Tuesday, July 25, 2017

Association of Mutans Streptococci Between Caregivers and Their Children


Resident’s Name: Carol Caudill                                                                        Date: 7-26-2017
Article Title: Association of Mutans Streptococci Between Caregivers and Their Children
Author(s): Douglass, Li, Tinanoff
Journal: Pediatric Dentistry
Date: Sept/Oct 2008
Major Topic: Relationship between levels of mutans streptococci in caregivers and children and interventions
Type of Article: literature review
Main Purpose: To review sources of MS colonization in children and to study what effect MS levels in primary caregivers have on children’s MS colonization. Evaluate studies examining interventions to reduce MS transmission
Key Points: (2 lines Max): There is strong evidence that mothers are the primary source of mutans streptococci transmission to children. More studies need to be done for fathers and other caregivers. More studies also need to be done to examine the effectiveness of microbiological interventions.

Intro
·      Incidence of dental caries has decreased in most industrialized countries in the past 30 years; however, it remains highly prominent in children with low SES and in underdeveloped countries
·      Mutans streptococci most frequently associated with caries are strep mutans and strep sobrinus
·      Children with high MS levels have higher levels of caries
·      MS colonization of the oral cavity in children is believed to be caused by transmission from the primary caregiver
Materials
·      Performed a literature search in PubMed and selected 46 studies published between 1975 and 2006
Results
·      Data have consistently shown that children acquired at least 1 phenotype or genotype of MS isolate identical to their mothers
·      Studies are mixed about whether fathers are an MS source
·      This is further complicated by the fact that on the whole studies found that spouses share at least 1 identical MS isolate
·      Children were most likely to harbor MS when their mothers were highly colonized
·      Different intervention studies tried different methods to decrease mom’s MS levels to try to decrease cavities in children. Agents included 1% chlorhexidine gel with dietary counseling, prophylaxis, OHI, and restorative treatment; 10% chlorhexidine varnish; 40% chlorhexidine gel; iodine, NaF; xylitol gum. These studies had mixed results
Discussion
·      Problem with early investigations: mostly used an older method to distinguish MS isolates that may have lacked sensitivity and accuracy
·      Genotyping suggests that mothers are the primary MS transmission source
·      We can’t rule out that fathers may also be a source of MS for their children. However, more studies are needed
·      Studies may be complicated by the fact that MS can be transmitted between mothers and fathers
·      Low SES is a strong risk factor for MS colonization but few studies have examined its role in the transfer of MS
·      Limitations in the maternal intervention trials make comparisons and generalizability difficult and there is no data regarding the cost effectiveness of these programs.

Remarks:
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Assessment of Article:  Level of Evidence/Comments: Level 1, literature review

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