HOME - Clinical cases - Pediatric dentistry
 
 
05 June 2019

Early Childhood Caries: where does it start?

Alessandra Abbà


Although caries is on the decline in most population groups, early childhood caries (ECC) prevalence continues to be high, especially in low socioeconomic minority groups. Caries is a multifactorial disease with complex  and various elements that affect risk for disease. Nevertheless, the mutans streptococci have been recognized as the main etiologic agent involved in the initiation of human dental caries. An important question to solve is the source of initial MS colonization. 
The study of Childers et al. analyzed Streptococcus mutans (Sm) colonization and genotypes (GT) between mother and child (M-C) at specific time in a high caries risk cohort. The aim of the authors is to explore the hystory of caries in early dental development and the association with ECC.

MATERIALS AND METHODS
96 African-American infants (average age 1.1 years) and their mothers in a small community setting in Alabama were included in this longitudinal study beginning in March 2008 and followed for 36-months. The mothers had dental examination that were conducted recording decayed, missing, filled surface score (DMFS/dmfs), according to WHO criteria. Plaque sample at the baseline visit and at a two-year follow-up were collected too.   Infants/children had plaque samples (i.e., primary molars that had erupted after baseline) collected from all tooth surfaces using sterile toothpicks at each visit. Samples were transferred to the laboratory. Caries outcomes were defined as both binary (yes/no) and count (dmfs score) in children at an average age of four years. Sm isolates were genotyped using repetitive extragenic palindromic-PCR (rep-PCR). Statistical analyses were conducted for associations of Sm in M-C dyads with caries outcomes.  

RESULTS
Of 96 infants/children recruited at baseline (average age 1.1 years), only 69 were available for the study after 36 months of follow-up (subject attrition was approximately five percent per year), mostly because of moving out of the community. By the 36-month follow-up visit, 68 children and 66 mothers had at least one Sm isolate from plaque samples available for rep-PCR genotyping. Sm counts from SBS (Saliva and biofilm Sample) of children at 18 month follow-up visit (average age two and one-half years), were found to be significantly different between M-C with matching GT and those that were in the No-Match M-C group (P<.03 Mann-Whitney U test). Plaque Sm plate counts for mothers at baseline was lower in the No-Match M-C group, however was not significantly different (P=.47). The median number of GT observed in both mother and children was two (range one to four and one to seven, respectively).  Twenty-seven Sm genotypes (GT) from 3,414 isolates were identified. M-C were categorized as GT Match (N=40) or no-Match (N=29). When modeling the severity of ECC at 36-months (~4 years old), the estimated dmfs in the Match group was 2.61 times that in the no-Match group (P=.014).  

CONCLUSIONS 
ECC was found to be highly associated with Sm in children, as well as mother’s matching GT.  Collected data suggest vertical transmission of Sm in 40 of 69 children that shared GT with their mother, although the possibility that  other individuals transmitted the Sm can’t be excluded. Nonetheless, these findings support the importance of the mother's oral microbial status as a reflection of risk for caries.    


For additional informations:
Association of Colonization with Streptococcus mutans Genotypes from Mothers and Early Childhood Caries

Related articles

Type 1 diabetes mellitus is a chronic autoimmune disease characterized by destruction of pancreatic beta cells and consequent lack of insulin production. It affects over half a million children...


One of the most common materials for the restoration of primary teeth are glass ionomer cements (GIC), because of their time-saving feature. Nonetheless their...


Dental caries of primary dentition continues to be one of the major health problem in the world. And even if prevention and acknowledgment of the dental...


Dental pulp in deciduous teeth can be involved earlier than in permanent teeth in the progression of carious lesions. In addiction it is also known that...


Dental caries are frequent and represent real oral health problems even in preschoolers and school children. It is a disease of the hard tissues of the tooth,...


Read more

In the last decade, the development of new technologies has moved in parallel with a rapid evolution of restorative materials on the rails of Digital...


In the latest issue of European Journal of Orthodontics (April 2020) a clinical practice guideline on orthodontically induced external apical root resorption ...


Title: Luting strategies for adhesive dentistryAuthor: Prof. Lorenzo BreschiWhen: September 17 th, 2020Time: 11am west coast - 2pm east coast - 8pm GTM+2 Price: $ 49.99...


Prosthetic treatments require dental impressions which during the Covid-19 pandemic are considered to have a high risk of contagion (both for dental operators and for reference dental technicians),...


It is commonly known that a root canal-treated tooth (RCTT) has more possibilities to fracture than a tooth with vital pulp. Several factors must be...


 
 
 
 

Newsletter

 
 
 
 

Most popular

 
 

Events