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Can oral care for babies prevent future cavities?

Cavities are the most prevalent infectious disease in U.S. children, according to the Centers for Disease Control and Prevention. Now, researchers are looking for ways to halt the spread of cavity-causing bacteria in infants and prevent future decay.

Scientists at the University of Illinois recently confirmed the presence of bacteria associated with early childhood caries (the cause of cavities) in infant saliva. Early childhood caries (sometimes referred to as baby bottle tooth decay) refers to tooth decay in infants and toddlers. ECC most often occurs in the upper front teeth but other teeth may also be affected. In some unfortunate cases, infants and toddlers have experienced decay so severe that the teeth cannot be repaired and need to be removed.

In PLoS ONE, a peer-reviewed, open-access website, Kelly Swanson, Ph.D., and his team of researchers at the U of I shared information about preventive measures that keep the bacteria from growing and the possibility of developing ways to contain the bacteria and decrease its overall potential for damage.

"By the time a child reaches kindergarten, 40 percent have dental cavities," said Dr. Swanson, lead researcher and a University of Illinois professor of animal science. "In addition, populations who are of low socioeconomic status, who consume a diet high in sugar, and whose mothers have low education levels are 32 times more likely to have this disease."

Looking at infants before their teeth erupted, Dr. Swanson's team found value in preventive care measures for very young children.

"We now recognize that the 'window of infectivity,' which was thought to occur between 19 and 33 months of age years ago, really occurs at a much younger age," said Dr. Swanson. "Minimizing snacks and drinks with fermentable sugars and wiping the gums of babies without teeth, as suggested by the American Academy of Pediatric Dentistry, are important practices for new parents to follow to help prevent future cavities."

In addition, his team used high-throughput molecular techniques to characterize the entire community of oral microbiota, rather than focusing on identification of a few individual bacteria.

"Improved DNA technologies allow us to examine the whole population of bacteria, which gives us a more holistic perspective," Dr. Swanson said. "Like many other diseases, dental cavities are a result of many bacteria in a community, not just one pathogen."

Researchers learned that the oral bacterial community in infants without teeth was much more diverse than expected; they identified hundreds of species. This demonstration that many members of the bacterial community that cause biofilm formation or are associated with ECC are already present in infant saliva justifies more research on the evolution of the infant oral bacterial community, Dr. Swanson said.

Could manipulating the bacterial community in infants before tooth eruption help prevent this disease in the future?

"The soft tissues in the mouth appear to serve as reservoirs for potential pathogens prior to tooth eruption," he said. "We want to characterize the microbial evolution that occurs in the oral cavity between birth and tooth eruption, as teeth erupt, and as dietary changes occur such as breastfeeding vs. formula feeding, liquid to solid food, and changes in nutrient profile."

Dr. Swanson added that educating parents-to-be on oral hygiene and dietary habits is the most important strategy for prevention of dental cavities.

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

09/07/2011

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