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Int Poster J Dent Oral Med 4 (2002), No. 4     15. Dec. 2002

Int Poster J Dent Oral Med 2002, Vol 4 No 04, Poster 147

To the importance of bottle-feeding habits for the transmission of mutans streptococci from mothers to infants and their caries status among German families

Language: English

Authors: PD Dr. rer.nat.habil. Susanne Kneist1, Prof. Dr. Annerose Borutta1, Dr. Dietrich Eherler2, Patrick Chemnitius1, Anja Merte1, Prof. Dr. Dr. Lutz Stößer1
1University of Jena, Department of Preventive Dentistry
2University of Jena, Department of Economic Sciences

Date/Event/Venue:
04.07.-07.07.2001
48th Annual Congress of the European Organization for Caries Research
Graz, Austria


Aims and Methods

Children are susceptible to infection by mutans streptococci (MS) between the ages of 1.5 and 3 years. The aim of the present study was to investigate those factors that could be correlated with MS transmission among German children aged 30 months.

  • A questionnaire concerning the nutrition history and childhood nursing practice was completed by 155 mothers.
  • The dental caries status (dmft) of 155 children was examined.
  • The salivary MS of the children and their mothers were determined by Dentocult® SM strip mutans (Orion Diagnostica) (fig.1).
Fig. 1: Sampling of salivary mutans streptococci in children and their mothers by Dentocult® SM Strip Mutans
  • Two isolates were picked from spatulas from 34 mother-infant-pairs. 128 isolates were identified as MS (fig. 2).
  • Bacteriocine-fingerprinting was performed for all strains (n=128)
Fig. 2: Macrocolonies of mutans streptococci on the plastic spatula of Dentocult® SM Strip Mutans Fig. 3 Bacteriocin-Fingerprintig of mutans streptococci (strains of one mother and their child by inhibition zones against one indicator strain)
  • Indicator strains were used:
       S. sanguis (n = 3)     S. oralis (n = 4)
       S. gordonii (n = 1)     S. mitis (n = 1)
       S. salivarius (n = 1)

 

Results

  • A graphical model (TETRAD III) was used for statistical analyses (p-value of 0.05 were considered statistically significant (fig. 4).
  • It was apparent that MS and dmfs formed a separate set with the highest significance (phi 0.346).
  • The caries decay of the children was registered at a mean dmft of 0.6 ± 2.0.
  • Higher scores of MS correlated significantly with higher caries decay (Spearman's correlation coefficient 0.32712, X2-test p 0.0001).
  • In children the upper incicors showed significant frequent decay (X2-test p 0.0001). 15% of the children had developed early childhood caries (fig. 5).
  • A positive correlation could be found between high salivary MS counts in children and bottle-feeding at night (X2-test p 0.003) (fig. 4, 6).
  • 65% of the mothers and 24% of the children harboured high MS counts (scores SM 2 and 3). The levels of mothers of children with and without MS were not significantly different (X2-test 0.741)
  • 59% of the strains of the mother and 53% of the strains of children produced bacteriocins. S. sanguis, S. oralis, S. gordonii, S. mitis and S. salivarius were usually inhibited (fig. 7 and 8, tab. 1).
  • 41% of mother-infant-pairs harboured bacteriocin producing strains. 10 profiles could be estimated for S. mutans and 3 for S. sobrinus. Furthermore, in the half of mother-infant-pairs strains with identical fingerprints could be determined (tab. 2, 3).

 

Conclusion

The data suggest that bottle-feeding, especially at night, may support the fidelity of MS transmission from mothers to infant and that bottle-feeding at night may contribute to a higher caries rate.

Fig. 4: Multifactorial Analyses Variables
Variables
A:Education of the mothers (1=at least class 10; 0=lower education)
B:Occupation of the mothers (1=working; 0=no working)
C:The child has the bottle at night (1=yes; 0=no)
dmft:Caries index of deciduous teeth (0=healthy; 1=carious, to summarize d-, m-, and f-components)
E:Visible plaque at anterior teeth (1=yes; 2=no)
F:Scores of mutans streptococci (1=high; 0=low)
G:Regular supervision of toothbrushing by the mothers of the children and additional toothbrushing (1=yes; 0=no)
H:Cariogenicity of meals (1=cariogenic; 0=no cariogenic)


Fig. 5: Caries status of upper incisors and MS scores (n = 155 children)


Fig. 6 Nursing bottle at night and MS scores (n = 155 children, p 0.003 s)


Fig. 7 Bacteriocinogeny of MS strains of mothers against indicator strains


Fig. 8 Bacteriocinogeny of MS strains of infants against indicator strains



  Test strains   Indicator strains
    S. sanguis S. oralis S. mitis S. gordonii S. salivarius
    OMZ 9S HG 1473 HG 1475 HG 1290 HG 1601 NS 30 NS 9 OMZ 8 HG 295 OMZ 47
MOTHERS   S. mutans
(n = 5 of 52)
21 ± 6 20 ± 6 17 ± 4 18 ± 5 19 ± 5 17 ± 4 20 ± 5 18 ± 4 14 ± 3 14 ± 2
  S. sobrinus
(n = 3 of 10)
- 20 ± 1 26 ± 3 20 ± 0 - 22 ± 1 20 ± 1 - 16 ± 1 16 ± 2
INFANTS

S. mutans
(n = 31 of 56)

18 ± 5 18 ± 6 18 ± 6 16 ± 3 15 ± 3 18 ± 5 16 ± 4 17 ± 6 14 ± 2 16 ± 3
  S. sobrinus
(n = 4 of 10)
11 ± 0 16 ± 4 22 ± 7 23 ± 3 - 22 ± 2 21 ± 1 - 14 ± 3 18 ± 0
Table 1: Diameter of inhibition zones (x ±S D, mm) of indicator strains of oral streptococci by MS strains of mothers and infants

The median of 100 macrocolonies were determined with mean of 7.6 ± 0.5 mm around the macrocolonies indicated the presence of bacteriocines


Profile Indicator strains
     S. sanguis   S. oralis   S. gordonii   S. mitis   S. salivarius 
S. mutans              
I (n = 34)  + + + + +
II (n = 8)  + + + +  
III (n = 6) + +   + +
IV (n = 4) + + +   +
V (n = 1) + + +    
VI (n = 7) + +      
VII (n = 1) +        
VIII (n = 2)   + + +  
IX (n = 1) + +   +  
X (n = 2)   +      
S. sobrinus              
XI (n = 5) + + +   +
XII (n = 1) + + +    
XIII (n = 1) +   +    
Table 2: Profiles of bacteriocinogeny of strains of S. mutans and S. sobrinus of 14 mother-infants-pairs


  MOTHERS
  I II III  IV  V VI  VII   VIII  IX  XII 
 INFANTS                     
I 6     1            
II           2        
III 1 (1)1    1 (1)     1 (13)           
IV                  1 (31)   
V                    
VI                    
VII 1                  
VIII            1 (13)         
IX  1 (33)   1 (33)                 
XII                    
Table 3: Identical profiles of bacteriocinogeny between MS strains of 14 mother-infant-pairs

1in bolds strains of mother-infant-pair-no. with different profiles


Literature

  • Kneist S, Scharff S, de Soet JJ, van Loveren C, Stößer L: Bacteriocin production by human strains of mutans and oral streptococci. Caries Research 2000, 34, S. 308
  • Rupf S, Merte K, Eschrisch K, Stößer L, Kneist S: Peroxidase reaction as a parameter for discrimination of Streptococcus mutans and Streptococcus sobrinus. Caries Research 2001, 35, S. 258-264

This Poster was submitted by PD Dr. rer.nat.habil.Susanne Kneist.

Correspondence address:
PD Dr. rer.nat.habil. Susanne Kneist
Nordhäuser Straße 78
D-99089 Erfurt Germany