Cariës bij moeders en tandbederf bij hun kinderen

Al vroeg na de geboorte worden kinderen besmet met mondbacteriën die vooral afkomstig kunnen zijn van hun moeders. Streptococcus salivarius is meestal de eerste bacterie die zich blijvend in de mond vestigt, zo blijkt uit de onderzoeksliteratuur. In een longitudinaal onderzoek werden moeders met een grote cariësactiviteit preventief behandeld en hun kinderen daarna tot hun 10e jaar gevolgd. In 1 groep gebruikten de moeders dagelijks kauwgum met Xylitol en in de andere groep werden de gebitten met fluoride of chloorhexidine behandeld. Een derde groep functioneerde als een controlegroep. Na 10 jaar bleken de resultaten bij de kinderen opvallend.

In a Finnish study carried out in 1990s, high-caries-risk mothers used xylitol gum on daily basis when their child was 3-24-month old, whereas the high-risk control mothers received biannual fluoride or chlorhexidine treatments. The maternal prevention reduced colonization of mutans streptococci and early childhood caries in children. The present retrospective study aimed to extend the post-trial follow-up to 10-year-old children (n = 148). Additionally, the dental health of these high-caries-risk children was compared with a reference group comprising the rest of the children in the same age cohort (n = 359). The annual data on dental health and treatments were gathered from public dental care registers.The median caries-free age (dmft = 0 and DMFT = 0) was 8.2 in the xylitol, 5.8 in the control, and 8.1 in the reference group (xylitol versus control, P = 0.005, HR = 1.75; 95% CI 1.18-2.60, reference versus xylitol, P = 0.410, HR = 1.13; 95% CI 0.84-1.51 Cox regression). Thus, the children in the xylitol group had caries-free teeth longer than the control group. Compared to the reference group, the xylitol group did not show notable difference. Up to 4 years of age, figures for cumulative restorative treatment visits were 0.2 in the xylitol, 0.7 in the control, and 0.4 in the reference group (xylitol versus control P = 0.006, Student's t-test). The reduced mother-child transmission of mutans streptococci seems to have long-term effects on children's dental health. The maternal use of xylitol reduces caries occurrence and need for restorative treatment in assumed high-caries-risk children to the average level of the whole age cohort.

Bron

Laitala ML, Alanen P, Isokangas P, Söderling E, Pienihäkkinen K. Long-term effects of maternal prevention on children's dental decay and need for restorative treatment. Community Dent Oral Epidemiol 2013 Jun 20. doi: 10.1111/cdoe.12057. [Epub ahead of print]