Association of Mutans Streptococci Between Caregivers and Their Children 8/6/10

Department of Pediatric Dentistry
Resident’s Name: Murphy Program: Lutheran Medical Center - Providence
Article title: Association of Mutans Streptococci Between Caregivers and Their Children
Author(s): Douglass MS DDS, Joanna. Yihong Li, DDS, MPH. Tinanoff, DDS
Journal: Pediatric Dentistry
Year. Volume (number). Page #’s: 2008. v30 #5. 375-387
Major topic: Early colonization of SM in children and how what causes it
Minor topic(s): How we can stop the colonization
Main Purpose: Determine how SM colonize early, and how to stop it
Overview of method of research: Systematic review of numerous literature

Findings: The incidence of dental caries has been steadily declining over the past 30 years. However recently, this decline has slowed down considerably. In order to get a cavity, three things are needed. A surface(a tooth), a substrate(carbs/sugar), and some type of antagonist(bacteria). A particular group of bacteria has been isolated, and shown to be the major cause of dental caries, Strep Mutans and Strep Sorbinus. This group of bacteria has the ability to adhere to enamel, produce acid for dietary carbs, and survive at a very low pH.
In children, SM colonization is believed to be caused from the child’s primary caregiver. The transmission has been associated with high SM levels, open lesions, poor oral hygiene in caretakers, LSES, and frequent snacking by the child.
The authors searched PubMed for strep mutans, mother, father, infant, child, transmission, and colonization. 46 studies published from 1975-2006 came up, and they were reviewed by the authors. In 1975, Berkowitz and Jordan were the first to demonstrate the vertical transmission of SM from mother to child.
One question that was raised by the authors was, is the father(or other caretakers) an SM source as well. Various studies said different things. There was basically a 50/50 split on yes or no.
How can we stop the invasion?
Four separate studies reported that a mom using a chlorhexidine rinse or gel combined with fluoride rinses or varnishes had decreased SM levels, and thus, the children had a reduction of SM colonization. Another study discussed having the mom chew xylitol gum to help control SM levels, leading to decreased SM levels in mom.

Key points/Summary:
1. SM can be transmitted from mother to child, especially when mom has high SM levels. Other ways transmission occurs is through diet, SES, behavioral factors, and other factors not yet known.
2. Fathers, grandparents, and other caregivers may play a role in the early colonization of SM in children
3. Studies showing strategies that lower mom’s SM levels are too small and need to be broadened.
4. More clinical trials are needed

Assessment of Article: Long winded article, definitely important info. Take away the basics.