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Cesarean birth may increase child’s risk for tooth decay

Women with tooth decay and cavities who deliver babies by cesarean section should pay special attention to their newborns' oral health, according to a recent study published in the Journal of Dental Research.

Researchers at New York University conducted a four-year study of 156 mother-infant pairs; 127 women had vaginal delivery and 29 had cesarean delivery. The women were predominantly African-American, from an inner-city area of Birmingham, Ala., and included in the study beginning in their third trimester of pregnancy.

Women in the study who had cesarean delivery had high levels of Streptococcus mutans infection, as well as decay on an average of one-third of their teeth. A majority of these women had an annual family income of $10,000 or less — a potential barrier to accessing dental care — and a history of sexually transmitted disease.

The research team found that babies delivered by cesarean section were infected by S. mutans almost a year earlier than were infants delivered vaginally. They said this was a significant finding, since previous studies have linked earlier bacterial infection with a higher rate of dental decay in children.

"Vaginally delivered infants offer oral bacteria a less hospitable environment," said Dr. Yihong Li, associate professor, Basic Science and Craniofacial Biology, NYU College of Dentistry. "They develop more resistance to these bacteria in their first year of life, in part because of exposure to a greater variety and intensity of bacteria from their mothers and the surrounding environment at birth. C-section babies have less bacterial exposure at birth, and therefore less resistance."

The findings suggest that mothers who have dental decay should inform their dentists if they have cesarean delivery because of the potentially higher risk that the child also will develop caries, said Dr. Li.

Researchers say further study is needed to determine if cesarean births can be linked to earlier acquisition of S. mutans and other oral bacteria in a broader cross-section of the population, and if a higher incidence of decay follows.

Please contact the ADA if you have questions about this article.

©2010 American Dental Association. All rights reserved. Reproduction or republication is strictly prohibited without the prior written permission from the American Dental Association.

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