Mutans Streptococci as Predictor for Caries in Infants: Systematic Review

Background: It is important to understand the natural history of early childhood caries (ECC) in order to implement effective prevention strategies. Recent evidence suggests that the acquisition of particular bacteria in the first year of life is important for later caries outcomes. A systematic review of the literature is needed. Prevention and early intervention are critical if the adverse effects of ECC on a child's quality of life are to be avoided. This research forms part of a larger systematic review exploring the putative risk and protective factors (biological, social, environmental, behavioural) for ECC in the first year of life. Objectives: Conduct a systematic review of international epidemiological literature addressing the acquisition and development of oral bacteria in children in the first year of life and subsequent development of ECC. Methods: Search strategy inclusion criteria were: Medline (1996-2010); children aged under 12 months at study recruitment, Mutans streptococci (MS) in saliva/plaque biofilm at baseline, caries examination by age 18 months. Initial screening by title and abstract by two reviewers PL and SH. Results: 119 articles; 8 were retrieved and 2 met all criteria. One focused on link between MS, caries and nursing bottle habits in a disadvantaged group, the second on MS, caries, dietary and oral health practices in southern England. Conclusion: The two studies were limited. Study one was unable to evaluate any association with caries as only three children had caries. The second was unable to detect caries in either the 12 or 18 month old infants. Further cohort studies are required to determine the strength of any link between MS colonization within the first year of life and subsequent evidence of early childhood caries. This research is supported by a NHMRC Research Training Scholarship.