Mode of delivery, mutans streptococci colonization, and early childhood caries in three‐ to five‐year‐old Thai children

Abstract

Objective To investigate whether mode of delivery is associated with mutans streptococci (MS) colonization and early childhood caries (ECC) in preschool Thai children. Methods Three hundred and fifty mothers and their 3-to 5-year-old children (184 born vaginally and 166 born by Caesarean section) participated in the study. Data included a dental examination, MS colonization assessed by the Dentocult® SM Strip Mutans method, and a questionnaire survey of family socio-demographic information, as well as children’s birth history, dietary habits, and oral health practices. Results Overall, ECC prevalence was 56% in 3-year-old and 78% in 5-year-old Thai children. Compared to children delivered by C-section, vaginally born children experienced increased ECC prevalence (73.8% versus 59.6%; P = 0.009) and were more likely to have higher MS scores (OR = 1.8, 95% CI = 1.1–2.9), adjusting for mother’s gestational age, MS score, feeding practice habits; child’s age and tooth brushing habits. Children’s MS scores were highly correlated with their mothers’ MS scores (P < 0.001). Additionally, children’s age, MS colonization, and mothers’ prechewing feeding habits were the most significant risk indicators for ECC in Thai children. Conclusion Our findings suggest that mode of delivery is significantly correlated with MS colonization and caries outcomes in young Thai children. Future studies are needed to further understand the possible biological mechanisms linking mode of child delivery to the colonization of cariogenic microbiota and development of ECC.

Effect of Mode of Delivery on Early Oral Colonization and Childhood Dental Caries: A Systematic Review

“…The main characteristics of the studies including the outcomes assessed are described in Table 1. According to the methodological quality assessment, 5 studies were classified as strong [19-23], 1 study as weak [24], and the remaining studies were considered moderate [14, 25-31]. …”

“…Three studies rated weak [24] to moderate [25, 30] in quality assessment reported significant lower frequency of S. mutans detection among infants born by cesarean section compared with those vaginally delivered but only among younger groups (2 days, 1 month, and 3 months old). Instead, 6 studies that were considered to have moderate [14, 27, 28, 31] to strong [21, 23] methodological quality reported no significant differences in prevalence of oral colonization by S. mutans between groups by mode of delivery (Table 2).…”

“…Four studies presented results on caries prevalence by mode of delivery [19, 24, 26, 29]. The prevalence of caries varied across studies, ranging from 8.1 [19] to 67.0% [24].…”

“…The prevalence of caries varied across studies, ranging from 8.1 [19] to 67.0% [24]. A study that scored weak [24] reported significant differences in prevalence of dental caries by mode of delivery among children aged 3–5 years such that children born by cesarean section presented lower odds of dental caries than those vaginally delivered. Three studies that scored moderate [26, 29] to strong [19] reported no differences in dental caries prevalence between groups by mode of delivery (Table 4).…”

“…Two studies compared groups by mode of delivery with regard to DMFT and DMFS; one reported results about children aged 3 years [19], and the other presented stratified results at age 3 and 5 years [24]. …”