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.

A longitudinal controlled study of factors associated with mutans streptococci infection and caries lesion initiation in children 21 to 72 months old.

Resident: Adam J. Bottrill
Date: 06AUG10
Region: Providence
Article title: A longitudinal controlled study of factors associated with mutans streptococci infection and caries lesion initiation in children 21 to 72 months old.
Author(s): Law V.
Journal: Pediatric Dentistry
Page #s: Jan-Feb; 28(1): 58-65
Year: 2006
Major topic: Strep mutans infections and carious lesions
Minor topic(s): NA
Type of Article: Longitudinal, controlled study
Main Purpose: To determine factors associated with mutans streptococci (MS) infection and development of carious lesions in a group of children 21-72 months old.

Key points in the article discussion:

I. Methods:

A. 63 caries-free children divided into:
1. 24 children colonized with MS.
2. control group of 39 children without MS.
B. Recalled every 3mo for approx 24mo.
C. Each visit, data recorded
1. Plaque, enamel hypoplasia, carious lesions, MS status

II. Results:

A. MS associated with...
1. visible plaque, enamel hypoplasia
2. begining "tooth-brushing" AFTER 12mo.
3. lack of parental assistance
4. increase hours of non-parental "child care."

B. Those who developed carious lesions during study did/presented with the following MORE than those children who remained caries-free.
1. had more hypoplastic teeth
2. ate more sugar
3. did not brush regularly

III. Conclusions!

A. You might want to sit down for this one!!! .... Lack of oral hygiene, consumption of sugary snacks and enamel hypoplasia are significant factors for both MS infection AND carious lesion initiation.

Assessment of article:

This is EITHER:
1. The article to end all articles...
OR
2. An irrefutable breakthrough that will shock the world...
OR
3. An article describing stuff we sort of already knew...

....YOU DECIDE

Determining the Prevalence and Risk Factors for Early Childhood Caries in a Community Dental Health Clinic

Resident: Roberts

Date: 8/6/10

Article title: Determining the Prevalence and Risk Factors for Early Childhood Caries in a Community Dental Health Clinic

Author: Schroth, Robert et al.

Journal: Pediatric Dentistry

Volume: 29 number 5

Year: 2007

Purpose: to determine the prevalence and trends of patients with ECC at a community dental clinic in Manitoba, Canada, and to identify factors assoc. with ECC.

Methods: a chart review of 834 charts of children less than 6 years old seen at a community health center between the years 1991 and 2004 in Winnipeg, Manitoba, Canada.

Discussion/ Conclusion: The avg. age of the patient when they were first seen was 50 +- 12.7months. Those with ECC were generally older than younger among the inclusion criteria. The prevalence increased with family size and number of siblings.

No correlation was found among homes with one parent or two living at the residence.

There were no significant differences among the prevalence of ECC and sex of the child. ECC had a greater prevalence among low income households. No significant difference between rates of decay and those with or without medical issues were found. Those who had failed appointments tended to have greater amounts of decay and generally were more susceptible to being referred out.

Assessment: The results were interesting but not mind blowing. The article was full of statistical data for those that are interested.