An assessment of the cariogenicity of commonly used infant milk formulae using microbiological and biochemical methods

Comparative evaluation of human breast milk, bovine milk, and infant milk formula on cariogenicity in children: An in vivo study

AIM

The aim of the study was to compare the cariogenicity of human breast milk (HBM), bovine milk, and infant milk formulas.

PATIENTS AND METHODS

Ninety children of 1-4 years were randomly selected according to the type of milk they consume and were divided into five groups: Group I - HBM, Group II - cow milk, Group III - buffalo milk, Group IV - Lactogen 2, and Group V - Dexolac 4. Three parameters were assessed (salivary pH, plaque pH, and Streptococcus mutans count). Baseline salivary pH was measured, plaque sample was collected from children before feeding, and then, children were fed with milk. The second sample was collected after 45 min of feeding and the third sample after 3 h of second sample collection. Collected plaque samples were assessed for plaque pH and were sent to microbiological laboratory and cultured on blood agar. The intergroup comparison was done by one-way analysis of variance (ANOVA) and Tukey test. Intragroup comparison was done by one-way anova and Bonferroni test. P < 0.05 was considered statistically significant.

RESULTS

No statistically significant difference in intra- and intergroup comparisons of salivary pH was noted. However, with regard to plaque pH, there is a statistically significant difference in the second sample in Groups III, IV, and V. There was an increase in colony-forming units of S. mutans in plaque samples from baseline to the third sample in Groups IV and V.

CONCLUSION

Lactogen 2 and Dexolac 4 showed greater cariogenic activity, buffalo milk is mildly cariogenic, whereas HBM and cow milk showed least cariogenicity.

Impact of breastfeeding and other early-life factors on the development of the oral microbiome

The oral cavity is home to the second most diverse microbiome in the human body. This community contributes to both oral and systemic health. Acquisition and development of the oral microbiome is a dynamic process that occurs over early life; however, data regarding longitudinal assembly of the infant oral microbiome is scarce. While numerous factors have been associated with the composition of the infant oral microbiome, early feeding practices (breastfeeding and the introduction of solids) appear to be the strongest determinants of the infant oral microbiome. In the present review, we draw together data on the maternal, infant, and environmental factors linked to the composition of the infant oral microbiome, with a focus on early nutrition. Given evidence that breastfeeding powerfully shapes the infant oral microbiome, the review explores potential mechanisms through which human milk components, including microbes, metabolites, oligosaccharides, and antimicrobial proteins, may interact with and shape the infant oral microbiome. Infancy is a unique period for the oral microbiome. By enhancing our understanding of oral microbiome assembly in early life, we may better support both oral and systemic health throughout the lifespan.

A preliminarily Investigation on Oral Colonization and Counts of Streptococcus mutans and Streptococcus mitis in a Group of Predentate Infants in Relation to Some Maternal and Infant Factors (A Longitudinal Observational study)

Aim

Bacterial colonization of infants' oral cavities is a key factor for future caries risk. This study sought to longitudinally assess oral bacterial colonization in a group of predentate infants in relation to some mother and infant factors.

Materials and methods

A total of 50 mother-infant pairs were enrolled. When infants were 3-month-old, data were collected about some infant and mother factors; additionally, maternal Decayed, Missing, and Filled Teeth (DMFT) scores and salivary samples of mothers and infants were obtained. At 6 months of infant's age, another infants' salivary samples were obtained. Saliva was cultured to detect and quantify Streptococcus mutans (S. mutans) and Streptococcus mitis (S. mitis).

Results

Streptococcus mitis (S. mitis) was detected in all infants at 3 months. 74 and 96% of infants acquired S. mutans at 3 and 6 months, respectively. S. mutans detection was significantly higher with higher maternal DMFT scores, salivary S. mutans counts, and lower S. mitis counts, as well as when infants were given sugar-containing complementary foods/drinks. At 3-6 months, infants' S. mutans counts were significantly positively correlated with maternal S. mutans counts and DMFT scores and negatively correlated with maternal S. mitis counts. The opposite was evident for infants' S. mitis counts. Regression analysis showed that increased maternal DMFT scores and S. mutans counts, and Cesarean delivery were strong predictors for increased infant's S. mutans counts. While increased DMFT scores and maternal S. mutans counts were strong predictors for reduced infant's S. mitis counts.

Conclusion

Poor maternal oral health, early introduction of sugars in the diet, and probably Cesarean delivery can negatively impact infants' oral bacterial colonization and possibly future caries risk.

Clinical significance

Understanding factors associated with oral colonization of both caries-producing and protective flora in infants of different populations is important for caries prevention. This, in turn, can aid tailoring oral health promotion programs for expectant mothers.

How to cite this article

Wassel MO, Salman NS, Metwalli NE. A preliminarily Investigation on Oral Colonization and Counts of Streptococcus mutans and Streptococcus mitis in a Group of Predentate Infants in Relation to some Maternal and Infant Factors (A Longitudinal Observational study). Int J Clin Pediatr Dent 2023;16(1):79-86.

Sugar content in infant formula: Accuracy of labeling and conformity to guidelines

BACKGROUND

Infant formulae are a primary source of nutrition during the first years of life, to which sugars are frequently added. This may contribute to adverse dental health problems if consumed excessively when coupled with prolonged and nocturnal feeding habits.

AIM

To assess the amount and type of dietary sugars in commercially available infant formulae in the UAE.

DESIGN

Sucrose, glucose, and fructose were measured in 71 different brands of commercially available infant formulae for retail sale in the UAE. Analysis was performed using high-performance liquid chromatography with refractive index detection. Sugar values were compared with the reported levels on the nutritional labels. A comparison between findings, product labels, and international standards for infant formulae was performed.

RESULTS

Of the 71 samples, 23 had detectable sugar levels, varying between sucrose, glucose, and fructose. Ten samples were found to have sugars contributing to more than 5% of total energy intake ranging between 5.68% and 27.06%. All infant formula packages had carbohydrate levels mentioned on the labels, but very few mentioned the added sugar content.

CONCLUSIONS

Many infant formula products tested contained sugars that exceeded the standard recommended intake. Tighter regulations that monitor the amount of sugar in infant formulae and guidelines for comprehensive labeling systems are required.

Assessment of Cariogenicity by pH-value Decrement of Plaque Solution with Four Infant Milk Formulas: An In Vitro Study

Introduction

People all over the world use a wide variety of infant formulas to nourish the infants. Recent studies demonstrated the high caries-inducing potential of infant formulas. This indicates a need for awareness toward the possible role of the infant formulas in the etiology of early childhood caries (ECC).

Aim

The present study was undertaken to evaluate and comparatively assess the change in plaque pH solutions after fermenting four commonly used infant milk formulas.

Materials and methods

This simple randomized study was carried out on 40 healthy children aged 4–6 years old. The children received full-mouth prophylaxis before examination. They were asked not to implicate oral hygiene for 24 hours and not to have anything at least 2 hours prior the study. Supragingival plaque from the buccal surface of posterior teeth was collected using a Hu-Friedy's curette. Four commonly used infant milk formulas were prepared and given to children for rinsing. The pH of plaque samples were measured at 30 and 60 minutes at 37°C.

Results

The present study showed that all of the four infant milk formulas decreased the mean pH values in plaque solutions significantly after 30 and 60 minutes of preparation.

Conclusion

Our results showed that the plaque pH varied in response to the oral rinsing with the various infant formulas and most of infant formulas were able to reduce the pH significantly below the pH before the rinse. Based upon this study further evaluation of the cariogenicity of infant formulas is recommended.

How to cite this article

Pandey A, Pathivada L, Kajapuram P, et al. Assessment of Cariogenicity by pH-value Decrement of Plaque Solution with Four Infant Milk Formulas: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(3):263-266.

Evaluation and co-relation of the Oratest, colorimetric Snyder's test and salivary Streptococcus mutans count in children of age group of 6-8 years

AIM

Evaluation and co-relation of the caries susceptibility using Oratest, colorimetric Snyder's test and salivary Streptococcus mutans count amongst children in the age group of 6-8 years.

MATERIALS AND METHODS

A total of 120 healthy children were grouped into control and test groups according to their dmft/DMFT scores. Snyder's test, salivary S. mutans count and Oratest were performed for each individual.

RESULTS

The relationship of three caries activity tests with each other and with existing caries status was found out.

CONCLUSION AND CLINICAL IMPLICATIONS

The present study has shown that Oratest has a definite clinical relationship with caries status and microbiological relationship with S. mutans count of the individual.