Introduction: Otitis media, also known as middle ear infection, refers to any inflammation of the middle ear. It may be attributable to bacteria like Streptococcus pneumoniae and Hemophilus influenzae (most commonly involved), though viruses can also cause middle ear infection. It affects the pediatric group during the first three years of life, with 80% youngsters having had one otitis media episode at the minimum by age three years, 50% having had at least three episodes, while a smaller number experience their first episode after age three years. This phenomenon has also been linked to an increased presence of Streptococcus mutans which in turn raises the risk of acquiring dental caries. Objective: To determine whether an association exists between middle ear infection and the high occurrence of Streptococcus mutans that ultimately leads to dental caries in children and causes poor oral hygiene problems. Materials & Methods: A comprehensive and well-organized search of published articles was conducted in February 2022. The investigation was conducted using the Reporting Items for Systematic Reviews. Articles that fulfilled the predefined inclusion and exclusion criteria were appraised with respect to the key objectives of the review. Results: Based on the findings of the studies highlighted in this systematic review, not only was there a positive correlation between middle ear infection and dental caries, but some data were also supplied on the nature of the link between early childhood caries and middle ear infection. Conclusion: Increased Streptococcus mutans levels in early childhood together with other contributory risk factors such as middle ear infection could enhance the incidence of early childhood dental caries.