Streptococcus mutans, early childhood caries and new opportunities

Antifungal Susceptibility of Oral Candida Isolates from Mother-Infant Dyads to Nystatin, Fluconazole, and Caspofungin

The carriage of Candida albicans in children's oral cavities is associated with a higher risk for early childhood caries, so controlling this fungus in early life is essential for preventing caries. In a prospective cohort of 41 mothers and their children from 0 to 2 years of age, this study addressed four main objectives: (1) Evaluate in vitro the antifungal agent susceptibility of oral Candida isolates from the mother-child cohort; (2) compare Candida susceptibility between isolates from the mothers and children; (3) assess longitudinal changes in the susceptibility of the isolates collected between 0 and 2 years; and (4) detect mutations in C. albicans antifungal resistance genes. Susceptibility to antifungal medications was tested by in vitro broth microdilution and expressed as the minimal inhibitory concentration (MIC). C. albicans clinical isolates were sequenced by whole genome sequencing, and the genes related to antifungal resistance, ERG3, ERG11, CDR1, CDR2, MDR1, and FKS1, were assessed. Four Candida spp. (n = 126) were isolated: C. albicans, C. parapsilosis, C. dubliniensis, and C. lusitaniae. Caspofungin was the most active drug for oral Candida, followed by fluconazole and nystatin. Two missense mutations in the CDR2 gene were shared among C. albicans isolates resistant to nystatin. Most of the children's C. albicans isolates had MIC values similar to those from their mothers, and 70% remained stable on antifungal medications from 0 to 2 years. For caspofungin, 29% of the children's isolates showed an increase in MIC values from 0 to 2 years. Results of the longitudinal cohort indicated that clinically used oral nystatin was ineffective in reducing the carriage of C. albicans in children; novel antifungal regimens in infants are needed for better oral yeast control.

Efficacy of Silver Diamine Fluoride on Streptococcus mutans Count Present in Saliva

Aim and objective

Evaluate the efficacy and longevity of silver diamine fluoride (SDF) to inhibit the dental caries initiator bacteria; Streptococcus mutans count in saliva.

Study design

Twenty children having class I and II dental caries with no prior restorations were included in the study. Unstipulated saliva samples were collected before and immediately after application of SDF, 1, 3, and 6 months after application, and intergroup comparison was done.

Materials and methods

Silver diamine fluoride was applied on the cavitated surfaces with microbrush tip under isolation, then wait for 4 minutes and washed away all surfaces with water spray. Saliva was collected in a sterile saliva collection tube and sent for microbiological culture assessment. CFU/mL of S. mutans count was done with the Digital colony counter. For statistical analysis, paired T-test was performed.

Results

Silver diamine fluoride showed a significant drop in CFU/mL of S. mutans count at 1 month then 3 and 6 months accordingly.

Conclusion

Silver diamine fluoride can be used to prevent and arrest dental caries and the best result can be achieved by quarterly application.

How to cite this article

Chakraborty S, Gupta N, Gambhir N, et al. Efficacy of Silver Diamine Fluoride on Streptococcus mutans Count Present in Saliva. Int J Clin Pediatr Dent 2021;14(5):700–704.

The implication of probiotics in the prevention of dental caries

The current oral health crisis, whose causes are varied and complex, necessitates timely oral evaluation and early detection and treatment of oral health problems. Dramatic changes in eating habits and lifestyles are associated with the recent decline in oral health. Probiotics are "good" bacteria that support digestion and a healthy immune system and offer various health benefits to the host. Traditionally, probiotics have been used to improve gut health; the most common uses have historically been as a treatment or prevention of gastrointestinal infections and disease. During the last decade, studies have additionally suggested the intake of probiotics for oral health purposes. Probiotic use provides an effective strategy to combat oral disease, including the development of dental caries and periodontal infection. The aim of this review is to describe the beneficial roles of probiotic bacteria in the oral cavity and the potential mechanisms by which these bacteria exert their effects on oral health.

Early childhood caries update: A review of causes, diagnoses, and treatments

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management.

Childhood caries as influenced by maternal and child characteristics in pre-school children of Kerala-an epidemiological study

Purpose:

The most common chronic disease of childhood is early childhood caries which is five times more prevalent than asthma and seven times higher than that of allergic rhinitis. Most children do not receive dental care until they are three years old, yet by the time more than thirty percent of children from lower socioeconomic groups already have caries. To determine the prevalence and severity of early childhood caries among pre-school children, to describe the child characteristics associated with the development of early childhood caries and to find the association of early childhood caries and maternal risk factors.

Materials and Methods:

This descriptive study was carried out among children attending the immunization clinic of Sree Avittam Thirunal Hospital, Medical College, Trivandrum and children attending the randomly selected Anganwadies and Day care centres in Trivandrum, the capital of Kerala, wherein there are migrants from all over the State. A total of 350 children aged 12-36 months and their mothers were studied. The mother was first interviewed by a structured questionnaire; then the child's and mothers clinical examination was carried out covering caries experience and oral hygiene status.

Results:

Among 350 children studied the prevalence of dental caries in this study population was found to be 50.6 %(177). Statistically significant associations were found between the severity of decay and the child's age(P<0.001), female gender(P<0.05),low socioeconomic status (P<0.05), feeding frequency (P<0.05), type of feeding(P<0.01), fell asleep with nipple in mouth (P<0.05), duration of breast feeding(P<0.001), consumption of cariogenic type of snacks(P<0.01), age of commencement of tooth brushing(P<0.05), brushing frequency(P<0.05), oral hygiene status of child(P<0.001), DMFS scores of mothers (P<0.001), and oral hygiene status of mother (P<0.001).

Knowledge and attitude of parents or caretakers regarding transmissibility of caries disease

Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1%) adults reported that their children had already been seen by a dentist, 264 (41.3%) answered that their children had never gone to a dentist, and 4 (0.6%) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7%) answered yes, 489 (76.4%) answered no, and 44 (6.9%) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease.

Promoting oral health from birth through childhood: prevention of early childhood caries

Early childhood caries (ECC) is the single most common chronic childhood disease in the United States. Associated with a characteristic clinical presentation, ECC results from a culmination of risk factors, including cariogenic bacteria, inappropriate feeding practices, and social variables. It is essential that nurses become knowledgeable about ECC health promotion and prevention interventions to facilitate their efforts in everyday patient encounters and improve the overall oral health status of infants and children. This article provides an overview of ECC along with suggestions for actions that nurses can take to improve the oral health of children.

Early Childhood Caries among a Bedouin community residing in the eastern outskirts of Jerusalem

Background

ECC is commonly prevalent among underprivileged populations. The Jahalin Bedouin are a severely deprived, previously nomadic tribe, dwelling on the eastern outskirts of Jerusalem. The aim of this study was to assess ECC prevalence and potentially associated variables.

Methods

102 children aged 12–36 months were visually examined for caries, mothers' anterior dentition was visually subjectively appraised, demographic and health behavior data were collected by interview.

Results

Among children, 17.6% demonstrated ECC, among mothers, 37.3% revealed "fairly bad" anterior teeth. Among children drinking bottles there was about twice the level of ECC (20.3%) than those breast-fed (13.2%). ECC was found only among children aged more than one year (p < 0.001); more prevalent ECC (55.6%) was found among large (10–13 children) families than among smaller families (1–5 children: 13.5%, 6–9 children: 15.6%) (p = 0.009); ECC was more prevalent among children of less educated mothers (p = 0.037); ECC was more prevalent among mothers with "fairly poor" anterior dentition (p = 0.04). Oral hygiene practices were poor.

Conclusion

ECC levels in this community were not very high but neither low. This changing population might be on the verge of a wider dental disease "epidemic". Public health efforts clearly need to be invested towards the oral health and general welfare of this community.

Position of the American Dietetic Association: Oral health and nutrition

It is the position of the American Dietetic Association (ADA) that nutrition is an integral component of oral health. The ADA supports the integration of oral health with nutrition services, education, and research. Collaboration between dietetics and dental professionals is recommended for oral health promotion and disease prevention and intervention. Scientific and epidemiological data suggest a lifelong synergy between nutrition and the integrity of the oral cavity in health and disease. Oral health is an integral part of systemic and nutritional health. Two primary oral infectious diseases are directly influenced by diet and nutrition. Dental caries or tooth decay is modulated by numerous factors, including diet composition and frequency. Periodontal or gum disease is associated with malnutrition. Chronic diseases such as diabetes and cardiovascular disease that are modulated by diet and nutrition intervention have oral sequelae. As we advance in our discoveries of the links between oral and nutrition health, practitioners of both disciplines must learn to provide screening, baseline education, and referral to each other as part of comprehensive client/patient care. The future of dietetics practice requires dietetics professionals to provide medical nutrition therapy (MNT) that incorporates a person's total health needs, including oral health. Inclusion of both didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in both dental and dietetic education programs. Collaborative endeavors between dietetics and dentistry in research, education, and delineation of health provider practice roles are needed to ensure comprehensive health care to persons with oral infectious disease and/or oral manifestations of systemic diseases.

Management of common breastfeeding issues

Breastfeeding provides ideal nutrition, growth hormones, and antibodies that change over time as growing infants' and children's needs change and provides these inexpensively, with no harm to the environment. Breastfed infants are healthier than other infants overall, and research indicates that the health benefits may continue on into adulthood. Increasingly, women are choosing to initiate breastfeeding in the hospital, but the attrition starts early and is dramatic. For women to meet their breastfeeding goals, physicians must not only give lip service to "breast is best" but also become knowledgeable in breastfeeding management and actively promote breastfeeding in their practices and in their communities.