Delaying Streptococcus mutans Colonization in Children Leads to Reduced Caries Experience

Subjects The children who are the subjects of this report were enrolled in an earlier mother-child investigation that examined the effectiveness of treating high mutans streptococci (MS) mothers with xylitol to delay the transmission of MS to their children.(1-3) Colonization was previously determined at age 2 years and caries occurrence recorded until age 5 years. 1 Inclusion for the current report depended on the availability of records of dental visits, dental health, and treatments from birth until age 10 years. Children were placed in one of two cohorts based on the detection of MS at age 2 years (detected, n = 29; not detected, n = 118). Key Exposure/Study Factor The key exposure is the acquisition of detectable levels of Streptococcus mutans. This was tested at age 2 years and recorded as 'plus' or 'minus.' Main Outcome Measure The main outcome measure was caries experience, which was recorded until the children reached age 10 years. The caries experience was subdivided into (1) the amount of time the children remained caries free, (2) dentinal caries occurrence as recorded by dmft and DMFTscores, and (3) the number of dental visits for restorative treatment. Main Results The null hypothesis was not supported. The median age of first dmft or DMFT registration for age 2 MS-negative children was 8.0 years, whereas it was 4.6 years for age 2 MS-positive children. This difference was highly significant (p < 0.001). The MS-negative children had significantly lower dmft scores at age 6 (p < 0.001), 8 (p < 0.001), and 10 (p < 0.006) years compared to the MS-positive cohort. Additionally, the MS-negative children averaged significantly fewer visits (p = 0.005) for restorations than did the MS-positive children over the time interval of the study. Conclusions The data reflect a strong association between the age of colonization with S. mutans and subsequent caries experience. Furthermore, these data suggest that efforts to delay the transmission of S. mutans from mother to child may have long-term benefits for the oral health of the child.