Association of Early Gut Microbiome with Prospective Infantile Teething Problems

Objectives: Teething is a natural physiological process in early childhood and associated symptoms may cause distress in both child and parents. The child’s immunity may be an important modulating factor. Studies in teething problems (TPs) have been impeded by beliefs in non-scientific evidence. Objective: This study aimed to explore potential associations between early gut microbiome and TPs in infants.
Methods: Subjects were recruited through the GUSTO (Growing Up in Singapore Towards healthy Outcomes) birth cohort study in Singapore. Data was collected at 6, 9, 12, 15 and 18 months of age by trained personnel during home/clinic visits through interviewer-administered questionnaires and simple oral examinations. Fecal samples collected at day3, week3, months3 and 6 from birth were individually extracted for total DNA. Next-generation sequencing was carried out on regions V4-6 within the 16S rDNA bacterial genes. An incidence of TP was defined as cumulatively having ≥1 of the following teething-related signs and/or symptoms (TSS): fever, pain, decreased food intake and decreased daily activity. The 39 subjects were divided into two groups for analysis, TSS=0 (n=16) and TSS≥3 (n=23) within the first 18 months of life. Standard ANOVA tests and pairwise unweighted Unifrac dissimilarity measures were used in microbiome analyses.
Results: Significantly higher relative abundances of Streptococcus spp. (p<0.01) and Enterococcus spp. (p<0.05) were detected at week 3 compared to other time-points across all subjects. The gut microbial community at week 3 was significantly more diverse in the TSS≥3 infants compared to the TSS=0 infants. The TSS≥3 group had a higher Unifrac β-diversity index (p<0.05).
Conclusions: Transient compositional differences within a specific time window during early gut microbiome development may have manifestations later on during infantile teething. This association may have an immunity basis considering the vital role of gut microbiome in immune education within the first 6 months of life.