry Department of the Nishtar Institute of Dentistry in Multan, Pakistan. We enrolled 753 patients aged three to nine years, of both genders, each with at least one cavitated lesion graded 3-6 according to the International Caries Detection and Assessment System (ICDAS). SDF was directly applied to dried and isolated teeth using a micro brush and left to absorb for up to two minutes (adjusted based on the child's cooperation), and parents were instructed to ensure the child refrained from eating or drinking for an hour post-application. Baseline examinations were performed by consultant restorative dentists, and reexaminations were conducted after two to three weeks by a consultant unaware of the study.
Results: The study included children aged three to nine years, with a mean age of 6.02±1.35 years. The majority of patients (61.75%) were aged between three and six years. Among the 753 patients, 619 (82.20%) were male, and 134 (17.80%) were female, with a male-to-female ratio of 4.6:1. The efficacy of 38% SDF in arresting active dental caries lesions in children was observed in 720 (95.62%) patients.
Conclusion: This study demonstrates that 38% SDF is highly effective in halting active dental caries lesions in children.
... ECC is a widespread public issue that results in significant pain and infection in many children, impacting physical development, diminishing learning abilities, and increasing future treatment expenses [9,10]. This dental disease affecting young children is multifactorial, infectious, and transmissible, particularly among vulnerable and low-income populations [11,12]. ...
Background: Early childhood caries (ECC) is a widespread dental problem that impacts children below the age of six years. Traditional restorative treatments like fillings are often challenging and invasive for young children. Silver diamine fluoride (SDF) offers a minimally invasive and cost-effective alternative for managing ECC. However, the effects, acceptance, and understanding of this treatment by parents remain crucial for its successful implementation.
Aim: To evaluate the impact and level of acceptance of SDF treatment in ECC.
Materials and Methods: Thirty-two children from an Anganwadi center aged between two to five years suffering from ECC were selected. A 38% SDF was applied for 3 minutes on the identified carious lesion, and the arrest percentage was checked after a recall period of three weeks and three months. The Likert scale was used for the questionnaire regarding parental feedback about the ease of application procedure, tooth discoloration, possible pain associated with the procedure, and the taste of SDF.
Results: In the present study, a total of 75 surfaces were subjected to the application of SDF. After a period of three weeks, it was observed that 64 of these surfaces had successfully undergone the process of caries arrest. This finding was deemed to be statistically significant, with a P value of 0.021. Furthermore, the remaining surfaces that had not achieved caries arrest were subsequently treated at three months. The results of this subsequent treatment were also found to be statistically significant, with a P value of 0.027. These findings highlight the efficacy of both caries treatment and caries arrest in relation to the utilization of SDF.
Conclusion: SDF was found to be minimally invasive, easy to administer, inexpensive, highly efficient, and effective treatment in arresting caries in the primary dentition of young children, particularly in patients lacking cooperation.
... Although we could not directly prove the human-to-dog transmission of S. mutans owing to the lack of genetic analyses of oral bacteria from dog owners, these amplicon sequencing results suggested that S. mutans in dogs was transmitted from humans. A systematic review and meta-analysis study has proven the mother-to-child vertical transmission of S. mutans [21]. Although the exact mechanism underpinning human-to-dog oral bacterial transmission remains unclear, the risk of such a transmission has been suggested in several studies covering a long period [5,[8][9][10][11]. ...
With the increase in the number of households raising dogs and the reports of human-to-dog transmission of oral bacteria, concerns about dogs’ oral health and the need for oral hygiene management are increasing. In this study, the owners’ perceptions about their dogs’ oral health and the frequency of oral hygiene were determined along with the analysis of dog dental plaque bacteria through metagenomic amplicon sequencing so as to support the need for oral hygiene management for dogs. Although the perception of 63.2% of the owners about their dogs’ oral health was consistent with the veterinarian’s diagnosis, the owners’ oral hygiene practices regarding their dogs were very poor. The calculi index (CI) and gingiva index (GI) were lower in dogs who had their teeth brushed more than once a week (57.89%) than in dogs brushed less than once a month (42.10%); however, the difference was nonsignificant (CI: p = 0.479, GI: p = 0.840). Genomic DNA was extracted from dental plaque bacteria removed during dog teeth scaling, and metagenomic amplicons were sequenced. The 16S amplicons of 73 species were identified from among the plaque bacteria of the dogs. These amplicons were of oral disease-causing bacteria in humans and dogs. The 16S amplicon of Streptococcus mutans matched that of the human S. mutans, with type c identified as the main serotype. This result suggests that human oral bacteria can be transmitted to dogs. Therefore, considering the high frequency of contact between dogs and humans because of communal living and the current poor oral health of dogs, owners must improve the oral hygiene management of their dogs.
... All of this is true despite there being national consensus guidelines as well as a Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG) about the importance of OH for pregnant patients, and many states (including Massachusetts) also having prenatal OH guidelines (Oral Health; MA State Guidelines; Committee Opinion). As part of a comprehensive OH assessment, questions should include asking about the patient's daily brushing and flossing habits, access to a dentist and dental insurance, last dental visit, and any acute dental concerns (da Silva Bastos 2015). ...
Purpose
Oral health (OH) has significant effects on pregnancy and infant outcomes. This study assesses the perspectives of obstetrical clinicians about OH education and promotion.
Methods
A fifteen-item survey was developed and circulated to obstetrics and gynecology (OBGYN) and family medicine (FM) physicians, and other prenatal health clinicians in Massachusetts (MA). Additionally, eight physicians were purposively sampled for in-depth interviews to discuss their experience with prenatal OH training and practice. Bivariate relationships between outcome variables from the survey (e.g., previous OH training, awareness of OH guidelines, asking about OH during prenatal visits) were analyzed along with coding and analysis of the qualitative interview data.
Results
The majority (77%) of the 86 survey respondents did not feel well-trained in OH. We found significant associations between being well-trained in OH and: (1) awareness of state guidelines (X² = 11.85, p < 0.001); (2) asking about OH during prenatal visits (X² = 9.21, p = 0.002); and (3) routinely referring patients for dental care (X² = 15.35, p < 0.001). Lack of access to dental insurance and dental professionals were found to be major perceived barriers to care. Responses from the interviews reinforced these findings.
... Research has shown evidence towards vertical transmission of S. Mutans, caries causing bacteria prior to the eruption of first primary tooth. However, quite contrary to previous evidence [10], mothers in the present study incorrectly assumed that there is no such risk [15]. This finding coupled with a significant oral disease burden in the study population and not taking a child to the dentist early enough indicates greater possibility of transfer of unfavourable bacteria to the newborns mouth in the future. ...
Background of the StudyMyths regarding oral health are extensively prevalent and have considerable impact on pregnant women’s dental behaviour and practices. Thus, this study sought to understand misconceptions (pregnancy and early childhood oral care) and their determinants amongst pregnant women.MethodsA questionnaire designed to assess the participants' demographics, parity, oral health behaviour and misconceptions was administered to 305 pregnant women attending antenatal care. Oral health (DMFT, bleeding on probing and periodontal pocket) was examined. Independent t test, analysis of variance and linear regression were used for statistical computations.ResultsEarly childhood myths (5.54 ± 1.87) were more prevalent amongst the study population than pregnancy-related myths (3.28 ± 1.89). Bivariate analysis exhibited that myths were significantly more prevalent in mothers who were ≤ 30 years of age (8.79 ± 2.565), primi parous (8.90 ± 2.141), illiterate (9.07 ± 2.764) and who had never visited a dentist (8.46 ± 2.016). Both pregnancy and early childhood myth scores were positively correlated to DMFT (p = 0.00; p = 0.031). Educational status and age were significant negative predictors of myths with p values of 0.00 and 0.34, respectively. Parity emerged as the only significant positive predictor (p = 0.002).Conclusion
The high prevalence of myths in the present study advocates that standardized, culturally appropriate and simple educational messages need to be developed and delivered to break these misconceptions. Minimum one visit to a dental surgeon during second trimester should be advocated and encouraged for all pregnant women.
... A Cárie na Primeira Infância (CPI) é um problema de saúde global, afetando aproximadamente 50% das crianças em idade pré-escolar, no mundo. Além disso, cáries não tratadas apresentam prevalência semelhante à observada no Brasil (70-80 %) em vários países do mundo (Bastos et al., 2015;Chen et al., 2017Chen et al., , 2019Lin et al., 2017;Uribe et al., 2021;World Health Organization, 2021). ...
Objetivo: Conhecer a percepção dos profissionais da saúde, da educação e dos pais ou dos responsáveis sobre a saúde bucal de crianças de 0 a 5 anos, em um município da região metropolitana de Belo Horizonte. Metodologia: O estudo utilizou uma abordagem qualitativa e como instrumento da coleta de dados, o grupo focal, realizado com dois grupos: um com os responsáveis e outro com os profissionais. A análise de conteúdo foi feita segundo Graneheim e Lundman, assumindo como referencial teórico as diretrizes da Política Nacional de Saúde Bucal para esse grupo etário. Resultados: Foram identificados 3 temas comuns aos dois grupos: o papel do serviço, da família e da escola na produção da saúde. Os profissionais percebem o serviço como resolutivo, com fluxo de consultas coordenado entre pré-natal e odontologia. porém acham necessária a capacitação dos professores em relação à saúde bucal. Os responsáveis pelas crianças consideraram ser importante a atuação do serviço na prevenção desde nascimento, educação em saúde bucal e assistência às gestantes. Os responsáveis pelas crianças reconhecem seu papel desde amamentação até os cuidados com higiene bucal e hábitos, e consideraram estas tarefas difíceis. Os profissionais entendem que ações escolares são impactantes na promoção de saúde das crianças. Conclusões: Os participantes consideram que a família é responsável pelo cuidado da criança, juntamente com a escola e os serviços de saúde e que esse cuidado deve se iniciar a partir da concepção, com a gestante. Esses resultados serão dados importantes para uma proposta de ação no município de estudo.
... La CPE est une maladie des plus fréquentes chez l'enfant et que l'on peut prévenir (128). ...
Thomas Marquillier. Carie de la petite enfance : déterminants et prévention. Etude épidémiologique dans la région des Hauts-de-France. Santé publique et épidémiologie. Université Paris-Nord - Paris XIII, 2021. Français. NNT : 2021PA131058 . tel-03874910
La santé orale de l'enfant entretient un lien étroit avec la santé générale. Par l'intermédiaire de ses différentes fonctions, elle permet la croissance et le développement de l'enfant pour l'emmener vers l'âge adulte en bonne santé. La carie de la petite enfance (CPE) est une pathologie multifactorielle, qui touche les dents temporaires des enfants âgés de moins de six ans. Cette maladie, à fort potentiel de récidive, est considérée comme chronique dans les populations socialement vulnérables. L'impact de la CPE, tant sur le plan individuel que populationnel, et les inégalités sociales en santé orale qui en découlent montrent qu'il est indispensable de mettre en œuvre des stratégies de prévention adaptées. Dans une logique compréhensive et avec une perspective d'intervention, la complexité de la pathologie conduit à s'interroger sur les prédicteurs de la maladie. Une revue de portée nous a permis de préciser quelles sont les caractéristiques à prendre en compte pour une intervention, à savoir les connaissances des parents et leur niveau de littératie en santé orale ainsi que sur les croyances qui orientent les comportements en santé orale. Une étude épidémiologique prospective en milieu hospitalier, menée dans une région marquée par de fortes inégalités sociales de santé, les Hauts-de-France, a permis de mettre en évidence par ses résultats préliminaires, les déterminants de santé et de recours aux soins dentaires pédiatriques au niveau structurel et individuel. A la fin du recrutement, une analyse multivariée de l'ensemble des données permettra de caractériser plus précisément le profil des patients et de mettre en évidence les facteurs associés à la sévérité de la pathologie. Ce travail de recherche permet d'ores et déjà d'aboutir à la proposition d'un modèle d'intervention complexe, centré sur l'éducation thérapeutique du patient et visant à réduire les inégalités sociales de santé orale. Au-delà d'un modèle centré sur l'hôpital, cette proposition questionne quant à la mise en place sur un territoire défini d'un réseau d'acteurs gradué selon le stade de la maladie carieuse et les lieux fréquentés et mettant en œuvre des interventions en faveur du développement d'un continuum éducatif en santé orale.
... Several studies have also suggested the possibility that dental caries could be correlated with anxiety and stressful situations; in fact, a positive correlation was found between salivary cortisol levels and the experience of tooth decay in children [16]. Several connections are observed between maternal salivary bacterial challenge and children's dental health: countless studies report that vertical transmission, especially of Streptococ-cus mutans, from mother to child is strongly associated with an increased incidence of ECC [17][18][19]. Therefore, ECC prevention strategies should include measures to prevent or delay early colonization by cariogenic bacteria [20]. ...
Tooth decay remains one of the most common diseases in children, although it is a preventable injury and despite significant advances that has been made in terms of attention and care for oral hygiene. Several studies have shown the association between prevalence of tooth decay in children and parents’ incorrect oral care habits, with a low educational level and a low socioeconomic background. The question that arises concerns the actual oral hygiene knowledge of mothers, fathers, family members or caregivers of young patients; therefore, the aim of this review is to investigate the genesis of gaps in the topic. A literature search was conducted through the Scopus and PubMed search engine and ended in May 2022; only studies from the past 20 years were included. Current evidence suggests that parents and caregivers still have little knowledge about their children’s oral health: there is not enough awareness about the importance of preventing oral diseases, due to poor attention to good oral hygiene but also lack of information from health professionals and institutions. In the future, all the professionals involved in the pregnant woman’s care should increase parents’ knowledge, solve their doubts, collect and compare data in order to design effective intervention programs.
... Mothers are considered the main carriers of the oral microbiome, but also of cariogenic germs [9]. The earlier this colonization of the child's oral cavity takes place and the higher the microbial load of the maternal oral cavity observed, the higher the risk for the development of ECC [10]. ...
Early childhood caries is a challenge. Early dental screening flanked by multidisciplinary preventions by pediatricians, dentists, and midwives (MWs) may be helpful. New recommendations for dental screening in children (FUs) and fluoride have been introduced in Germany. The aim of this study was to investigate whether midwives consider FUs useful and implement early childhood caries prevention, as well as fluoride recommendations. The survey was conducted using an online questionnaire. Demographic data, including 11 items on early childhood dental prophylaxis and fluoride, were requested. Agreement was recorded using Likert scales. The data were analyzed descriptively. Two hundred and seventeen female MWs participated (age: 44.1 (11.04) years). One hundred and four (47.9%) participants knew about the FUs. Of the MWs, 30.7% found a referral from the first tooth to be very important (important/neutral/unimportant: 27%/27.9%/14.4%), compared with 84.8% for the entire primary dentition (11.8%/2.8%/0.5%). Of the MWs, 41.7% always recommended fluoride toothpaste from the first tooth (often/occasionally/rarely/never: 22.7%/12.4%/7.9%/15.3%) and 48.1% completely rejected fluoride-free toothpaste (always/often/occasionally/rarely: 9.8%/8.9%/17.3%/15.9%). In addition, 54.8% never recommended the use of fluoride tablets (always/often/occasionally/rarely: 9.2%/7.4%/10.2%/18.4%). The FUs are not yet well-known among MWs, and only less than one-third recommended dental check-ups, starting with the first tooth. This contrasts with the high uptake of fluoridated toothpaste. More educational work should be carried out to convince more MWs of the benefits of the FUs.
... Dental and medical organizations recognize the implications of poor oral health during pregnancy and have established professional guidelines for practice (American College of Obstetricians & Gynecologists, 2013; American Academy of Pediatric Dentistry, 2021; American Academy of Periodontology, 2004). Untreated dental caries can lead to vertical transmission of oral pathogenic bacteria, namely Streptococcus mutans, from mother to child, which can increase the risk of the child developing early childhood caries (ECC) (da Silva Bastos et al., 2015). However, women can reduce the occurrence of ECC by transferring good oral hygiene habits to their children (Adiatman et al., 2017). ...
Objective
The purpose of this study was to assess oral health knowledge, attitudes, and practices of women who had given birth in the United States within the past 2 years, and to evaluate factors affecting women's dental service utilization during pregnancy.Methods
This study used a descriptive, cross-sectional design and employed non-probability sampling methods. The 47-item questionnaire included: oral health behaviors (8), knowledge (5), attitudes (12), and practices during pregnancy (10), and demographic (12) questions. Participants were recruited through multiple postpartum support group forums on Facebook. Logistic regression was used to identify potential predictors of dental utilization during pregnancy.ResultsNinety-one percent of the participants had at least an associate's degree, and 85.6% had dental insurance coverage during pregnancy. Approximately 56% knew the connection between poor oral health and pregnancy complications; however, only 11% obtained this information from their OBGYNs and 10% from their dental offices. Although women aware of the association were more likely to visit the dental office during pregnancy (64%, p < .001), the majority (74%) who experienced tooth or gum related issues during pregnancy reported not receiving any dental or gum treatment. Women, who had positive dental attitudes and awareness of an increased risk of pregnancy complications due to poor oral health, were more likely to receive dental care during pregnancy regardless of dental coverage.Conclusion
Medical and dental providers could play an active role in educating women on the importance of having good oral health, potential oral/systemic relationships, and the benefits of receiving dental care during pregnancy.
... The perinatal period is a "teachable moment" for oral healthcare and can potentially affect maternal and infant health. The odds of children having untreated caries doubled when the mother had untreated caries [15]. ...
b> Objective: Oral health is an integral part of preventive healthcare for pregnant women. This study aimed to determine the oral health problems and oral hygiene practices and identify the factors affecting dental treatment utilization among a representative population of pregnant women in Dubai. Methods: A cross-sectional study was conducted using data from anonymous structured questionnaires filled by 1,450 pregnant women attending primary health centers across different geographical locations in Dubai. Results: Of the 1,450 women, 97.8% brushed at least once a day. At least one dental problem during pregnancy was reported by 49.9%, but dental attendance during pregnancy was only 17.4%. Factors associated with dental visits were nationality, previous pregnancy, oral health problems, brushing habits, routine dental visits, and professional advice on oral care. The odds of dental attendance increase for UAE national women by 1.48, women who had other children before the current pregnancy by 1.35, those having oral health problems by 1.85, those who brush more than once a day by 1.51, those who visited the dentist routinely at least once a year by 1.92, and those who received oral health education by 2.82. The most cited reasons for not going to the dentist were no perceived dental problem (51.8%) and concerns regarding the safety of dental treatment during pregnancy (33.9%). Discussion/Conclusion: In spite of acceptable oral hygiene practices, a significant number of pregnant women (49.9%) experience dental problems. However, only a few women (17.4%) visit the dentist during their pregnancy. It is critical to design and implements strategic oral health programs for pregnant women in Dubai.
... 8,9 The latest evidence emphasized the importance of preventive measures such as dental counselling and early oral hygiene practise before age one since ECC is a preventable disease when early intervention is provided. 10,11 Still, if left untreated, it can cause pain, growth and developmental disorders, premature tooth loss, speech disorder, and exert adverse effects on the permanent tooth. 12 Children with dental caries on their primary teeth in younger age are also more prone to develop dental caries in their permanent dentition. ...
Introduction: Early childhood caries (ECC) is considered a global health concern due to its high prevalence and effect on the overall health of children.
Aim: The present study aimed to investigate prevalence of ECC and associated risk factors in a Turkish subpopulation of children.
Materials and methods: Five hundred forty-two (299 boys, 243 girls) children were enrolled in this study. Caries experience on primary teeth was measured using decayed or filled teeth (dft) index and the presence of caries was diagnosed if dft >0. A structured questionnaire was employed to mothers through interview.
Results: ECC was significantly associated with increased age (OR=1.032; 95% CI, 1.018–1.047; p<0.001), low level of family income (OR=2.91; 95% CI, 1.567–5.404; p=0.001), low educational level of mother (OR=2.602; 95% CI, 1.509–4.485), night-time frequent breastfeeding (OR=1.695; CI, 1.07–2.685; p=0.024) and bottle feeding with sugary beverages (OR=1.689; CI, 1.002–2.847; p=0.049). First dental visit age (OR=1.482; 95% CI, 1.254–1.753; p<0.001) and initial age of tooth brushing (OR=2.062; 95% CI, 1.324–3.209; p=0.001) were found to be protective against ECC development.
Conclusions: The current study highlights potential factors that are commonly associated with the risk of developing ECC. From the perspective of public health, a better understanding of socioeconomic, environmental, maternal and behavioural risks factors for ECC will aid improving maternal and child-based health promotion and preventive programmes.
... 83 Depending on the typing method used, mother-child transmission of S. mutans has been shown to range from 50% to 85%, with multilocus sequence typing being the most discriminatory among the methods. 84 Factors that promote transmission of S. mutans from mother to child include high S. mutans counts in the mother's saliva and a diet rich in sucrose, and it has been suggested that the production of mutacin by the S. mutans strains harbored by the mother may also enhance this process. 85 Transmission of S. mutans can be effectively reduced if mothers from a high-caries-risk population regularly use xylitol-containing chewing gum, as concluded in a recent meta-analysis. ...
Acquisition and establishment of the oral microbiota occur in a dynamic process over various stages and involve close and continuous interactions with the host and its environment. In the present review, we discuss the stages of this process in chronological order. We start with the prenatal period and address the following questions: ‘Is the fetus exposed to maternal microbiota during pregnancy?’ and ‘If so, what is the potential role of this exposure?’ We comment on recent reports of finding bacterial DNA in placenta during pregnancies, and provide current views on the potential functions of prenatal microbial encounters. Next, we discuss the physiological adaptations that take place in the newborn during the birth process and the effect of this phase of life on the acquisition of the oral microbiota. Is it really just exposure to maternal vaginal microbes that results in the difference between vaginally and Cesarian section‐born infants? Then, we review the postnatal phase, in which we focus on transmission of microbes, the intraoral niche specificity, the effects of the host behavior and environment, as well as the role of genetic background of the host on shaping the oral microbial ecosystem. We discuss the changes in oral microbiota during the transition from deciduous to permanent dentition and during puberty. We also address the finite knowledge on colonization of the oral cavity by microbes other than the bacterial component. Finally, we identify the main outstanding questions that limit our understanding of the acquisition and establishment of a healthy microbiome at an individual level.
... 29 A systematic review and meta-analysis concluded that there was an association between S. mutans mothers and their respective children through vertical transmission. 30 The present study showed that only 7.3% of expectant mothers were aware of the transmission of bacteria causing dental caries from mother to child by kissing or sharing utensils. This response was not under the survey conducted by Thomas et al. (22.2%) and Shenoy et al. which reported that 35.6% of participants knew about the transmission of bacteria from mother to child. ...
Introduction:
Good oral health during pregnancy and infancy is important for the overall health and well-being of mother and child, respectively.
Aim:
To assess the knowledge and attitude of expectant mothers regarding the effect of their oral health and its influence on infant oral health.
Materials and methods:
A cross-sectional study was conducted among expectant mothers. They were randomly selected from those reporting to the Department of Gynecology in Government and Private Hospitals in Durg, Chhattisgarh. A total of 124 closed-ended, self-administered questionnaire were filled by participants, which had 21 items addressing the knowledge and attitude of expectant mothers regarding their oral health and oral hygiene practices; the transmission of bacteria from mother to child; cariogenic food consumption; effect of periodontal disease on infant's teeth and safe trimester for dental treatment. Data were tabulated and subjected to statistical analysis.
Results:
Significant differences were found in expectant mothers' knowledge and attitude based on their age (p = 0.02, 0.07), education level (p = 0.001, 0.95), trimester (p = 0.83, 0.43), and number of pregnancies (p = 0.05, 0.10), respectively.
Conclusion:
The knowledge related to the oral health of pregnant women during pregnancy was found to be low and needs to be improved.
Clinical significance:
Execution of educational programs along with other healthcare professionals to motivate expectant mothers.
How to cite this article:
Pattanshetti K, Kothari HP, Tiwari J, et al. Assessment of Knowledge and Attitude of Expectant Mothers Regarding Effect of Their Oral Health and Its Influence on the Infant Oral Health. Int J Clin Pediatr Dent 2020;13(5):471-475.
... This is consistent with our speculation that S. mutans isolated from different dental plaque sites may be closely related strains. Previous studies have shown that vertical transmission of S. mutans from mother to child and horizontal transmission from child to child are the two sources of S. mutans colonization in children [32,33]. MLST was used to evaluate the transmission of S. mutans [34,35]. ...
Introduction. Streptococcus mutans is an important cariogenic microbe.
Hypothesis/Gap Statement. The potential characteristics of S. mutans isolates from site-specific dental plaque are still not clear.
Aim. This study aimed to investigate the phenotypic and genetic characteristics of S. mutans isolates from site-specific dental plaque in China.
Methodology. We used S. mutans isolated from children with early-childhood caries (ECC) and caries-free children to compare the phenotypic and genetic characteristics of S. mutans from site-specific dental plaque samples. The ECC subjects presented two sites: a cavitated lesion and a sound surface. The caries-free subjects presented one sound surface. Growth pattern, biofilm, decrease in pH, extracellular polysaccharide, expression levels of virulence-related genes, multilocus sequence typing (MLST) and phylogenetic trees were evaluated among these three sites.
Results. The phenotypes detected between the cavitated and sound surfaces of ECC children were similar. However, the capacity for biofilm formation, pH drop and expression levels of genes ( gtfB and spaP ) of S. mutans in the caries-free group were lower compared with those of the ECC group. We identified 44 new alleles and 77 new sequence types. More than 90 % of the children with ECC shared an identical sequence type. The distribution of sequence types among different subjects showed diversity, and child-to-child transmission was detected.
Conclusions. This is the first report of MLST on site-specific dental plaques in a single subject, and indicates that S. mutans isolated from site-specific dental plaque of a single subject showed similar phenotypes as a result of the isolates were closely related.
... Moreover, at the age of 18 months, the oral microbiome is known to become stable and the microbial diversity of tongue is comparable to that of adults 7,12 . Also, vertical transmission of mutans streptococci from parents occurs between the ages of 19 and 31 months [13][14][15] . This period is called the "window of infection" 16 . ...
The onset and progress of dental caries and periodontal disease is associated with the oral microbiome. Therefore, it is important to understand the factors that influence oral microbiome formation. One of the factors that influence oral microbiome formation is the transmission of oral bacteria from parents. However, it remains unclear when the transmission begins, and the difference in contributions of father and mother. Here, we focused on the oral microbiome of 18-month-old infants, at which age deciduous dentition is formed and the oral microbiome is likely to become stable, with that of their parents. We collected saliva from forty 18-month-old infants and their parents and compared the diversity and composition of the microbiome using next-generation sequencing of 16S rRNA genes. The results showed that microbial diversity in infants was significantly lower than that in parents and composition of microbiome were significantly different between infants and parents. Meanwhile, the microbiome of the infants was more similar to that of their mothers than unrelated adults. The bacteria highly shared between infants and parents included not only commensal bacteria but also disease related bacteria. These results suggested that the oral microbiome of the parents influences that of their children aged < 18 months.
... The level of caries risk is in luenced by various factors such as socioeconomic status, dietary habits, educational level, and other demographic factors (Costa et al., 2012). Untreated dental caries in preschool children may result in an increased risk of caries incidence, resulting in pain and infections; increased treatment costs from increased emergency room visits and hospital admissions and the need for general anesthesia; and missed days from school and work (de Abreu da Silva Bastos et al., 2015). Management approach to dental caries includes traditional therapeutic techniques, which includes the drill and ill and preventive strategies. ...
The present study aimed to assess the parental acceptance of silver diamine fluoride and to determine whether the acceptability level differs depending on the demographic factors and the location of dental caries. Demographic data and the opinion about the staining effect of SDF treatment on primary teeth were obtained through questionnaire from parents of 60 children aged between 2-5 years with ECC in Chennai, India. The opinion was obtained after showing clinical photographs of SDF treatment. Of the 60 participants, male parents with low socioeconomic status, tend to accept the SDF treatment more. To our knowledge, this is the first study to check for the parental acceptance and perception of silver fluoride treatment in Indian populations. The results show that parent's gender, child's gender, socioeconomic status, level of education, number of children in the family plays an essential role in the acceptance of SDF treatment by the parents. Parents with high socioeconomic status accept SDF treatment to avoid treatment under general anesthesia. A significant difference between male and female and the anterior and posterior teeth (P < 0.05) was observed in acceptance ratings of SDF treatment. Though parents have a concern with the discoloration associated with SDF treatment, most of them prefer SDF treatment over treatment under general anesthesia.
... After referring to the 2015 Global Burden of Disease Study, it is the most prevalent condition that affected 560 million children with primary dentition [2]. Caries which are not treated for long time increases the risk of infection in other permanent and deciduous teeth, which leads to decrease in school attendance, discomfort, expensive emergency treatments and the need for general anaesthesia and limitation of growth and development [3]. Children have limited adaptive capacity which leads to difficulty in some treatment procedures [4]. ...
Major part of the world population is affected with carious teeth, among which the number of children affected are maximum. Carious lesions are more common in susceptible, uninsured and financially weak populations. Caries which are not treated for very long period of time along with no utilisation of available services in both developing and under developed countries pose an essential public health question. Children have limited adaptive capacity which may also lead to difficulty in some treatment procedures. Hence, the need for an efficient and affordable approach for the dental caries treatment was required in areas which have finite access to oral health care services like the school children. Nowadays, Silver Diamine Fluoride (SDF) is very much in demand as it can control caries progression and is very less technique sensitive. This approach does not require caries excavation using instruments, in addition silver has many antimicrobial properties and fluoride helps in remineralization.
... Also of interest is whether mothers transmit cariogenic bacteria to their children, putting them at higher risk of dental caries (previously reviewed by De Abreu Da Silva Bastos et al. 2015). We found no studies that assessed transmission of the oral microbiome and specific microbes from mother to child. ...
Oral microbiomes vary in cariogenic potential; these differences may be established early in life. A major concern is whether mothers transmit cariogenic bacteria to their children. Here we characterize early salivary microbiome development and the potential associations of that development with route of delivery, breastfeeding, and mother’s oral health, and we evaluate transmission of microbes between mother and child. We analyzed saliva and metadata from the Center for Oral Health Research in Appalachia. For this cohort study, we sequenced the V6 region of the 16S rRNA gene and used quantitative polymerase chain reaction to detect Streptococcus mitis, Streptococcus sobrinus, Streptococcus mutans, Streptococcus oralis, and Candida albicans in the saliva from mothers and their infants, collected at 2, 9, and 12 mo (Pennsylvania site) and 2, 12, and 24 mo (West Virginia site). Breastfed children had lower relative abundances of Prevotella and Veillonella. If mothers had decayed, missing, or filled teeth, children had greater abundances of Veillonella and Actinomyces. There was little evidence of maternal transmission of selected microbes. At 12 mo, children’s microbiomes were more similar to other children’s than to their mothers’. Infants’ salivary microbiomes became more adult-like with age but still differed with mothers’ microbiomes at 12 mo. There was little evidence supporting transmission of selected microbes from mothers to children, but risk of colonization was associated with tooth emergence. Children are likely to acquire cariogenic bacteria from a variety of sources, including foods and contact with other children and adults.
... Identifying the pathways is considered as an important step in the prevention of dental caries in order to prevent the spread of infection and provide more conscious selections for preventive methods. 25,26 According to many studies conducted, there is a positive correlation between the amounts of S. mutans in a mother and a child's oral flora. 2,17,27 The findings of our study are also consistent with these findings. ...
Aim
The degree of vertical (intrafamilial) and horizontal (extrafamilial) transfer of Streptococcus mutans ( S. mutans) to a child shows differences according to cultures. The wrong care habits may result in transfer of S. mutans. The aim of this study was to determine the vertical and horizontal transmission of S. mutans to a child and effective factors.
Materials and Methods
Mothers and kindergarten staff of 37 children aged between 4 and 5 years who initially started in two kindergartens (Group 1, n = 19; Group 2, n = 18) were included in this in vivo study according to 95% reliability and 80% theoretical power. Intraoral examination of mothers and children made according to the World Health Organization criteria (dmf-t/DMF-T) was done, following which mothers were asked to fill questionnaire forms including knowledge and attitudes of them about oral/dental health care. 1 mL saliva samples received from children/mothers/staff were examined microbiologically in order to isolate and quantify S. mutans. Arbitrarily primed polymerase chain reaction analysis was done to determine the genetic characteristics of S. mutans. All examinations were repeated to evaluate the horizontal transmission in the fifth month. Parametric tests ( t-test and two-way analysis of variance) were employed for comparison of the variables that meet the normality assumption and nonparametric tests (Mann–Whitney) were also used.
Results
It was observed that there is a statistically significant correlation between mother DMF-T values and mother–child S. mutans similarity level ( P < .05). There is a statistically positive correlation between the habits of using a common fork, spoon, glass, and mother–child similarity level.
Conclusion
Vertical and horizontal transfers occurred in Turkish families in order to prevent the transfer of S. mutans; wrong baby care habits that may lead to the transfer of S. mutans, which is the main factor in case of tooth decay, should be avoided.
... found in dental plaque, the most studied case is the transmission of cariogenic microorganisms from mother to child [33]. Although there are no studies that address the transference of ARG between mother and child from the oral microbiota, it can be assumed that if there is a bacterial transmission, the transference of ARG would be obvious. ...
Objective
This investigation aimed to detect coincidences in the antimicrobial resistance genes (ARG) profiles between members of a group living in a household and to compare them between other groups in order to establish if an exchange of ARG occurs and if dental plaque microbiota can be considered as a source and reservoir of ARG that can be shared between humans and pets.
Methods
One hundred sixty dental plaque samples were obtained from four groups. Shelter Dogs group (n = 20), Adult pet owners and Dogs group (AD group, n = 40), Adult pet owners, Children and Dogs group (ACD group, n = 60), and Adult non-pet owners and Children group (AC group, n = 40). DNA was obtained, and specific primers with polymerase chain reaction for ARG detection were used.
Results
The AD group exhibited the most coincidences in their ARG profiles, 14(70%) of the 20 profiles coincided in 100% followed by the ACD group with 9(45%) coincidences. While the AC group was the less coincident group, only 7(35%) of the 20 profiles coincided. tetM was the most prevalent with 53.1%, followed by tetQ with 52.5% and cfxA with 51.2%. While the less prevalent were tetW with 31.8%, blaTEM-1 with 27.5%, and ermC with 18.7%.
Conclusion
Dental plaque microbiota can be considered as a source and reservoir of ARG that can be shared between humans and dogs living in a household. The dogs seems to play an important role in the transference of ARG, and the children appear to be the most affected by carrying the most significant number of ARG.
... Dental caries is a preventable and reversible disease if treated at an early stage, but if not treated it can cause pain, bacteremia, growth and developmental disorders, premature tooth loss, speech disorder, and adverse effects on permanent tooth successor, not to mention increased of treatment costs 12 . ...
Background/Aim : Dental caries is the most common chronic disease affecting children worldwide today and represents a serious public health problem. Since pediatricians are the first health professionals whom children visit, they can be considered as a reliable source of information regarding the recognition of potential health problems and suggesting their solution, so they have a key role in primary health prevention. The aim of this study is to determine the position of pediatricians in the prevention of oral health of children in Montenegro through the assessment of their knowledge, attitude, and practice of primary professional preventive measures.
Material and Methods : A cross-sectional survey was undertaken among the 84 pediatricians employed in Montenegro Community health services. Self-addressed reply envelope survey consisted questionnaire of 60 questions divided into 5 modules, was used as an instrument for the research.
Results : Response rate was 86%, while 68,3% pediatricians think that gender is a risk factor for dental caries. Fact that cavity-causing bacteria can be transmitted from the mother was confirmed by 69% of respondents. Only 45% of them practice the current guidelines on the recommendation of the first dental examination up to 12 months of life.
Conclusions : It can be concluded that pediatricians in Montenegro have positive attitudes about prevention and believe they have the responsibility to prevent caries but have shown insufficient knowledge about caries and risk factors for the oral diseases.
... There is evidence of vertical transmission of S. mutans, i.e., from mother to child. A systematic review and meta-analysis demonstrated an association between S. mutans in mothers and their respective children (20). From this study, the possible intrafamilial transmission between the mother-child pairs was also evidenced among the children and their respective parents and grandparents. ...
Background:
The main aims of this cohort study were to measure the intrafamilial risk of transmission, sharing and stability of the most virulent S. mutans genotypes.
Material and methods:
A total of 392 clinical isolates of S. mutans obtained from caries-active adults and genotyped to evaluate their transmissibility over time. After extraction of the chromosomal DNA, PCR were performed to detect the genes involved in the production of GbpA (gbpA) and mutacin types I, II, III and IV (mutAI, mutAII, mutAIII and mutAIV).
Results:
The gbpA, mutAI, mutAII, mutAIII and mutAIV genes were detected in 77.3, 12.5, 51, 16.6 and 89.8% of S. mutans isolates, respectively. The virulence of S. mutans was associated with its transmission (P< 0.01) and stability (P = 0.01), with the most virulent genotypes having higher transmissibility (RR = 1.83, 95% CI 1.44 to 2.32) and higher stability in the oral cavity (RR = 1.52, 95% CI 1.06 to 2.19).
Conclusions:
Genotypes with the genetic information to synthesize GbpA and mutacins present an important ecological advantage in the process of colonization by S. mutans; they remain stable among the oral microbiota of the host and favor intrafamilial transmission. Key words:Streptococcus mutans, virulence factors, transmission, dental caries.
... Caries is a multifactorial chronic disease influenced by biological, lifestyle, and behavior factors [4]. Risk factors for early childhood caries include: bacteria transmission from mother to infant [5]; the social determinants of health [2]; parental knowledge [6], attitudes and behaviors towards oral health (e.g., diet, pacifier use, and daily tooth brushing); prolonged bottlefeeding practices [7], and cultural beliefs around primary or "milk teeth" [8,9]. Oral health is connected to socioeconomic status; those with higher income are more likely to access a dentist and have dental insurance coverage [10]. ...
... There is evidence of vertical transmission of S. mutans, i.e., from mother to child. A systematic review and meta-analysis demonstrated an association between S. mutans in mothers and their respective children (20). From this study, the possible intrafamilial transmission between the mother-child pairs was also evidenced among the children and their respective parents and grandparents. ...
... Une méta-analyse publiée en 2015 a mis en évidence le lien entre les défauts de l'émail et le risque élevé d'avoir des lésions carieuses [25] . La mère, de par sa proximité avec l'enfant, représente la principale source de bactéries qui sont véhiculées par la salive lors d'une transmission verticale [26] . Une transmission horizontale peut également avoir lieu lorsque les enfants échangent des objets mis à la bouche à la crèche ou à l'école. ...
EMC - Médecine buccale [Article 28-157-A-10]
Les caries précoces de l’enfant sont une pathologie chronique multifactorielle d’origine bactérienne. C’est une maladie complexe qui s’exprime principalement dans des groupes à risques qui cumulent l’essentiel de la maladie. Sa terminologie ainsi que la compréhension de son étiopathogénie ont évolué au fil du temps. Les facteurs associés à cette pathologie sont nombreux, au même titre que les conséquences de la maladie sur l’enfant et son entourage. L’approche moderne de la maladie repose sur l’ICCMSTM (International Caries Classification and Management System). Ce système propose une approche de la pathologie en quatre étapes et renvoie à une prise en charge suivant le gradient thérapeutique. De l’approche préventive à la réhabilitation prothétique, en passant par les restaurations en méthode directe, cet article propose une approche contemporaine de la maladie carieuse chez l’enfant, applicable en pratique quotidienne au cabinet dentaire.
... The least frequently reported practice to advise parents was that of avoiding sharing utensils with children, which is of concern bacterial transmission from mother to child occurs through salivary contact. [14][15][16] Previous studies reported that 24 to 64.4 percent of pediatricians believed that cariogenic bacteria can be transmitted from mothers to children. 12,13,17 Better education of pediatricians to improve their awareness of this basic infection control advice can potentially reduce children's acquisition of cariogenic bacteria. ...
Purpose: The purpose of this study was to assess: (1) oral health knowledge and practices of pediatricians and pediatrics residents in Riyadh, Saudi Arabia; (2) their adherence to American Academy of Pediatrics (AAP) guidelines for caries-risk assess- ment and anticipatory guidance; and (3) the barriers that prevent their adherence to these guidelines.
Methods: Participants completed a questionnaire comprised of three sections: (1) demographic and professional characteristics; (2) oral health knowledge and practices; and (3) adherence to AAP oral health guidelines and barriers against adherence. The association between knowledge and practices scores and demographic and profes- sional characteristics was assessed using Mann Whitney and Kruskal Wallis tests.
Results: One-third of 1,261 pediatricians and pediatrics residents returned complete questionnaires. The mean±(standard deviation [SD]) knowledge score was 5.0±2.4 (out of 12), and the mean±(SD) practice score was 13.4±5.4 (out of 26). Only 8.3 percent reported following the AAP oral health guidelines, and the barriers against this included lack of awareness (60.9 percent), inadequate training on oral health (28.1 percent), and lack of time (21.6 percent).
Conclusion: Most pediatricians and pediatrics residents in Riyadh had inadequate oral health knowledge and practices as well as poor adherence to the AAP guidelines. Unfamiliarity with the guidelines was reported to be the main barrier against following them. (J Dent Child 2019;86(1):10-6)
Received November 1, 2018; Last Revision November 23, 2018; Accepted November 27, 2018.
... The acquisition of mutans streptococci in children occurs during the first year of life, which is called the window of infectivity (1). The principal source from where infants acquire mutans streptococci is thought to be their main care provider, especially the mother, because the mothers and children present similar or identical bacterial profiles (2,3). Some authors have suggested that mutans streptococci acquisition in children increases with the erupted teeth (4). ...
... It is a known fact that the most important bacteria responsible for dental caries are S. mutans. da Silva Bastos et al., [21] in a systematic review and meta-analysis, concluded that there is scientific evidence of mother-to-child transmission of S. mutans. The AAPD has recommended that maternal dental health should be preserved through proper oral health education and regular dental checkups during and after pregnancy in order to reduce the risk of bacterial colonization and thus transmission to infants. ...
Aim: The aim of this study was to evaluate the amount of knowledge and awareness regarding early childhood caries (ECC) among general dental practitioners of Gujarat state. Materials and Methods: A list of inquiries by means of questionnaires for gauging the knowledge regarding ECC was sent via E-mail to 500 general dental practitioners utilizing Google online survey form. Results: The results were based on the answers given by the participants according to their own perception and were quantified accordingly with the help of a pie chart. Conclusion: Although Dental Practitioners have good awareness regarding ECC, there is a need to update their knowledge in order to contribute towards the prevention and treatment of ECC.
Topical anticaries agents are non‐invasive methods to control and prevent dental caries. SDF is a fluoride‐based agent added to the arsenal of caries prevention tools. It has got a lot of attention since its introduction in the 1970s because of its ability to prevent and arrest caries, as well as its excellent antibacterial and anti‐plaque action. SDF reduces acid production by microorganisms, decreases the Streptococcus mutans count, biofilm formation, increases enamel resistance, and promotes dentinal tubule obliteration when applied to the dental surface. SDF also assists in the remineralization of dentin. A biannual application of 38% SDF has been effective at preventing dentin demineralization. This “silver bullet” can be seen as an alternative for caries prevention in special health care needs children which is minimally invasive and safe. Along with the advantages, there are some disadvantages, and work has been carried out to explore the use of silver nanoparticles (SNP) as anticaries agents to shield the teeth from aesthetic damage caused by Silver diamine fluoride. SNPs are identified to have the potential to prevent and inhibit dental caries while not discoloring demineralized dental enamel. SNPs have a greater surface area for interaction with microorganisms than other particles, making them more effective antimicrobial agents. Fluoride combined with SNP solution has a synergistic effect that promotes enamel remineralization while also acting as a bactericidal agent against cariogenic microorganisms. This review aims to bring out the various advantages and disadvantages related to the use of SDF and SNPs to aid in future research.
Primary tooth decay is the most common noncommunicable chronic disease in young children worldwide. Caries is no longer regarded as a transmissible infectious disease caused by Streptococcus mutans (S. mutans), as was believed in recent decades. The identification of increased levels of S. mutans in the dental plaque is still associated with the occurrence of caries. However, the two observations are not causally linked, but are both consequences of increased sugar consumption. This leads to bacterial dysbiosis within the dental biofilm and to demineralisation of tooth surfaces. The rejection of the assumption that S. mutans is causal in the development of caries has consequences for the counselling of parents about caries prevention. The previously often demanded renunciation of sucking on pacifiers or licking the spoon before feeding warm food to the infant with the aim of preventing caries development in the child must therefore be regarded as outdated. The omission of this requirement is confirmed by the fact that children whose parents have had saliva contact with the child by licking the pacifier or spoon have significantly fewer allergies and are diagnosed with asthma less often than other children.
According to the Academy of Gesneral Dentistry more than 90% of all systemic diseases have oral manifestations (Kane, The effects of oral health on systemic health General Dentistry, 2017). When dental professionals collaborate with their medical colleagues, patients will benefit from aligned knowledge and treatment modalities. Working together, inter-professionals can provide significant contributions toward the prevention of dental caries. Furthermore, by referring and advocating for each other, medicine and dentistry can positively impact their patients’ lifetime bodily health.
It is estimated that 75% of the baby boomer generation will end up in in long-term health care facilities (Haumschild and Haumschild, J Am Med Dir Assoc 10(9):667–671, 2009).This means that there will be an increased problem in the access to health care providers, which would further the burden on the national health care system. Therefore, it is essential to cross train physicians, nurses, dentists, nutritionists, and personal support care workers to recognize early oral risk factors which could also prevent systemic disease. It does not matter who initially examines the patient so long as the essential needed care is rendered.
This chapter will provide beneficial interdisciplinary information on the etiology of caries, caries risk factors, mechanisms of the carious process, and how it is possible to reverse caries. The relationship between dental caries and systemic health will be discussed as well as how to diagnosis and treatment plan carious lesions. Finally, the chapter will provide interdisciplinary caries prevention, and contemplate methods on how to manage caries throughout life.
Dental caries is a common chronic disease affecting humans in all age groups. Various factors can affect the formation of caries including demineralization and remineralization processes with oral flora; dietary and oral hygiene habits; salivary composition, flow rate, pH and buffering capacity; morphological features of the teeth; fluoride exposures, environmental and socioeconomic factors. One of the most important factors causing inter-individual variations in caries susceptibility is the host genetics. Several genes affect individual caries susceptibility. Genes play a role in immune response, development of saliva and tooth enamel. The present review aims to overview the literature focusing on the genetic features of dental caries.
Purpose: To systematically evaluate the horizontal transmission of Streptococcus mutans in children and analyze its relationship with dental caries. Methods: Seven databases were searched for observational studies that have determined the transmission of S. mutans among children younger than seven years. Selection of included studies, data extraction, and quality assessment using Downs and Black's (1998) scoring system were performed. The inverse variance random-effect approach was used to pool the results, and statistical heterogeneity was evaluated using I-squared statistics. Results: Fifteen studies were included for qualitative synthesis, five of which were pooled for quantitative analysis. The risk ratio (RR) of sharing only one genotype in caries-free children versus children with caries was found to be 0.60 (95 percent confidence interval [95% CI] equals 0.45 to 0.80; P ≤ 0.001). The RR of sharing more than one genotype was 1.46 (95% CI equals 1.13 to 1.89; P=0.004) in children with caries versus caries-free children. These findings imply that children sharing only one genotype have a 40 percent lesser risk, and children sharing more than one genotype have a 46 percent higher risk of having dental caries. Conclusions: The systematic review provides evidence of the horizontal transmission of S. mutans and its association with dental caries.
Zahnkrankheiten bei Kindern und Jugendlichen können den Durchbruchszeitpunkt der Zähne in die Mundhöhle, die Zusammensetzung der Zahnhartsubstanzen, die Zahnzahl und -größe sowie farbliche Veränderungen betreffen. Neben Zahnfehlbildungen des Schmelzes und des Dentins werden genetisch bedingte Veränderungen, die alle Zähne beider Dentitionen betreffen, von erworbenen Veränderungen differenziert. Letztere zeigen Auswirkungen an denjenigen Zähnen, deren Zahnhartsubstanzen zum Zeitpunkt des Einflusses gebildet wurden. Erworbene Schmelz- und Dentindysplasien sind sehr viel häufiger als hereditäre Veränderungen. Ätiologisch kann die bei jedem 3. bis 4. Kind in Deutschland feststellbare Molaren-Inzisiven-Hypomineralisation derzeit nicht erklärt werden. Karies gehört trotz des deutlichen Rückgangs der Prävalenz im Kindesalter immer noch zu den häufigsten chronischen Erkrankungen. Aufgrund der eingeschränkten Fähigkeit zur Kooperation stellen fortgeschrittene Läsionen eine therapeutische Herausforderung dar, sodass der Prophylaxe ein hoher Stellenwert eingeräumt werden muss.
Tooth decay is a serious public health problem, and identifying risk factors to the disease in pregnant women is essential. The use of the Cariogram, could contribute to implementing preventive measures to improve women’s health during pregnancy. The purpose of this study was to determine the risk to dental caries in pregnant women. The Cariogram presents the results of the five risk factors of caries, and it was observed that the patients have a 42% of chance to avoid new carious lesions and 58% could present lesions, which could be caused by 40% related to diet and bacteria. Conclusion: To date, existing studies are not sufficient to ultimately identify main caries risk factors associated with dental decay in pregnant women.
El propósito de esta investigación fue evaluar la transmisión y el grado de homología de Streptococcus mutans en 24 binomios madre-niño asistentes al Hospital Universitario de Maternidad y Neonatología de la Ciudad de Córdoba, República Argentina. Muestras de saliva total sin estimular del binomio a los 6 y 18 meses de edad del niño y muestras de biofilm supragingival a los 18 meses del niño fueron analizadas a través de la técnica de reacción en cadena de la polimerasa con primers arbitrarios (AP-PCR). Las muestras previamente fueron sembradas en Agar Miris Salivarius 0,28 mg/ml de bacitracina, durante 48 hs a 37°C y 5% co2 para el desarrollo de Streptococms mutans. Las colonias bacterianas se identificaron morfológica y bioquímicamente usando Api 20 Strep y se recuperaron en 5 ml de caldo cerebro corazón e incubaron a 37°C durante 48 hs. La extracción de ADN se llevó a cabo según el método de Bollet. La AP-PCR se realizó con los primees OPA-02 y OPA-05. Los productos de AP-PCR se observaron por electroforesis en gel de agarosa 1% (0,5 mg/ml de bromuro de etidio). La información generada fue procesada en el programa Infostat P 1.5, aplicando el índice de identidad Simple Matching. De los binomios madre-niño analizados el 47,05% de las cepas aisladas en las madres presentaron similitud genética con las de sus hijos. Si bien reconocemos a la madre como la fuente de infección más importante, consideramos que no es la única de la edad temprana.
Objective Objective: To detect the presence and transmission of S. mutans carrier of the spaP gene in samples of bacterial plaque in mother/child pairs from municipal child education centers, and the possible association with dental caries. Methods The sample comprised 56 mother/child pairs. For the evaluation of the prevalence and severity of caries, the DMFT and dmft indices were used, following World Health Organization criteria. The oral hygiene pattern was also evaluated using the Simplified Oral Hygiene Index and O'Leary's plaque control index. Using DNA extracted from bacteria in the dental plaque of mother/child pairs, a sequence of the S. mutans spaP gene was amplified using PCR. The chi-squared test, Fisher's exact test and Pearson's correlation coefficient were applied, using a level of significance of p< 0.05. Results The mothers presented a DMFT index of 11.02 (SD=6.3) while the children exhibited a dmft index of 2.09 (SD=3.2). Approximately 40% of mother/child pairs had a good oral hygiene index. A higher percentage of children with caries had, in their dental plaque, S. mutans harboring the spaP+ gene (p=0.03). No association was detected between the presence of S. mutans spaP+ in the dental plaque of mother and child. Conclusion An association was found between experience of caries in the children and the presence of bacteria carrying the spaP+ gene. Our results did not detect vertical transmission. Indexing terms: Dental caries. Polymerase chain reaction. Streptococcus mutans. Transmission. RESUMO Objetivo Detectar a presença e a transmissão de S. mutans portador do gene spaP em amostras de placa bacteriana em pares mãe/criança de centros municipais de educação infantil e possível associação com a cárie dentária. Métodos A amostra foi composta por 56 pares mãe/criança. Para avaliação da prevalência e severidade de cárie foram utilizados os índices CPO-D e ceo-d seguindo critérios da Organização Mundial de Saúde. O padrão de higiene bucal foi avaliado através do Índice de Higiene Oral Simplificado e do índice de controle de placa O´Leary. Utilizando o DNA extraído das bactérias da placa dentária dos pares mãe/criança, uma seqüência do gene spaP de S. mutans foi amplificado pela PCR. Os testes de Qui-quadrado, exato de Fisher e correlação de Pearson foram realizados. Adotando-se significância de p< 0,05. Resultados As mães apresentaram índice CPO-D de 11,02 (DP=6,3) enquanto as crianças mostraram índice ceo-d de 2,09 (DP=3,2). Aproximadamente 40% dos pares mãe/criança tinham um bom índice de higiene bucal. Maior porcentagem das crianças com cárie apresentaram em sua placa dentária S. mutans abrigando o gene spaP+ (p=0,03). Não foi detectada associação entre a presença de S. mutans spaP+ na placa dentária da mãe e seu filho. Conclusão Foi verificada a associação entre a experiência de cárie nas crianças e a presença da bactéria portadora do gene spaP+. Nossos resultados não detectaram a transmissão vertical. Termos de indexação: Cárie dentária. Reação em cadeia da polimerase. Streptococcus mutans. Transmissão. Detection of Streptococcus mutans of the spaP gene and dental caries in mother/child pairs ORIGINAL | ORIGINAL Detecção de Streptococcus mutans portador do gene spaP e cárie dentária em pares mãe/criança
A metabolomic approach was used to analyze endogenous metabolites and to correlate with a specific biological state. The analysis of salivary metabolites is a growing area of investigation with potential for basic and clinical applications. Analyses of children's saliva in dif-ferent dentitions and with or without caries could poten-tially reveal a specific profile related to oral disease risk. Nuclear Magnetic Resonance (NMR) is well suited for mixture analysis followed by Principal Component Anal-ysis combined with Linear Regression (PCA-LR) statistics and was used to identify differences in the salivary metabolites. The classificatory analysis was performed using PCA-LR based on 1,000 cross-validation bootstrap runs from both classifiers in order to increase the data information from a small sample size. The PCA-LR pre-sented a statistically good classificatory performance for children with and without caries with an accuracy of 90.11 % (P \ 0.001), 89.61 % sensitivity (P \ 0.001), and 90.82 % specificity (P \ 0.001). Children with caries lesions presented higher levels of several metabolites, including lactate, fatty acid, acetate and n-butyrate. Saliva from subjects with different dentition stages was also analyzed. Although the salivary samples were poorly classified, permanent dentition presented increased levels of acetate, saccharides and propionate. The NMR data and PCA-LR were able to classify saliva from children with or without caries, with performance indexes comparable to the partial least-squares regression discriminant analysis (PLS-DA) results also performed. Our data also showed similar salivary metabolite profiles for healthy subjects despite the differences in their oral hygiene habits, socio-economic status and food intake.
The aim of this study was to determine whether random amplified polymorphic DNA (AP-PCR) analysis is able to differentiate genetically different clones of mutans streptococci, in 22 Brazilian family members. Stimulated saliva samples were collected from fathers, mothers and infants. For 5-18 months babies with erupting primary dentition, plaque samples were collected using sterile tooth pick tips. From these samples, mutans streptococci were isolated on SB-20 agar plates. After growth, representative colonies were identified by biochemical methods on the basis of carbohydrate fermentation. Streptococcus mutans isolates were obtained from all family members and AP-PCR typed separately with a random primer (OPA-13). Bacterial cell lysates were used as template in PCR reactions and the amplified DNA fragments obtained were compared by agarose gel electrophoresis. Results demonstrated that the father shared the baby's genotype in three families and the mother shared the baby's genotype in 12 families seven babies harbored Streptococcus mutans strains similar to those of their siblings. The technique was able to demonstrate the genetic Streptococcus mutans in Brazilian family members.
Background:
Although caries is prevalent in adults, investigators have tested few preventive therapies in adult populations. In a randomized controlled trial, the authors evaluated the effectiveness of xylitol lozenges in preventing caries in adults at elevated risk of developing caries.
Methods:
The Xylitol for Adult Caries Trial (X-ACT) was a three-site placebo-controlled randomized trial. Participants (n = 691) aged 21 through 80 years consumed five 1.0-gram xylitol or placebo lozenges daily for 33 months. They underwent clinical examinations at baseline and at 12, 24 and 33 months.
Results:
Xylitol lozenges reduced the caries increment 10 percent. This reduction, which represented less than one-third of a surface per year, was not statistically significant. There was no indication of a dose-response effect.
Conclusions:
Daily use of xylitol lozenges did not result in a statistically or clinically significant reduction in 33-month caries increment among adults at an elevated risk of developing caries.
Clinical implications:
These results suggest that xylitol used as a supplement in adults does not reduce their caries experience significantly.
Objective:
High levels of Streptococcus mutans on teeth of young children are predictive of Early Childhood Caries (ECC). Transmission from mother-to-child is common and studies have demonstrated treatment of the mother results in less ECC. The objective of this study was to determine how dentists have adopted the practice of counseling about ECC.
Methods:
In 2006 as part of a larger study on dental care for pregnant women, we surveyed 829 general dentists in Oregon. The questionnaire contained questions to capture the extent to which general dentists have adopted counseling pregnant women about ECC transmission, to describe personal and practice characteristics, and examine how dentists' views on the ease of adopting of new procedures related to ECC counseling. Multivariate logistic regression was used to identify separate and additive effects of demographic and practice characteristics, attitudes, and beliefs.
Results:
The adjusted odds of a dentist who strongly believed in the link between mothers and babies and provided ECC counseling were 1.60 (95% CI 1.3-2.0, P<0.01). The odds of a dentist who reported discussing ECC with staff members and provided counseling were 2.7 (95% CI 1.7-4.3, P<0.01). Male dentists were less likely to counsel patients than female dentists (Adjusted OR=0.5, 95% CI 0.3-1.0, p<0.05).
Conclusions:
The strongest predictors of counseling patients about ECC were dentists' belief in the evidence of caries transmission and dentists' discussion of ECC during staff meetings.
Streptococcus mutans, a member of the human oral flora, is a widely recognized etiological agent of dental caries. The cariogenic potential of
S. mutans is related to its ability to metabolize a wide variety of sugars, form a robust biofilm, produce copious amounts of lactic
acid, and thrive in the acid environment that it generates. The remarkable genetic variability present within the species
is reflected at the phenotypic level, notably in the differences in the cariogenic potential between strains. However, the
genetic basis of these differences is yet to be elucidated. In this study, we surveyed by PCR and DNA hybridization the distribution
of putative virulence genes, genomic islands, and insertion sequences across a collection of 33 strains isolated from either
children with severe early childhood caries (S-ECC) or those who were caries free (CF). We found this genetically diverse
group of isolates to be remarkably homogeneous with regard to the distribution of the putative virulence genes and genetic
elements analyzed. Our findings point to the role of other factors in the pathogenesis of S-ECC, such as uncharacterized virulence
genes, differences in gene expression and/or enzymatic activity, cooperation between S. mutans strains or with other members of the oral biota, and host factors.
This study utilized multiple genetic analyses to detect evidence of maternal MS acquisition in children with S-ECC.
Twenty-seven mother/child pairs were selected from children with 5-ECC preceding dental rehabilitation under general anesthesia. Plaque samples were collected from the mother, child, and the child's carious lesion. Arbitrarily primed-polymerase chain reaction (AP-PCR) genotyped 6-8 MS isolates from each plaque sample, and unique genotypes were identified. Representative MS isolates with unique genotypes were characterized by pulsed-field gel electrophoresis (PFGE). Cluster analysis using the Dice band-based similarity coefficient was used to generate dendrograms from gel bonding patterns. A Dice coefficient >70% indicated similarity or match among PFGE genotypes.
In 26% (7/27) of mother/child pairs, all of the child's isolates matched the mother. In 15% (4/27), some of the child's genotypes matched the mother, and in 59% (16/27), no isolates matched the mother. Maternal transmission was a mode of MS acquisition in 41% (11/27) of mother/child pairs, while acquisition from non-maternal sources occurred in 74% (20/27).
MS genotypes that did not match maternal strains were identified in the majority of children (74%) within this S-ECC population. Evidence of maternal transmission was detected in 41% of mother/child pairs.
Transmission of Streptococcus mutans, a major dental caries pathogen, occurs mainly during the first 2.5 years of age. Children appear to acquire S. mutans mostly from their mothers, but few studies have investigated non-familial sources of S. mutans transmission. This study prospectively analysed initial S. mutans oral colonization in 119 children from nursery schools during a 1.5-year period and tracked the transmission from child to child, day-care caregiver to child and mother to child. Children were examined at baseline, when they were 5-13 months of age, and at 6-month intervals for determination of oral levels of S. mutans and development of caries lesions. Levels of S. mutans were also determined in caregivers and mothers. A total of 1392 S. mutans isolates (obtained from children, caregivers and mothers) were genotyped by arbitrarily primed PCR and chromosomal RFLP. Overall, 40.3 % of children were detectably colonized during the study, and levels of S. mutans were significantly associated with the development of caries lesions. Identical S. mutans genotypes were found in four nursery cohorts. No familial relationship existed in three of these cohorts, indicating horizontal transmission. Despite high oral levels of S. mutans identified in most of the caregivers, none of their genotypes matched those identified in the respective children. Only 50 % of children with high levels of S. mutans carried genotypes identified in their mothers. The results support previous evidence indicating that non-familial sources of S. mutans transmission exist, and indicate that this bacterium may be transmitted horizontally between children during the initial phases of S. mutans colonization in nursery environments.
Streptococcus mutans is a known pathogen of dental caries and its major cell surface antigens have been widely investigated. Recently, an approximately 120 kDa Cnm protein with binding properties to type I collagen was identified, and its encoding gene (cnm) cloned and sequenced. In the present study, we sequenced cnm from 47 different clinical S. mutans strains and found that the nucleotide alignment of the collagen-binding domain was well conserved. We devised a PCR method for identifying the cnm gene, examined the prevalence of cnm-positive S. mutans strains in various mother-child groups, and assessed the significance of such strains for transmission and dental caries. The detection rate of cnm-positive strains was significantly lower in strains isolated from Japanese children in the 2000s (8.0 %) as compared to those isolated in the 1980s (15.8 %) (P<0.05). Furthermore, the presence of S. mutans possessing cnm in salivary specimens collected from 55 S. mutans-positive mother-child pairs was 40 and 32.7 % in the mothers and children, respectively. The frequency of cnm-positive children whose mothers were also positive was 72 %, which was significantly higher than that of cnm-positive children with negative mothers (P<0.0001, odds ratio 17.5). In addition, clinical parameters indicating dental caries were significantly increased in children with cnm-positive S. mutans in saliva (n=13), as compared to those with cnm-negative S. mutans (n=15) and S. mutans-negative children (n=20) (P<0.01). These results indicate that cnm-positive S. mutans strains are closely correlated with dental caries, while vertical transmission in cnm-positive mother-child pairs was also demonstrated.
The purposes of this literature review were to: (1) review the sources of mutans streptococci (MS) colonization in children and the effect of MS levels of primary caregivers on children's MS colonization; and (2) evaluate studies examining interventions to reduce transmission of MS from caregivers to their children. Forty-six studies were reviewed. Strong evidence demonstrated that mothers are a primary source of MS colonization of their children. A few investigations showed other potential sources of children's MS colonization, notably fathers. The role of other factors influencing transmission, such as socioeconomic status (SES) and specific cultural or behavioral practices, are unclear. There were at least 12 reports of microbiological interventions to reduce transmission of MS from caregivers to their children. Even though most studies found a reduction of MS in the children and 2 showed significant caries reduction, these studies generally lock consistent findings regarding caries reduction, hove a small sample size and inadequate control groups, and lock blindness of investigators and subjects. The efficacy of microbiological approaches on the caregivers to reduce caries risk in children still needs to be established through more rigorously designed clinical trials.
Attempts to study the acquisition, transmission, and other aspects of the natural history of Streptococcus mutans infections in humans have been hampered by limitations and inconsistencies in methods by which phenotypic characteristics of individual isolates are examined. Because most mutans streptococci associated with human dental caries fall within the biotype I (serotypes c and f) grouping, designated S. mutans, these typing methods are of little value in distinguishing individual isolates. Here we show that strains of S. mutans obtained from over 30 individuals demonstrate unique "fingerprints" of chromosomal DNA digested with restriction endonuclease HaeIII. To demonstrate that this polymorphism in restriction fragments can be used to study the acquisition and transmission of this organism, we examined isolates of S. mutans from three mother-infant pairs obtained at the time the infant first became colonized by this organism. Results indicate that strains of S. mutans found in infants exhibit restriction fragment profiles identical to those of their mothers, strongly supporting the notion that mothers transmit this organism to their infants. Also, we show that strains of S. mutans with the same restriction fragment profile were stably maintained over a 3-year interval in the one mother-infant pair studied. Moreover, we found that mothers and their infants harbored only a few individual strains, suggesting that transmission of this organism is probably confined within discrete family cohorts. Collectively, these findings demonstrate the potential utility of genomic fingerprinting in studying the natural history of S. mutans infections in humans.
The transmission of mutans streptococci is thought to occur along familial lines based on investigations which have shown common strains within family units by using phenotypic typing methods, such as bacteriocin production and immunity profiles and serotyping. Difficulties in implementing these typing methods, coupled with conflicting interpretations of results between laboratories, led us to study the conservation of Streptococcus mutans strains within a mother-child cohort by using a genotypic marker, plasmid DNA. Plasmids (all 5.6 kilobases in size) were observed at an overall frequency of 3.3%, with a significantly different frequency in whites (1.5%) compared with blacks (6.6%). Plasmid-containing strains were significantly clustered in mother-child pairs compared with nonrelated individuals (58 versus 3.3%; P less than 0.001). Moreover, the different plasmid groups (I and II) were highly conserved within racial boundaries (P = 0.007). In those instances in which we were able to characterize distinct strains by either biotype or plasmid profile, we found that mothers harbored a more heterogeneous population of mutans streptococci than did their children. This suggested, among other possibilities, that children acquire additional strains as they approach adulthood. Alternatively, we may have been unable to detect more heterogeneity of strains in children because of quantitative differences of strains in saliva. We present collective data which show that strains of S. mutans are highly conserved within not only mothers and their children but also racial groups, suggesting vertical transmission of this organism within human populations. Moreover, we show that levels of S. mutans found in the saliva of the mother correlated with levels found in her child, demonstrating a quantitative relationship within mother-child pairs.
Previous cross-sectional studies using bacteriocin profiles, serotyping, or genotyping suggest that mothers are the principle source of mutans streptococci (MS) to their infants. This study determined the commonality of MS genotypes between mothers and their infants at the time of initial acquisition. Oral bacteria of mothers and their infants were monitored from birth for approximately 3 years at three-month intervals. Genotypes of MS in infants appeared identical to those present in mothers in approximately 71% of 34 mother-infant pairs studied. Interestingly, female infants acquired MS genotypes identical to their mothers' with significantly greater fidelity than male infants (88% vs. 53%). Homology of genotypes between mothers and their infants at initial acquisition strongly suggests that MS strains were transmitted from mother to infant and that this transfer exhibited gender specificity. In no instance did we observe homology of genotypes between fathers and infants or fathers and mothers, further supporting the notion that acquisition of MS in humans follows maternal lines. Although the prevalence of dental caries was low in this young child population (11/34; 32%), we observed that male children who harbored the same genotype as their mothers had a 13 times greater likelihood of having caries than female children who acquired their mothers' strain; this difference was statistically significant (p < 0.01). Although we do not know the biological mechanisms governing fidelity of acquisition between a mother and her infant, our data suggest that caries outcome may be, in part, determined by both the source of MS and the presence of a specific genotype of MS.(ABSTRACT TRUNCATED AT 250 WORDS)
The production of bacteriocin-like inhibitory substances, mutacins, by mutans streptococci varies among isolates. To find if the degree of mutacin activity of an isolate was related to its transmission between mother and her child, 19 mothers and their 18-month- to 3-year-old children were sampled for their oral mutans streptococci. In addition, the stability of mutacin activity was studied with isolates from the mothers and with isolates from five unrelated 5-year-old children in 5- to 7-year follow-up studies. A total of 145 oral mutans streptococcal isolates were serotyped by immunodiffusion, ribotyped, and mutacin typed by the stab culture technique. Mutacin was produced by 88% of the strains against more than 1 of the 14 indicator strains, representing mutans streptococci, Streptococcus sanguis, Streptococcus salivarius, Streptococcus oralis, Streptococcus gordonii, and Streptococcus pyogenes. Streptococcus mutans isolates showed more inhibitory activity than did Streptococcus sobrinus isolates. Identical ribotypes had similar mutacin activity profiles within a subject, initially and in the follow-up studies, in all but two cases. The mothers harbored a total of 37 different mutans streptococcal ribotypes. Six children were negative for mutans streptococci. Transmission was probable in 9 of 20 mother-child pairs on the basis of the presence of identical strains, as determined by ribotyping and bacteriocin (mutacin) typing. S. mutans strains shared between a mother and her child showed a broader spectrum of inhibitory activity than did nontransmitted strains. In conclusion, the mutacin activity of clinical isolates is reasonably stable, and this virulence factor seems to be of clinical importance in early colonization by S. mutans.
Our previous study reported that the fidelity of mutans streptococci (MS) transmission from mother to infant was gender- and race-specific within a Birmingham, Ala., population. We hypothesized that fidelity might be a function of postnatal nurturing practices. The purpose of the present study was to investigate those factors that could be correlated with MS transmission among Chinese children whose nurturing histories were known. Forty-eight families with 2- to 3-year-old children were selected from two kindergartens of Beijing, China. A questionnaire concerning the childhood nursing practice was obtained from the parents. Dental caries status was examined, and bacterial samples were collected for all participants twice at 6-month intervals. An average of six isolates of MS was picked at random from selective medium from each individual at each visit. Chromosomal DNA fingerprints were performed for all MS isolates to determine the genomic similarity within each family and among individuals. The results showed that 66% of the children at 2-3 years of age harbored MS, and 46% were caries-active. Of those children, 70% were breast-fed. Among the children whose chromosomal DNA fingerprint genotypes of MS matched that of their mothers, 88% were breast-fed compared with only 12% who were not breast-fed (p = 0.03). We also found that children who were breast-fed for more than 9 months were likely to harbor strains of MS common to their mothers (p = 0.04) and experience more dental caries (dmft = 4.4) at 3 years of age compared with children who were breast-fed less than 9 months (dmft = 1.4, p = 0.04). The data suggest that breast-feeding, especially prolonged breast-feeding, may correlate with the fidelity of transmission and that prolonged breast-feeding may contribute to a higher caries rate.
The aim of this study was to perform a follow-up evaluation of the Streptococcus mutans and Streptococcus sobrinus colonization profile of children's oral cavities, which included the pattern of vertical transmission from mother to child,
genotypic diversity, and stability of the strains. The subjects were 16 mother-child pairs, who were monitored for 20 months.
Samples of saliva, tongue dorsum, alveolar ridge mucosa, and dental plaque from the children were collected bimonthly. Saliva
samples from the mothers were also collected. After isolation and identification, the arbitrarily primed PCR method was performed
for the genotypic characterization of S. mutans (968 isolates) and S. sobrinus (111 isolates). At the time the strains were acquired, the children harbored one to four distinct genotypes of S. mutans and only one genotype of S. sobrinus. Although S. mutans prevalence and genotypic diversity were greater than those of S. sobrinus, the presence of matching genotypes of S. mutans and S. sobrinus was similar (in 81.25 and 83.33% of mother-child pairs, respectively), suggesting vertical transmission for both species.
This longitudinal study showed an increase in genotypic diversity of S. mutans in the oral cavity during the follow-up period: most of the initially acquired genotypes persisted, normally those genotypes
transmitted by the mother, and some were lost during follow-up; new strains were also acquired. In conclusion, S. mutans and S. sobrinus genotypes acquired from maternal or alternative sources may show effective persistence in the oral cavity and/or transitory
detection in the children's mouths, reflecting the continuous development of oral microbiota in children.
S. mutans plays a key role in dental caries. The extent to which perinatal events influence the acquisition of S. mutans is unclear. We hypothesized that several maternal factors, including the mode of delivery, influence the initial acquisition of S. mutans in infants. A prospective cohort study was conducted in 156 mother-infant pairs. The study found that maternal gestational age (p = 0.04), S. mutans level (p = 0.02), caries score (p = 0.02), sexually transmitted disease (STD) infection experience (p = 0.01), and family income (p = 0.03) had significant effects on the acquisition of S. mutans. Among infants who became infected, those delivered by Caesarean section acquired S. mutans 11.7 mos earlier than did vaginally delivered infants (p = 0.038). C-section infants harbored a single genotype of S. mutans that was identical to that of their mothers (100% fidelity). Analysis of the data demonstrated the possible perinatal influences on infants' acquisition of a member of the cariogenic microbiota, and its potential effect on caries outcome.
Streptococcus mutans is the major pathogen of dental caries, a biofilm-dependent infectious disease, and occasionally causes infective endocarditis.
S. mutans strains have been classified into four serotypes (c, e, f, and k). However, little is known about the S. mutans population, including the clonal relationships among strains of S. mutans, in relation to the particular clones that cause systemic diseases. To address this issue, we have developed a multilocus
sequence typing (MLST) scheme for S. mutans. Eight housekeeping gene fragments were sequenced from each of 102 S. mutans isolates collected from the four serotypes in Japan and Finland. Between 14 and 23 alleles per locus were identified, allowing
us theoretically to distinguish more than 1.2 × 1010 sequence types. We identified 92 sequence types in these 102 isolates, indicating that S. mutans contains a diverse population. Whereas serotype c strains were widely distributed in the dendrogram, serotype e, f, and k strains were differentiated into clonal complexes. Therefore, we conclude that the ancestral strain of S. mutans was serotype c. No geographic specificity was identified. However, the distribution of the collagen-binding protein gene (cnm) and direct evidence of mother-to-child transmission were clearly evident. In conclusion, the superior discriminatory capacity
of this MLST scheme for S. mutans may have important practical implications.
Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.
The microbial and dietary factors that drive caries have been studied scientifically for 120 years. Frequent and/or excessive sugar (especially sucrose) consumption has been ascribed a central role in caries causation, while Streptococcus mutans appeared to play the key role in metabolising sucrose to produce lactic acid, which can demineralise enamel. Many authors described caries as a transmissible infectious disease. However, more recent data have shifted these paradigms. Streptococcus mutans does not fulfil Koch's postulates – presence of the organism leading to disease, and absence of the organism precluding disease. Furthermore, molecular microbiological methods have shown that, even with a sugar-rich diet, a much broader spectrum of acidogenic microbes is found in dental plaque. While simple sugars can be cariogenic, cooked starches are also now recognised to be a caries threat, especially because such starches, while not ‘sticky in the hand’, can be highly retentive in the mouth. Metabolism of starch particles can yield a prolonged acidic challenge, especially at retentive, caries-prone sites. These changes in the paradigms of caries aetiology have important implications for caries control strategies. Preventing the transmission of S. mutans will likely be inadequate to prevent caries if a sufficiently carbohydrate-rich diet continues. Similarly, restriction of sucrose intake, although welcome, would be unlikely to be a panacea for caries, especially if frequent starch intake persisted. Instead, approaches to optimise fluoride delivery, to target plaque acidogenicity or acidogenic microbes, to promote plaque alkali generation, to increase salivary flow or replace fermentable carbohydrates with non-fermentable alternatives may be more promising.
Abstract— Strains of Streptococcus mutans, an organism strongly implicated in the aetiology of human dental caries, have been identified by means of a bacteriocin typing technique. Examination of family groups suggests that the organism can be transmitted intrafamiliarly thus supporting the notion that human dental caries is an infectious transmissible disease.
The purpose of this study was to investigate whether there was an intrafamilial similarity of mutans streptococcal strains in some Swedish families using chromosomal DNA fingerprinting. Plaque samples were obtained from buccal and occlusal surfaces of 25 three-year-old children, their mothers and 18 fathers. The colonization levels of mutans streptococci were estimated with the “Strip mutans” test, and caries experience was scored by decayed, missing and filled teeth or decayed, extracted and filled teeth. Interviews about medical history, diet regimes, breastfeeding and care of the child were performed. In 11 families isolates of mutans streptococci were detected in all three individuals. These isolates were serotyped by immunofluorescent technique and genotyped using the restriction endonuclease Hae III. The results showed that 5 children harbored mutans streptococci genotypes different from their parents. Six children showed genotypes identical to their mothers. None of the children harbored genotypes similar to their fathers, even though two thirds of the fathers had high or very high mutans streptococci levels. No matching of genotypes was observed within the 11 parental pairs. Mothers as primary caregivers with high “Strip mutans” scores were more often observed in the group with identical genotypes within the mother-child pairs, the “matching group”, than in the “no-matching group”. These data indicate that the fathers and the children had not acquired each others' strains of mutans streptococci nor had the spouses. The results suggest that the children acquired mutans streptococci both from outside and inside the family.
The purpose of this study was to investigate the vertical transmission of mutans streptococci (MS) and lactobacilli in a group of Thai families.
One hundred eighty-one mother-child pairs were included in this study. Unstimulated saliva was collected using the spatula method and counted for evaluating the number of MS and lactobacilli on a selective medium. Genotyping of MS and Lactobacillus species were performed in 37 and 22 child-mother pairs, respectively. Typically, 3 to 4 isolates of MS and/or Lactobacillus strains from each mother and child were collected for genotyping by an arbitrarily primed polymerase chain reaction (OPA-02 primer for MS and enterobacterial repetivive intergenic consensus primers for Lactobacillus species).
Generally, MS and lactobacilli levels in children were associated with their mothers' levels. Genotyping of most isolates of MS and Lactobacillus strains in both mothers and children found diversity, and each individual showed a distinct genotypic pattern. The presence of matching genotypes of MS and Lactobacillus strains of mother-child was approximately 76% and 50%, respectively. The genotypes acquired from the maternal route show effective persistence in the children's oral cavities.
In Thai families, mothers can be the source for transmission of mutans streptococci and Lactobacillus strains to their children.
A systematic review of published data was conducted with the aim of assessing the caries preventive effect of consuming xylitol-based candies and lozenges.
Electronic and hand searches were performed to find clinical trials concerning the consumption of products containing xylitol, published up to November 2009. The studies must have had the following characteristics: (a) a comparison of caries progression in subjects who either did or did not consume candies or lozenges containing xylitol during a minimum follow-up period of 1 year; and (b) a concurrent comparison of the percentage of caries progression according to the World Health Organization criteria. The caries preventive effect of xylitol was assessed by calculating the prevented fraction.
The initial search identified 127 references. Six studies met the initial eligibility criteria, but three were excluded after thorough analysis. Two more articles were selected after hand searching, but they were excluded due to the presence of chewing gum in the experimental group. Of the three selected studies, two found a lower caries increment in the treatment groups. Although the findings of the analyzed studies suggest that the use of xylitol-based candies and lozenges could favor a reduction in caries increment, in general, their consumption did not seem to be effective on the proximal surfaces. Nevertheless, these findings are not supported by strong evidence.
This research demonstrates the need for well-designed randomized clinical studies with adequate control groups and high compliance by the subjects.
A new reliable genotyping method, multilocus sequence typing (MLST), was used to evaluate vertical transmission of the cariogenic pathogen Streptococcus mutans. A total of 136 S. mutans strains were isolated from saliva samples of 20 Japanese mother-child pairs, including 5 girls and 5 boys with primary dentition, and 5 girls and 5 boys with mixed dentition. The nucleotide sequences of 8 partial housekeeping genes, aroE, murI, gltA, glnA, glk, tkt, lepC, and gyrA, were analyzed and a similarity for all of those sequences between strains from a mother-child pair was regarded as indicating transmission, which was shown in 70% of the pairs. Interestingly, the rate of transmitted strains from mothers was significantly higher in the girls (90%) than in the boys (p = 0.001). Furthermore, the S. mutans sequence type (ST) with the highest distribution percentage in each maternal saliva sample was found to be transferred to their children. In addition, variations in two large conjugative-transfer associated regions, TnSmu1 and TnSmu2, were determined and compared with the STs defined by MLST. No variations in those two regions shown by PCR patterns were present in any of the strains isolated from the same families with the same STs, though isolates of some STs from different families showed distinct patterns for TnSmu2. Our results indicate that mothers are the main source for transmission of S. mutans to their children, while the present MLST method was also shown to be useful for investigating bacterial transmission.
The colonization of Strep. mutans in infants was studied using a selective medium. The organism was not detected in 91 normal predentate infants, but was detected in two out of ten predentate cleft palate infants with acrylic obturators. In infants with only erupted primary incisors, the organism was detected in plaque samples from 9 of 40 subjects. Serological characterization of 66 Strep. mutans isolates from nine mother-child pairs revealed the c serotype to be the most common. In addition one b, two d, and one E serotype were isolated from the mothers. All isolates from infants were of the c serotype. Subsequent samples were obtained in the case where the b serotype was detected. Strains of this serotype were isolated from both mother and infant.
Bacteriocin typing has been used as an epidemiological tool for tracing bacterial infections in man. The production of bacteriocins by 120 Streptococcus mutans isolates from 4 mother-infant pairs was studied to test the likelihood of maternal transmission of this species. The patterns of inhibition were sufficiently different to allow differentiation of the 120 isolates into 42 bacteriocin types. The bacteriocin codes of isolates within one pair did not correspond to the codes of strains isolated from any other pair examined. The number of infant strains (per 10 infant isolates) matching maternal strains within each mother-infant pair were , , , and for each of the pairs respectively. The results demonstrated significant intra-pair homogeneity of Strep. mutans strains based on bacteriocin production.
The majority of bacteria which colonize humans display sharp host and tissue tropisms; consequently, relatively little is known about how they initiate colonization on mucosal surfaces. The mouth has a variety of features which have enabled it to serve as a useful model for the discovery of basic principles of host-parasite interactions occurring in mucosal environments. Early studies demonstrated that indigenous bacteria attach to surfaces of the mouth in a highly selective manner; attachment was often observed to correlate with colonization. These studies led to the recognition that bacterial attachment is an essential step for colonization in environments which contain surfaces exposed to a fluid flow. Bacterial adhesion has subsequently grown into a major area of infectious disease research. Many bacteria have been found to possess proteinaceous components, called "adhesins", on their surfaces which bind in a stereochemically specific manner to complementary molecules, or "receptors", on the tissue surface. Adhesins are often lectins which bind to saccharide receptors, but some adhesins are thought to bind to proteinaceous receptors. Studies of components of human saliva, which adsorb to hydroxyapatite (HA) surfaces similar to those of teeth, and promote the attachment of prominent plaque bacteria, have revealed that the acidic proline-rich proteins (PRPs) promote the attachment of several important bacteria. These include strains of Actinomyces viscosus, Bacteroides gingivalis, some strains of Streptococcus mutans, and others. The salivary PRP's are a unique family of molecules. However, segments of PRPs are structurally related to collagen. This may be significant, since B. gingivalis and certain cariogenic streptococci bind to collagenous substrata, and such interactions may facilitate their invasion into gingival tissues, or into dentin or cementum, respectively. Another unexpected observation was that although A. viscosus and other bacteria bind avidly to PRPs adsorbed onto apatitic surfaces, they do not interact with PRPs in solution. PRP molecules evidently undergo a conformational change when they adsorb to HA, and adhesins of A. viscosus recognize cryptic segments which are only exposed in adsorbed molecules. This provides the bacteria with a mechanism for efficiently attaching to teeth while suspended in saliva. It also offers a molecular explanation for their sharp tropisms for human teeth. It has proven convenient to refer to such hidden receptors for bacterial adhesins as "cryptitopes" (from cryptic, meaning hidden, and topo, meaning place).(ABSTRACT TRUNCATED AT 400 WORDS)
The aim of the present study was to determine the source and transmission route of Streptococcus mutans. The frequency of this organism in saliva and plaque samples was compared among fifteen pairs of mothers and their children. The results showed that most of the mothers harboured almost equal or greater levels of S. mutans than their children. Similarities of the distribution of various serotypes and mutacin types were observed between these mothers and their offspring. Samples were also collected from plaque and/or carious lesions of the relatives of the subjects who carried one of the serotypes other than serotype c as the dominant S. mutans. The strains of the same serotypes of S. mutans which possessed similar mutacin patterns were predominantly detected in the siblings and mothers of each subject. However, a similar distribution of S. mutans strains was not clearly observed in other relatives including fathers, aunts, uncles and grandparents.
The production of bacteriocins by 314 Streptococcus mutans isolates from 20 mother-infant pairs was studied to test the likelihood of maternal transmission of this species. The patterns of inhibition were sufficiently different to allow differentiation of the 314 isolates into 41 bacteriocin types. The bacteriocin codes of isolates within one pair did not correspond to the codes of strains isolated from any other pair. The number of infant strains (per infant isolates) matching maternal strains within each mother-infant pair were 10/10, 10/10, 10/10, 12/12, 2/3, 10/10, 10/10, 10/10, 3/3, 5/10, 8/8, 3/3, 8/8, 3/3, 7/7, 4/4, 3/3, 8/8, 3/3 and 4/4 for pairs 1-20, respectively. Statistical analysis, utilizing a randomization test, generated a p value less than 0.0001, which is 12 standard errors above the level expected if the pairings were random.
To identify the source of infection with the potentially cariogenic Streptococcus mutans, unstimulated saliva and two approximal plaque samples were examined from each member of 10 families, five of which were re-sampled 6 months later. Each morphological type of Strep. mutans appearing on SB-20 medium was identified by a biochemical micromethod and by bacteriocin typing. Ninety-three per cent of the 46 subjects harboured Strep. mutans and multiple types were detected in 78 per cent of adults and 46 per cent of infected children. Each mouth yielded c/e/f biotypes and 46 per cent also carried d/g types. Generally, saliva types were the same as those in plaque and the second sampling confirmed the first. Most fathers did not share strains with others in the family but all the infected children shared at least one common strain with the mother. The mother as the major source of Strep. mutans infection in young children was confirmed.
Streptococcus mutans was detected in 38 of 156 infants harbouring 6–8 primary incisor teeth. The salivary level of Strep. mutans was determined for each of the 156 mothers of the infant subjects. The difference in the distribution of the salivary levels of Strep. mutans within the maternal populations of infected versus non-infected infants was statistically significant (P < 0.0001). In addition, the frequency of infant infection (0.58) was approximately nine times greater when maternal salivary levels of the organism exceeded 105 colony-forming units (CFU) per ml relative to the frequency of infant infection (0.06) observed when maternal salivary reservoirs were less than or equal to 103 CFU/ml.
The aim of this study was to investigate the intra-familial distribution of mutans streptococci in some Chinese families. Eighteen families consisting of mother, father and a 3-yr-old child without any older siblings participated. Clinical examination and interview were performed to obtain information about level of mutans streptococci in saliva, caries prevalence scored by DMFT or deft, general health, diet regimens, breast-feeding time, principal caretaker of the child and the parents' profession. At the same appointment, two pooled plaque samples from each subject were collected with the tips of sterile tooth picks. From these plaque samples, mutans streptococci were isolated on MSB-agar plates and identified by serotyping. Pure isolates were obtained from all subjects of 11 families. These isolates were genotyped using restriction endonuclease HaeIII. The results showed that in 4 families the mothers shared genotype with the child, and in 3 families it was the father and the child who harboured a similar genotype. In 2 families, all subjects harboured an identical genotype. Further, the spouses in one parental pair showed an identical genotype, and, finally, in one family all subjects harboured their unique genotypes. None of the investigated factors could explain the differences in the intra-familial distribution of mutans streptococci. The pattern of similar genotypes in these Chinese families differs from that reported for western families.
The aim of this study was to investigate the transmission of Streptococcus mutans between children with cleft lip and/or palate and their mothers.
Saliva samples of 21 mother-child pairs were collected and cultured on plates containing a selective growth medium for mutans streptocci. At least five separate colonies of each colony morphotype were isolated. A polymerase chain reaction (PCR) with randomly chosen primers was used to type the isolates.
The number of morphotypes and PCR types was significantly lower in the children than in the mothers. Significant correlations were found between the number of morphotypes and PCR types, in the children as well as in the mothers. In only 38% of the mother-child pairs were the same PCR types found in mother and child.
This suggests that S. mutans had been transmitted from mother to child in one-third of the population studied. No correlations were found among the number of colony-forming units, the number of colony-colony-morphotypes, and the number of PCR types of the mothers and transmission. Similar PCR types in mother and child were found significantly more often in children who had more than one PCR type. The results indicate that transmission of S. mutans from mother to child is not frequent in children with oral cleft. This may have consequences for preventive treatment of cleft lip and/or palate children and their mothers.
The purpose of this study was to investigate the intrafamilial distribution of mutans streptococci in Japanese families using chromosomal DNA fingerprinting with three endonucleases; EcoRI, HindIII and HaeIII. The analysis of 1,908 isolates cultured from the dental plaque of 76 subjects from 20 families (20 married couples and 36 of their children) resulted in the identification of 144 genotypes containing 114 strains of Streptococcus mutans (serotype c, 66.7%; e, 12.5%) and 30 strains of S. sobrinus (d, 13.2%; g, 7.6%). A mean of 1.89 genotypes (from one to four) was harbored in individual subjects, and a mean of 4.10 genotypes from two to seven was harbored in individual families. Among the 70 genotypes found in the children, 36 (51.4%) were in agreement with their mothers and 22 (31.4%) were in agreement with their fathers. The other genotypes (18.6%) did not correspond with the parents. Homologous strains between parents were found in only two couples. This result showed that fathers or others as well as mothers can be sources of transmission. Further, the serotype d, e and g strains showed significantly higher probabilities of transmission than serotype c.
The aim of this study was to evaluate the consistency of the prevalence of mutans streptococci in a group of Swedish families. Eleven families, which had previously been examined for genotypes of mutans streptococci, were re-examined after 2-5 years. The families consisted of mother, father and a child (mean age 7.2 years at the follow-up examination). One father did not participate. Pooled plaque samples were obtained from buccal and occlusal surfaces. Isolates of mutans streptococci were genotyped using chromosomal DNA digested with restriction endonuclease HaeIII, separated by gel electrophoresis and visualised through UV illumination after ethidium bromide staining. Comparing the DNA fingerprints of mutans streptococci found at baseline and follow-up, 9 children harboured one or two genotypes which were similar on the two sampling occasions. Two of these children had also gained a genotype. The remaining 2 children had lost a genotype each and 1 of them had gained two new genotypes. All 21 adults showed one or two genotypes identical to those found at baseline. Nine of these 21 adults had also lost one genotype. Four of these 9 and additionally 4 of the remaining adults showed one or two new genotypes. Six mother-child pairs shared a genotype at baseline and this pattern remained for five pairs at the end of the study. The results suggest that genotypes of mutans streptococci have a fairly high degree of consistency in children between 3 and 8 years of age as well as in adults, indicating persistence of the strains. However, the results also indicate that some subjects may gain and/or lose genotypes.
It has been shown that there is a window of infectivity for mutans streptococci between the ages of 19 and 31 months, when many children acquire mutans streptococci transmitted from their mothers. Part of the children that escape this window acquire mutans streptococci at a later age. In this group, maternal transmission is expected to be less prevalent. The present study compared the bacteriocin activity profiles of mutans streptococci isolated from mothers, fathers and children when the children acquired the mutans streptococci between the ages of 5 and 11. Twelve families were randomly selected from a group of 11-year-old children who were known to have acquired mutans streptococci during this age period. From the saliva of the mothers (n = 12), fathers (n = 8) and children (n = 12) approximately 30 mutans streptococci strains were isolated. All isolates were tested twice for bacteriocin activity against 21 indicator strains with a double-layer technique. Bacteriocin activity of strains was considered to be different when the number of strains against which bacteriocin was produced differed >1 or when the width of one or more inhibition zones differed > or =4 mm. In 7/12 mother-child pairs similar profiles were found. In the 8 father-child pairs similar profiles were only found on 2 occasions. In these 2 families, all 3 ( mother, father and child) harboured strains with a similar profile. In 4/8 father-mother pairs similar profiles were found. There was no correlation between the prevalence of mutans streptococci strains, the number of indicator strains against which the strains made bacteriocin, nor the mean size of the inhibition zones and the presence of similarity of bacteriocin activity profiles of mutans streptococci within the family members. The results show that even when a child acquires mutans streptococci after the age of 5, there may be similarity between mutans streptococci in mother, father and child, indicating that transmission between the family members occurs.
The purpose of this study was 1) to investigate whether a group of children not colonized by mutans streptococci (MS) at the age of 3 years were colonized several years later, and 2) to study whether MS that appeared in the children were identical to those found in the parents. In a previous study no MS were found in 13 3-year-old first-born children. In 10 of these children pooled plaque samples were again collected after 5 years, and in the other 3 children after 2 years. Additionally, separate plaque samples were obtained from the children's first permanent molars when the teeth were present. Pooled samples were also obtained from all the parental pairs at follow-up and from three pairs at baseline. MS were isolated, and genotyping was done through DNA fingerprinting by restriction endonuclease analysis. In 10 children MS were still not found. Among the three children with detectable MS the DNA fingerprints of the bacteria were the same in one girl and her mother and in one boy and his father; in the other boy no similar pattern was found in either mother or father. None of the individuals in the 13 parental pairs showed identical genotypes of MS. The results indicate an opportunity to remain MS-negative if not colonized at the age of 3 years. The difficulty of being colonized with MS from the spouse is highlighted.
The purposes of this study were to determine the age at the initial acquisition of mutans streptococci (MS) and to determine the transmission of MS among children at day nursery by describing the occurrence of genotypes prepared by chromosomal DNA fingerprinting of the bacteria using restriction endonuclease EcoRI and HaeIII. The samples were 39 children (23 boys and 16 girls) aged 0-5 years old, 14 pairs of parents and 6 nursery caretakers of a day nursery in Hiroshima city, Japan. The children had no dental caries throughout the experiment. Plaque samples of the children were taken using toothbrushes at 1 month intervals for 30 months. The initial acquisition of MS occurred between the ages of 8 months and 52 months with a mean age of 24.2 months. The cumulative probability of initial acquisition of MS increased rapidly at the age of 12 to 25 months after 10 to 20 primary teeth had erupted. Transmission of MS was found between child and mother (33.3%), child and father (8.3%) and child and others including amongst the children (58.4%), but no evidence of MS transmission from nursery caretakers was found. Two children acquired MS from intra- and extra-familial transmission. This study suggests that the child's environment also plays a role in the initial acquisition and transmission of MS, in addition to the oral condition of the children.
To explore the intrafamilial homology and longitudinal stability of colonization by early acquired mutans streptococci, genomic fingerprinting was performed on 254 strains (192 Streptococcus mutans and 62 Streptococcus sobrinus strains) collected from 16 families (16 mother-child pairs, seven fathers and four siblings). Genomic DNA was digested by the restriction endonuclease HindIII, followed by gel electrophoresis, Southern blotting, and hybridization with a digoxigenin-labeled 16S rDNA probe, and hybrid detection by enhanced chemiluminescence. One to five ribotypes were identified per person, and between two and nine (median five) within each family. Fourteen of the 16 mother-child pairs showed homology for at least one ribotype (range 1-4). Six of the seven father-child pairs had one ribotype in common. Ten of the 13 longitudinally examined children showed persistence of at least one ribotype over a period of up to 16 yr. The results support the notion of intrafamilial transfer of mutans streptococci, and suggest that colonization of early acquired strains persists into young adulthood.
The major route of early acquisition of mutans streptococci in humans is a vertical transmission from mother to child. The purpose of this longitudinal study was to examine the acquisition, distribution and persistence of Streptococcus mutans and Streptococcus sobrinus in children whose mothers harbored both species and to study the caries incidence in relation to colonization of these bacteria. Fifteen mother-child pairs were followed during the child's first 7 years. Stimulated salivary samples were taken from the mothers and the children. Plaque samples were also collected from the teeth and the tongue of the children. The samples were analyzed by cultivating techniques together with genomic fingerprinting and hybridizing. The caries experience was evaluated on the sampling occasions and retrospectively using the records of caries registrations from the community clinics. During the 7-year period 10 of the 15 children acquired mutans streptococci. Only 4 of them were colonized by both S. mutans and S. sobrinus despite the fact that their mothers harbored both species. In 2 of the children S. sobrinus was found later than S. mutans. A total of 26 genotypes were found in the children and 9 of them were identical to their mothers. New genotypes and a gain-loss pattern were noted especially in the children but also in their mothers. The groups of teeth first positive for the two species were the deciduous molars. The caries experience was low during the study period with 8 children showing no caries.
To investigate the transmission of Streptococcus mutans in a group of Turkish families using AP-polymerase chain reaction (PCR) detection.
Eight mothers who had high S. mutans levels in unstimulated saliva and 8 children aged between 2 and 3 years participated in the study. Plaque samples from each child were collected with the tips of sterile toothpicks for S. mutans counts. Although not part of the original study design, S. mutans samples were also obtained from the unstimulated saliva of the three fathers who shared the same households. Three typical isolates of S. mutans were isolated from TYCSB agar of each subject and identified by sugar fermentation tests. S. mutans ATCC 10449 was used as the reference strain. AP-PCR was conducted with OPA-05 primer.
All of the mothers and fathers shared the similar genotypes within their children. The fathers also harbored similar genotypes to their spouses.
The mothers or the fathers could be the source for the transmission of S. mutans to their children.
The aim of the study was to establish the colonization of Streptococcus mutans and to determine the possibility of intra-familial transmission in a group of Turkish children and their parents. A total of 56 children participated in the study together with their parents (20 fathers and 49 mothers). Saliva samples were collected from the individuals and cultivated on S. mutans selective TYCSB agar. The typical isolates of S. mutans were identified by using classical microbiological methods, as well as molecular typing of S. mutans clones which was performed by using AP PCR with OPA5 primer for the detection of transmission. The vertical transmission of salivary S. mutans was detected among 14 mother-father-child, 35 mother-child (one twins) and 6 father-child combinations. The homologies of strain types were recorded as 24% and 16.6% for mother-child and father-child combinations, respectively. A significant positive correlation (p<0.001) was found between the infected children and their parents with high S. mutans counts.