Mother-to-child transmission of Streptococcus mutans: a systematic review and meta-analysis

Socio-behavioural associates of Early Childhood Caries among preschool children aged three to four years in Gampaha district, Sri Lanka: a cross sectional study

BACKGROUND

Early Childhood Caries (ECC) is a highly prevalent disease among preschoolers in Sri Lanka, with stagnated prevalence over the decades. Therefore, it is important to determine the socio-behavioural associations of ECC among preschoolers to reduce the country's ECC burden.

METHODS

A cross-sectional study with a multistage cluster sampling technique was used to select 3 to 4 year-old preschoolers/mothers dyads in Gampaha district in 2019. Preschoolers who completed third birthday and had not completed fifth birthday on the day of data collection were selected. The dependent variable was the presence (dmft ≥ 1) or absence (dmft = 0) of ECC. Independent variables were sex, monthly family income, mother's educational and occupational status, child's birth order, family type, frequency of consumption of sweets and sweetened drinks, time of sweet consumption during the last 24 h, toothbrushing frequency, supervision of toothbrushing, dental visit, and maternal dental caries. A pre-tested validated questionnaire was used. Multiple logistic regression analysis was used.

RESULTS

Total of 1038 preschoolers were selected. There were 529 females (51.0%) and 509 males (49.0%). The prevalence of ECC was 56.3% (95% CI: 53.1-59.3). Consuming sweets between meals had a higher odds ratio than consuming sweets after main meals (OR = 1.72, 95% CI:1.25-2.35), consumption of sweets every day had a higher odds ratio than consumption of sweets several times a week or less (OR = 2.89, 95% CI: 2.02-4.13), consumption of sweetened drinks every day had a higher odds ratio than consumption of sweetened drinks several times a week or less (OR = 1.73, 95% CI: 1.07-2.79), and the presence of maternal caries had a higher odds ratio than the absence of maternal caries (OR = 1.74, 95% CI: 1.12-2.69). The use of adult fluoridated toothpaste than not using adult fluoridated toothpaste (OR = 0.64, 95% CI:0.48-0.85), tooth brushing twice per day than not brushing twice per day (OR = 0.67, 95% CI:0.51-0.89), and supervised toothbrushing than unsupervised toothbrushing (OR = 0.61, 95% CI: 0.41-0.93) was negatively associated with ECC.

CONCLUSIONS

ECC is highly associated with sweet consumption and oral hygiene behaviours among preschoolers in Gampaha District. Interventions should focus on the oral health behaviours of preschoolers to reduce ECC burden.

Oral Health Literacy Status, Knowledge Levels, Beliefs, and Behaviors of Pregnant Women

CONTEXT

Pregnancy may exacerbate the frequency and severity of some dental problems. However, most pregnant women avoid going to the dentist.

AIMS

To examine the oral hygiene and dental care behaviors of women during pregnancy, to measure their knowledge levels, to reveal their oral and dental health literacy status, and their beliefs about treatment.

SETTINGS AND DESIGN

The study was conducted for a period of 1 month with pregnant women over the age of 18 who presented to the obstetrics outpatient clinic and agreed to participate in the study and who had no known anomalies or complications.

METHODS AND MATERIAL

A survey was completed by face-to-face interviews with 317 pregnant women of different ages and gestational weeks. Participants were asked questions regarding their sociodemographic characteristics, pregnancy characteristics, oral hygiene-related beliefs, behaviors, and knowledge levels.

STATISTICAL ANALYSIS USED

The data obtained in the study were analyzed with SPSS 21.0 program. Since the kurtosis and skewness values were between +3 and -3, parametric tests were used.

RESULTS

In total, 317 pregnant women between the ages of 18 and 43 participated in the study. The most common beliefs are listed as; babies receive the necessary calcium from the teeth, antibiotics given during dental treatment harm the baby, and panoramic radiography taken during treatment harms the baby. 91.5% of the participants did not visit the dentist after planning a pregnancy, and 89% of them did not visit the dentist during pregnancy. The most common reason not to visit the dentist is not having a dental problem. The rate of knowing that dental infections during pregnancy will affect the baby is 50.5%.

CONCLUSIONS

In the present study, it is seen that pregnant women do not have adequate oral hygiene. The reasons were listed as various false beliefs and lack of sufficient knowledge. Health professionals should provide information about oral hygiene to pregnant women and direct them to the dentist.

An Assessment of Oral Health Training in Obstetrical Care in Massachusetts

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.

Clinical Effect of Thioglycosides Extracted from White Mustard on Dental Plaque and Gingivitis: Randomized, Single-Blinded Clinical Trial

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.

Salivary microbiome and MRP-8/14 levels in children with gingivitis, healthy children, and their mothers

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.

Assessing the Effects and Acceptance of Silver Diamine Fluoride Treatment in Early Childhood Caries

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.

Examining the Efficacy of 38% Silver Diamine Fluoride in Halting Active Dental Caries Lesions Among Children: A Descriptive Study

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.

Evidence Supporting Oral Hygiene Management by Owners through a Genetic Analysis of Dental Plaque Bacteria in Dogs

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.

Measuring quality of dental care during pregnancy

BACKGROUND

The authors aimed to develop and validate 2 Dental Quality Alliance measures of dental care access during pregnancy (Utilization of Services During Pregnancy, Oral Evaluation During Pregnancy) using claims and enrollment data and to report performance on these measures for a sample of Medicaid and Children's Health Insurance Program beneficiaries.

METHODS

The authors used Transformed Medicaid Statistical Information System enrollment and claims data for 7,767,806 people enrolled in 5 state Medicaid programs and Children's Health Insurance Programs during 2018. The authors used split-half reliability testing to assess measure reliability. The authors calculated 95% CIs to assess statistically significant variation in performance between programs.

RESULTS

The intraclass correlation coefficient used to assess agreement between the split samples was 0.992 (95% CI, 0.941 to 0.999; P < .0001) for Utilization of Services During Pregnancy and 0.983 (95% CI, 0.879 to 0.998; P < .0001) for Oral Evaluation During Pregnancy. Performance scores ranged from 20% through 34% of beneficiaries receiving any dental service during pregnancy (Utilization of Services During Pregnancy) and from 14% through 23% of beneficiaries receiving a periodic or comprehensive oral evaluation during pregnancy (Oral Evaluation During Pregnancy), with statistically significant differences between programs.

CONCLUSIONS

The measures reliably assessed access to dental services and can distinguish performance between programs.

PRACTICAL IMPLICATIONS

These measures can be used to advance population health by means of supporting national efforts to improve access to dental care during pregnancy.

The contribution of maternal factors to the oral microbiota of the child: Influence from early life and clinical relevance

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.

Misconceptions Regarding Essential Oral Health Care Amongst Pregnant Women Visiting a Tertiary Care Hospital in the State of Goa, India: A Descriptive Study

Background of the Study

Myths 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.

Methods

A 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.

Results

Early 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.

Maintaining and Improving the Oral Health of Young Children

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.

Genetic aspects of dental caries

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.

What Do Mothers (or Caregivers) Know about Their Children’s Oral Hygiene? An Update of the Current Evidence

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.

Attitude of Midwives towards Fluoride Recommendations and Oral Prevention in Infants and Young Children

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.

Postpartum U.S. Women's Oral Health Knowledge, Attitudes, and Practices During Pregnancy

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.

RESULTS

Ninety-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.

Acquisition and establishment of the oral microbiota

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.

Phenotypic and genetic characteristics of Streptococcus mutans isolates from site-specific dental plaque in China

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.

Comparison of oral microbiome profiles in 18-month-old infants and their parents

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.

Vertical and Horizontal Transmission of Streptococcus Mutans and Effective Factors: An In Vivo Study

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.

Assessment of Knowledge and Attitude of Expectant Mothers Regarding Effect of Their Oral Health and Its Influence on the Infant Oral Health

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.

Maternal Oral Health Influences Infant Salivary Microbiome

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.

Evaluation of CRAFT as a Tool for Caries Risk Assessment in 3- to 6-year-old Children and its Validation against Alban's Test: A Pilot Study

Introduction

Dental caries is a multifactorial disease and a dynamic process that can be prevented and reversed during the early stage. Risk assessment is an important step in decision-making and treatment planning. There are no valid tools available for the Indian population. Caries risk assessment for treatment (CRAFT) is a chairside tool for caries risk assessment and management. Valid, reliable, economical, and chairside caries risk assessment tool is the need of the hour for general and pediatric dentists.

Aim

To evaluate CRAFT as a tool for caries risk prediction among 3-years to 6-years-old children and to validate it against Alban test.

Materials and methods

A pilot study was conducted, including forty 3-years to 6-years-old children. Salivary samples were collected and inoculated on B.C.G.-Dextrose Agar. Caries activity was assessed using Alban test. Their parents/guardians completed the CRAFT assessment in entirety.

Results

The data were tabulated and subjected to suitable statistical analysis. High positive correlation between CRAFT scores and Alban's test (Spearman's Rho = 0.874) was found.

Conclusion

CRAFT scores were highly correlated with Alban scores in 3- to 6-year-old children. CRAFT could be successfully employed as a reliable, economical, chairside, and clinically feasible risk assessment tool with further research on a larger sample size.

Clinical significance

CRAFT can provide a framework for the clinician for preventive care and enhance patient–participation for CRA.

How to cite this article

Thakur JH, Subhadra HN, Jawdekar A. Evaluation of CRAFT as a Tool for Caries Risk Assessment in 3- to 6-year-old Children and its Validation against Alban's Test: A Pilot Study. Int J Clin Pediatr Dent 2019;12(6):538–542.

Dental plaque microbiota of pet owners and their dogs as a shared source and reservoir of antimicrobial resistance genes

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 seem 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.

The role of the pediatricians in dental caries prevention in Montenegro: The knowledge, attitude and practice

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.

Diet and Lifestyle Before and During Pregnancy - Practical Recommendations of the Germany-wide Healthy Start - Young Family Network

Diet and exercise before and during pregnancy affect the course of the pregnancy, the child's development and the short- and long-term health of mother and child. The Healthy Start - Young Family Network has updated the recommendations on nutrition in pregnancy that first appeared in 2012 and supplemented them with recommendations on a preconception lifestyle. The recommendations address body weight before conception, weight gain in pregnancy, energy and nutritional requirements and diet (including a vegetarian/vegan diet), the supplements folic acid/folate, iodine, iron and docosahexaenoic acid (DHA), protection against food-borne illnesses, physical activity before and during pregnancy, alcohol, smoking, caffeinated drinks, oral and dental hygiene and the use of medicinal products. Preparation for breast-feeding is recommended already during pregnancy. Vaccination recommendations for women planning a pregnancy are also included. These practical recommendations of the Germany-wide Healthy Start - Young Family Network are intended to assist all professional groups that counsel women and couples wishing to have children and during pregnancy with uniform, scientifically-based and practical information.

Influence of mode of delivery, family and nursing determinants on early childhood caries development: a prospective cohort study

INTRODUCTION

Conflicting results exist regarding mode of delivery and caries. We investigated the influence of the mode of delivery and selected family- and nursing factors during the first 2 years of life on the prevalence of dental caries at 5 years.

MATERIALS AND METHODS

551 infants were invited to a prospective medical study with focus on growth and overweight prevention. The parents of 346 infants (179 boys and 167 girls) accepted this invitation and at the age of 2-years, 336 of them agreed to dental check-ups and salivary samplings. At the ages of three and five years, 302 (90%) and 292 children (87%) could be re-examined with respect to caries by one of two calibrated examiners. All stages of caries lesions were scored on tooth and surface level. Background maternal and nursing data were collected semiannually through validated questionnaires and interviews.

RESULTS

The caries prevalence (initial + cavitated lesions) was 5.6% at 3 years of age and 18.9% at 5 years. The 5-year-olds delivered with caesarian section displayed a significantly elevated risk of having caries (relative risk [RR] 2.2; 95% confidence interval (CI) 1.4-3.6; p < .05). Parental smoking and siblings with caries were the most influential family determinants (p < .05) while drinking juice to meals at 2 years of age (p < .05) was most outstanding among the nursing factors (p < .05).

CONCLUSIONS

In this cohort, the mode of delivery (caesarian section) had a significant impact on the risk of early childhood caries (ECC) but also other family and infant nursing determinants were related to the development of the disease.

A Developmental Approach to Pediatric Oral Health

Orofacial growth and development is a complex process spanning the life course. This article provides an oral health overview in the context of overall growth, physical and social development from infancy through adolescence. It reviews oral health-specific developmental milestones during childhood (0-12 years) and adolescence (≥13 years). It examines issues particular to each age category or spanning multiple ages (eg, pediatric overweight and obesity, tobacco use, and dental trauma) in relation to oral health and development. In addition, the oral microbiome and its potential role in informing personalized oral health care across the life course is discussed.

Oral Health Interventions During Pregnancy

Oral health is a fundamental component of health and physical and mental well-being. Oral health is influenced by an individual's physiologic and psychosocial attributes and cumulative oral health experiences. The perinatal period is a critical time when health and oral health determinants set in and thus an important time for intervention. Recognition of the importance of oral health intervention during pregnancy and oral health infrastructures have substantially grown over the last several years. This article reviews the current state of knowledge and practice of oral health intervention during pregnancy with a focus on individual- and population-based strategies, and summarizes key agendas for advancing prenatal oral health.

Interdisciplinary Community-Based Oral Health Program for Women and Children at WIC

Objectives To evaluate the women, infants, and children (WIC) Oral Health Program in a county in Florida. Methods The non-traditional interdisciplinary program of the current study was designed to reach at-risk populations with untreated dental diseases and limited access to care; it provides oral health education, dental screenings, preventive dental services, and referrals for women, children, and families at WIC offices. We evaluated the health status of patients enrolled in the program and the services provided. Results From 2013 to 2016, the program provided dental screenings for 576 children and 180 women. Caries prevalence for 3-5 year olds was 46.0%. Only 6.6% (12/114) of pregnant women were eligible for comprehensive dental care under Medicaid (< 21 years). Further, 71.2% (47/66) of all pregnant women had unmet dental care needs. Conclusions for Practice Our results suggested that many children and women had untreated dental diseases and need preventive services and dental care. Also, many pregnant women were not covered by Medicaid. This program demonstrates that collaboration with the WIC program can improve access to oral health services for underserved populations.

The influence of mothers' oral health behaviour and perception thereof on the dental health of their children

Objective

The study aims to investigate how mothers' oral health behaviour and perception thereof influence the dental health in their children.

Methods

A total of 556 Vietnamese mother-child pairs participated in the current study. Mothers self-reported their oral status and oral health behaviour and perception. Dental caries of the children were examined using the index of decayed, missing, and filled teeth. The Dental Anxiety Scale instrument was used to assess the dental anxiety level in mothers and children.

Results

Among mothers, 41.3% had gingival bleeding, 40% perceived their dentition and gingival status to be at a good level, 68% brushed their teeth more than twice a day, and 17% had never visited a dentist. Mothers' oral health behaviour and their perception thereof were positively correlated with their frequency of dental visits (r = (0.105-0.221), p < 0.001) and negatively correlated with dental anxiety (r = (- 0.149- - 0.105), p < 0.05).Caries-free children were positively correlated with mothers having more than 20 teeth (r = 0.085, p < 0.05). Positive correlations between mothers and children were found in terms of frequency of fresh fruits consumption (r = 0.090, p < 0.05), drinking sweet beverages (r = 0.072, p < 0.05), and dental anxiety (r = 0.183, p < 0.001).

Conclusions

Maternal oral health was significantly associated with dental health of their children. Not only did maternal dental anxiety influence oral health of mothers but it was also a concomitant factor in the development of children's dental anxiety. The education programme on mothers' oral health-related knowledge can be a target for improvement of the oral health of mothers and children.

Oral, systemic and socioeconomic factors associated with preterm birth

BACKGROUND

The rates of preterm births have been increasing worldwide. Complications related to preterm births are associated with increased costs of care, and have a direct impact on the health system of the countries. Therefore, it is important to address factors associated with preterm birth in order to provide prevention strategies.

OBJECTIVE

This case-control study investigated oral, systemic, and socioeconomic factors associated with preterm birth in postpartum women. Participants were 279 postpartum women that gave birth to a singleton live-born infant. Cases were women giving birth before 37 completed weeks of gestation (preterm birth). Controls were women giving birth at term (≥37weeks). Data were collected through questionnaires, medical records and intra-oral clinical examinations, which included dental caries registration according to World Health Organization criteria and oral biofilm evaluation through visible plaque index.

RESULTS

Ninety-one women had preterm birth (cases) and 188 women had birth at term (controls), ratio 1:2. Caries lesions were present in 62.3% of the cases and in 62.5% of the controls. The univariate analysis showed no association between dental caries and preterm birth (Odds Ratio=1.08, p=0.90). The multivariate analysis showed that maternal educational level (Odds Ratio=2.56, p=0.01) and arterial hypertension (Odds Ratio=2.32, p=0.01) were associated with prematurity.

CONCLUSION

This study demonstrated that dental caries is frequent in postpartum women, but it does not appear to be associated with preterm birth. Meanwhile, maternal education level and arterial hypertension were associated with prematurity in this population.

Previous Medicaid Expansion May Have Had Lasting Positive Effects On Oral Health Of Non-Hispanic Black Children

Healthy tooth development starts early in life, beginning even before birth. We present new evidence suggesting that a historic public health insurance expansion for pregnant women and children in the United States in the 1980s and 1990s may have had long-lasting effects on the oral health of the children gaining eligibility. We estimated the relationship between adult oral health and the extent of state public health insurance eligibility for pregnant women, infants, and children throughout childhood separately for non-Hispanic whites, non-Hispanic blacks, and Hispanics. We found that expanded Medicaid coverage geared toward pregnant women and children during their first year of life was linked to better oral health in adulthood among non-Hispanic blacks. Our results also suggested that there might be a benefit to expanded public health insurance eligibility for children at ages 1-6 among non-Hispanic blacks and Hispanics. Medicaid expansions appear to have had long-lasting effects for certain low-income children and helped narrow racial/ethnic disparities in adult oral health.

Transmission patterns of Streptococcus mutans demonstrated by a combined rep-PCR and MLST approach

OBJECTIVE

Clinical typing methods of the oral pathogen Streptococcus mutans with molecular analysis can be very specific, but expensive. Repetitive extragenic palindromic PCR (rep-PCR) is a relatively inexpensive pre-screening alternative for isolate selection for additional analyses. This study evaluated the prediction accuracy of using rep-PCR to identify S. mutans multilocus sequence typing (MLST) sequence types (ST) among children and their family members. Potential S. mutans strain sources were evaluated for evidence of transmission.

MATERIAL AND METHODS

Ten dendrograms (rep-PCR), with 20 isolates each of the 10 most common S. mutans genotypes, were generated from different subjects. Using a cut-off of 98% similarity, 7-11 isolates of each genotype were selected for MLST analysis to determine ST match/no-match.

RESULTS

Overall, rep-PCR was 75% effective at determining MLST ST match/no-match and 90% effective when applied to related individuals. Most genotypes were further differentiated by MLST. MLST ST diversity was greatest for one genotype (genotype 12, G12) and evidence of transmission among children and their family members was identified by rep-PCR and MLST. Younger children (6 months to 4 years old) shared ST with their mothers but 50% of older children (5-9 years old) had ST not identified in their mother. Six ST were shared between different families and probable source members were identified.

CONCLUSION

This study confirms that rep-PCR offers an affordable option to predict diverse isolates for downstream applications.

CLINICAL RELEVANCE

Using a combined rep-PCR and MLST approach, it is possible to track probable transmission and strain sources for S. mutans genotypes.

Commonality of Risk Factors for Mothers' Poor Oral Health and General Health: Baseline Analysis of a Population-Based Birth Cohort Study

Objective The association between and commonality of risk factors for poor self-rated oral health (SROH) and general health (SRGH) among new mothers has not been reported. The purpose of this paper is to assess the commonality of risk factors for poor SROH and SRGH, and self-reported obesity and dental pain, among a population-based sample of new mothers in Australia. It also investigated health conditions affecting new mothers' general health. Methods Data collected at baseline of a population-based birth cohort was used. Mothers of newborns in Adelaide were approached to participate. Mothers completed a questionnaire collecting data on socioeconomic status (SES), health behaviours, dental pain, SROH, self-reported height and weight and SRGH. Analysis was conducted sequentially from bivariate to multivariable regression to estimate prevalence rate (PR) of reporting poor/fair SROH and SRGH. Results of the 1895 new mothers, some 21 and 6% rated their SROH and SRGH as poor/fair respectively. Dental pain was associated with low income and smoking status, while being obese was associated with low SES, low education and infrequent tooth brushing. SROH and SRGH was associated with low SES, smoking, and dental pain. SROH was also associated with SRGH [PR: 3.06 (2.42-3.88)]. Conclusion for practice There was a commonality of factors associated with self-rated oral health and general health. Strong associations between OH and GH were also observed. Given the importance of maternal health for future generations, there would be long-term societal benefit from addressing common risk factors for OH and GH in integrated programs.

Streptococcus mutans in Mother-Child Dyads and Early Childhood Caries: Examining Factors Underlying Bacterial Colonization

This study investigated the association between colonization of mother-child dyads with Streptococcus mutans (SM) and early childhood caries (ECC), with consideration of the mediator and confounders, using a theoretical model. Four hundred mothers and their children from São Luís, Brazil, were included in the study. A diagram based on directed acyclic graphs was elaborated to analyze the association between SM colonization of the mother, mediated by child SM, and ECC. Other maternal (socioeconomic, waist circumference, sugar consumption, DMFT index, and visible plaque) and child factors (sugar consumption, visible plaque, and child age) composed the theoretical model. A total effect model (maternal SM on ECC) and a direct effect model, adjusted by the mediation effect of child SM (maternal SM via child SM) on ECC, were analyzed. The outcome of interest in this study was ECC (number of teeth with caries experience, dmft), which was analyzed as a discrete variable by Poisson regression. The Paramed test was used to analyze mediation. The following variables were associated with ECC in the total effect model: maternal SM, maternal waist circumference ≥80 cm, DMFT, maternal visible plaque, child age ≥4 years, and increased sugar consumption of the child (>3 times/day). In the direct effect model, high maternal SM levels remained associated with ECC, while moderate and high colonization of the child with SM was also associated with ECC. Child SM colonization just partially mediated the effect of maternal SM on ECC (33%). Thus, factors other than the mechanism of bacterial colonization should be considered in mother-child dyads, including eating habits, oral hygiene practices, and a family history of caries.

Effect and acceptance of silver diamine fluoride treatment on dental caries in primary teeth

OBJECTIVES

Silver diamine fluoride (SDF) treatment has been identified as a potential solution to address the dental public health issues of untreated dental caries and insufficient access to care. The current study assessed the effectiveness of 38 percent SDF in arresting active dental caries lesions and in reducing or preventing associated dental pain and infections in young, at-risk children.

METHODS

We enrolled 32 children aged 2-5 years with 118 active caries lesions in primary teeth from a community dental clinic in Oregon. After baseline examinations, carious lesions were treated with 1-2 applications of 38 percent SDF. Children were re-evaluated at 3-week and 3-month recalls to assess color and consistency changes in lesions (soft/hard). Parents were interviewed regarding symptoms of pain or infection and were surveyed regarding subjective feelings about SDF.

RESULTS

Of 102 lesions (16 excluded from analyses), 100 were found to be arrested at first recall and all at second recall. The duration of SDF application was not associated with arrest of decay (P = 0.68). No incidence of pain or infection of an SDF-treated tooth was recorded. Parental impression of ease of application, taste, and esthetics was favorable.

CONCLUSIONS

Our results suggested SDF was effective in arresting active caries lesions in primary teeth in young children and was well accepted by parents. SDF offers an easy and highly efficient nonsurgical alternative treatment to traditional restorative dental treatment in young children, and it has great potential to aid the dental public health community to address dental caries in at-risk populations.

Dominant prevalence of Porphyromonas gingivalis fimA types I and IV in healthy Japanese children

Background/purpose

Porphyromonas gingivalis is a major causative agent of chronic periodontitis, whilst circumstances for acquisition of the bacterium remain to be elucidated. To examine prevalence of the bacterium harboring distinct fimA types in dental plaque of children, we established PCR procedures that are applicable for specimens with limited amounts. By this method, all six fimA types including type I and Ib were directly identified, and prevalence of fimA types and their frequency of guardian-child transmission in Japanese children were assessed.

Materials and methods

Genomic DNA was purified from dental plaque specimens of 132 periodontally healthy children (2-12 years old, 4.8 ± 0.2 years) and 19 mothers of resultant P. gingivalis-positive child subjects. PCR-based fimA genotyping was performed, and untypeable strains in the first PCR analysis were determined by a nested PCR.

Results

P. gingivalis was found in 15.2% of the subjects (2-10 years old, 5.1 ± 0.6 years), and the most prevalent types were I and IV (37.0% each), followed by Ib and III (11.1% each), and then II (7.4%). Seven (35.0%) of the 20 P. gingivalis-positive subjects had combined colonization of type I with other fimA types. In most cases, bacterial prevalence and fimA types in the children were distinct from those of their mothers, indicating that its maternal transmission was not significant.

Conclusion

These results suggest that colonization of non-disease-associated fimA types I and IV P. gingivalis to the oral cavity initiates from early childhood without showing any periodontal inflammation.

Awareness of Lebanese Pediatricians regarding Children's Oral Health

Pediatricians have an important role in early identification and prevention of oral health, but they reported lack of knowledge in this field.

Dentin caries risk indicators in 1-year-olds. A two year follow-up study

BACKGROUND

Early childhood caries (ECC) risk factors are suspected to vary between regions with different caries prevalence.

AIM

Identify ECC risk factors for 1-year-olds predicting dentin caries at 3 years of age in a region with low caries prevalence.

DESIGN

Caries risk was assessed by dental hygienist or dental assistant in 779 one-year-olds. The oral mutans streptococci (MS) score was performed from a tooth surface or (in pre-dentate children) from oral mucosa. A parental questionnaire with questions regarding family factors (siblings with or without caries), general health, food habits (night meals, breastfeeding, other beverage than water), oral hygiene habits and emerged teeth were answered by parents of the 1-year-olds. Dentin caries was assessed when the children were 3-year-olds. Simple and multiple logistic regression analyses were used for identification of caries-associated factors.

RESULTS

An increased caries risk was assessed in 4.4% of the 1-year-olds. Dentin caries was found in 2.6% of the 3-year-olds. Caries risk at 1 year was associated with caries at 3 years (OR = 6.5, p = .002). Multiple regression analysis found the variables Beverages other than water (OR = 7.1, p < 0.001), Caries in sibling (OR = 4.8, p = .002), High level of MS (score 2-3) (OR = 3.4, p = .03) and Night meal (OR = 3.0, p = .03) to be associated with caries. The single variables Beverage other than water between meals and Caries in sibling were more reliable than Caries risk assessed performed by dental personnel.

CONCLUSIONS

Behavioural, family and microbial factors are important when assessing caries risk among 1-year-olds in a region with low caries experience.

Relationship between the IgA antibody response against Streptococcus mutans GbpB and severity of dental caries in childhood

OBJECTIVE

Explore the associations between the severity of dental caries in childhood, mutans streptococci (MS) levels and IgA antibody response against Streptococcus mutans GbpB. Moreover, other caries-related etiological factors were also investigated.

DESIGN

36-60 month-old children were grouped into Caries-Free (CF, n=19), Early Childhood Caries (ECC, n=17) and Severe Early Childhood Caries (S-ECC, n=21). Data from socio-economic-cultural status, oral hygiene habits and dietary patterns were obtained from a questionnaire and a food-frequency diary filled out by parents. Saliva was collected from children for microbiological analysis and detection of salivary IgA antibody reactive with S. mutans GbpB in western blot.

RESULTS

S-ECC children had reduced family income compared to those with ECC and CF. There was difference between CF and caries groups (ECC and S-ECC) in MS counts. Positive correlations between salivary IgA antibody response against GbpB and MS counts were found when the entire population was evaluated. When children with high MS counts were compared, S-ECC group showed significantly lower IgA antibody levels to GbpB compared to CF group. This finding was not observed for the ECC group.

CONCLUSIONS

This study suggests that children with S-ECC have reduced salivary IgA immune responses to S. mutans GbpB, potentially compromising their ability to modify MS infection and its cariogenic potential. Furthermore, a reduced family income and high levels of MS were also associated with S-ECC.

Using community participation to assess acceptability of "Contra Caries", a theory-based, promotora-led oral health education program for rural Latino parents: a mixed methods study

BACKGROUND

Latino children experience more prevalent and severe tooth decay than non-Hispanic white and non-Hispanic black children. Few theory-based, evaluated and culturally appropriate interventions target parents of this vulnerable population. To fill this gap, the Contra Caries Oral Health Education Program, a theory-based, promotora-led education program for low-income, Spanish-speaking parents of children aged 1-5 years, was developed. This article describes qualitative findings of the acceptability of curriculum content and activities, presents the process of refinement of the curriculum through engaging the target population and promotoras, and presents results from the evaluation assessing the acceptability of the curriculum once implemented.

METHODS

Focus groups were conducted with low-income Spanish-speaking parents of children 1-5 years living in a city in an agricultural area of California. Interviews were digitally recorded, translated and transcribed, checked for accuracy and the resulting data was thematically coded and analyzed using a social constructionist approach. The Contra Caries Oral Health Education Program was then implemented with a separate but similar sample, and after completing the program, participants were administered surveys asking about acceptability and favorite activities of the education program. Data were entered into a database, checked for accuracy, open-ended questions were categorized, and responses to close-ended questions counted.

RESULTS

Twelve focus groups were conducted (N = 51), 105 parents attended the Contra Caries Oral Health Education Program, and 83 parents filled out surveys. Complete attendance and retention was high (89% and 90%, respectively). This study found that their children's oral health is a high priority. Parents were not only interested in, but actually attended classes focused on increasing their knowledge and skills with respect to early childhood oral health. The Contra Caries content and format was perceived as acceptable by parents. Strong opinions about curriculum content were expressed for including information on how caries starts and progresses, weaning from the bottle, oral health care for children and adults, motivational strategies for children's tooth brushing, dental visits and cavity restorations.

CONCLUSIONS

The Contra Caries Oral Health Education Program was acceptable to low-income, Spanish-speaking parents of children 1-5 years. Participating in the curriculum development and revision process likely played an important role in the parents' high acceptability of the program.