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Overview
Recent online articles by Health Day News  and Reuters Health report that babies born by cesarean section have a higher risk of developing caries. These reports were based on a study published in the September 2005 Journal of Dental Research,1 which found that Streptococcus mutans, a cavity-causing bacterium that grows on tooth surfaces, appeared nearly one year earlier in babies delivered by cesarean section.
In the study, the investigators followed 156 mother-infant pairs from Birmingham, Alabama, and identified several factors that had an effect on the acquisition of S. mutans, including maternal age, gestational age, maternal S. mutans level, maternal caries score, family income, and mode of delivery. One of the study’s key findings was that, although the infants delivered by C-section or regular birth had similar rates of S. mutans colonization (31.0 percent for C-section compared to 36.7 percent for vaginal birth), the C-section children acquired S. mutans almost one year earlier (17.1 months for C-section vs. 28.8 months for vaginal delivery).
The investigators hypothesized that vaginal delivery may expose newborns to early protection against S. mutans colonization by exposing them to numerous bacteria earlier and with greater intensity, influencing the pattern of microbial succession. Cesarean-section infants are delivered in a more aseptic manner, resulting in an atypical microbial environment that may increase their susceptibility to subsequent early S. mutans colonization. Other possible confounding factors, such as race, maternal and infant health status and exposure to antibiotics, were not well controlled in the study.
Since S. mutans plays a key role in the etiology of dental caries and is readily transmissible from caregivers to infants, the timing of S. mutans colonization in newborns has received considerable study in recent years. Previous research has associated various factors, such as low infant birth weight, early tooth emergence and pre-term birth, with the initial acquisition of S. mutans. Further study is needed to clarify the many factors associated with S. mutans acquisition in children, including mode of delivery.
The ADA will continue to monitor research on caries risk factors, promote approriate oral health care for infants and parents, and make appropriate recommendations to the profession. In assessing a patient’s health history, dentists are encouraged to consider a variety of factors that may influence caries susceptibility, such as the mother’s oral hygiene habits, fluoride accessibility, nutritional habits and general medical history. Children should have their first dental visit within six months of eruption of the first tooth and no later than 12 months of age. Finally, dentists are encouraged to provide appropriate oral health education to parents, caregivers and children.
Footnotes
1 Li Y, Caufield PW, Dasanayake AP, Wiener HW, Vermund SH. A longitudinal study of streptococcus mutans colonization in infants after tooth eruption. J Dent Res 82(7): 504-508 . Accessed Sept. 2, 2005.
The Journal of the American Dental Association
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Additional Resources
Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Page Posted September 2005
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