Oral health behaviors and bacterial transmission from mother to child: an explorative study

Perceptions, knowledge, and practices related to oral health in a group of pregnant women: A qualitative study

BACKGROUND

It is well known that the prevalence of dental caries and periodontal disease is increasing in pregnant women. Dental care is mostly sufficient to prevent oral diseases and perform timely interventions. However, few pregnant women go to the dental office during this period due to a lack of knowledge. The perceptions, knowledge, and oral health practices of pregnant women have been scarcely explored and should be taken into account to propose positive interventions in this population.

OBJECTIVES

To identify and explore the perceptions, knowledge, and practices of oral health in a group of pregnant women in Colombia.

MATERIAL AND METHODS

Twenty-four semistructured interviews were conducted in different areas of Colombia. The interviews were conducted via telephone, and the calls were recorded with the consent of the participants. The recordings were transcribed in Word® and checked for typing and transcription errors. The transcripts were analyzed using a hybrid approach combining inductive and deductive coding. The information was organized and encoded using NVivo12 ®software. We followed the Standards for Reporting Qualitative Research (SRQR) checklist.

RESULTS

Pregnant women reported having good oral health. One barrier mentioned for occupation (Job) was pregnancy. The appearance of the oral cavity has not negatively affected the relationships of pregnant women.

CONCLUSIONS

The pregnant women had good oral hygiene habits but did not receive dental check-ups. Knowledge in this group was limited and diverse. The information given by health professionals should be standardized, and some beliefs should be demystified.

RELEVANCE TO CLINICAL PRACTICE

In general, few pregnant women were aware of bleeding gums during pregnancy. Empower pregnant women to take care of themselves through regular dental check-ups with the aim of preventing and treating oral diseases. Oral hygiene education and healthy nutritional habits should be intensified during this stage.

PATIENT OR PUBLIC CONTRIBUTION

The participation in the study included a semistructured interview by telephone with the prior consent of the pregnant woman authorizing her involvement and the recording of the interview.

Predicting a Child's Oral Health Status from the Mother's Oral Health Behavior

OBJECTIVE

 A mother has a decisive role in maintaining children's oral health, especially before the child is of preschool age. The behavior of mother becomes a source of learning for children who can determine the child's condition, including health behavior. This study analyzes the relationship between maternal oral health behavior and children's oral health status.

MATERIALS AND METHODS

 The research methodology used is a quantitative observational study with a cross-sectional approach to determine the oral health behavior of mothers and children's oral health status. The population of this study were mothers with their first child aged between 3 and 5 years in Tanjungsari, Tanjungsari, Sumedang, West Java, Indonesia. The sampling method and technique used nonrandom and consecutive sampling from six health center units which yielded 46 mothers. Correlation analysis was done with chi-squared validity statistical test and Spearman rank correlation.

RESULTS

 The score for the mother's oral health behavior was 75.54, while the score for the child's oral health status was 54.46. The results of the Spearman rank correlation test showed that the maternal oral health behavior score's correlation coefficient (r) was 0.198 (p-value: 0.188). The calculation of the Spearman rank correlation shows that the mother's oral health behavior affects the child's oral health status in the food and beverage consumption selection.

CONCLUSION

 Based on all indicators of maternal oral health behavior studied, the behavior in maternal food and beverage consumption has a relationship with the child's oral health status, namely the better the behavior in the mother's food and drink consumption, the better the child's oral health status. Other indicators of oral health behavior did not show any relationship with the oral health status of children.

Impact of breastfeeding and other early-life factors on the development of the oral microbiome

The oral cavity is home to the second most diverse microbiome in the human body. This community contributes to both oral and systemic health. Acquisition and development of the oral microbiome is a dynamic process that occurs over early life; however, data regarding longitudinal assembly of the infant oral microbiome is scarce. While numerous factors have been associated with the composition of the infant oral microbiome, early feeding practices (breastfeeding and the introduction of solids) appear to be the strongest determinants of the infant oral microbiome. In the present review, we draw together data on the maternal, infant, and environmental factors linked to the composition of the infant oral microbiome, with a focus on early nutrition. Given evidence that breastfeeding powerfully shapes the infant oral microbiome, the review explores potential mechanisms through which human milk components, including microbes, metabolites, oligosaccharides, and antimicrobial proteins, may interact with and shape the infant oral microbiome. Infancy is a unique period for the oral microbiome. By enhancing our understanding of oral microbiome assembly in early life, we may better support both oral and systemic health throughout the lifespan.

Potential Pathogenic and Opportunistic Oral Bacteria in Early Life: The Role of Maternal Factors in a Portuguese Population

In early life, maternal factors are of the utmost relevance for oral microbiome acquisition and maturation. Therefore, our study explored the impact of maternal factors, such as saliva and breastmilk colonization, cardiovascular risk factors (CRF), type of delivery, oral health, and caregiving habits on the prevalence of potential pathogenic and opportunistic oral bacteria in early life. A total of 26 healthy mothers, 23 mothers with CRF, and their 50 children were included and samples (child's oral swabs, mother's saliva, and breastmilk) were collected 4 to 12 weeks after delivery and inoculated in selective and differential media for detection of non-fastidious Gram-negative and Gram-positive bacteria to isolate potential pathogenic and opportunistic bacteria identified by MALDI-TOF MS (414 isolates). Within mother-child dyads, the same species were identified in 86% of the pairs and potential pathogenic microorganisms from the Staphylococcaceae and Enterobacteriaceae families were found to be statistically significantly concordant between mother-child samples, particularly in the healthy group. Staphylococcus saprophyticus and Stenotrophomonas maltophilia oral colonization in mother-child pairs were associated with the presence of CRF. Breastfeeding was related to the early life oral colonization of Staphylococcus epidermidis in children from healthy mothers and C-section was associated with higher diversity of pathogens, independent of cardiovascular status (p = 0.05). This study reveals the presence of potential oral opportunistic and pathogenic bacteria in early life and highlights the importance of maternal factors in its acquisition.

Oral Care Recommendation for Cystic Fibrosis Patients-Recommendation for Dentists

Cystic fibrosis (CF) is a genetic disease that is caused by a defect in the gene coding for the transmembrane cystic fibrosis transmembrane conductance regulator (CFTR). Research papers published so far point out that despite the numerous dental treatment needs of CF patients, there are no oral care guidelines for this group of patients. The aim of the article is to propose standards of dental prophylactic and therapeutic procedures for CF patients in different age groups. Regardless of the CF patient's age, dental check-ups should be scheduled at least every 6 months. However, taking into account the actual condition of the individual CF patients, therapeutic visits may be scheduled for earlier dates, to provide well-fitting treatment, considering the level of risk of oral diseases. The described management standards may be helpful and may improve the quality of dental care provided to CF patients.

Self-perception on oral health and related behaviours among antenatal mothers attending a public antenatal clinic - Kerala

Background and Aims:

Antenatal oral care has been given least priority on a global scale. The study assesses self-perception of oral health knowledge and related behaviors among antenatal mothers.

Method:

A cross-sectional study was done among 400 pregnant women attending antenatal care clinic of a tertiary care center in Kerala, India. Details regarding knowledge, attitude, and practice were obtained, after getting an informed consent. The dental caries experience and gingival status were measured. To test the significance (p ≤ 0.05) between variables, Chi-square test was used.

Results:

Poor oral health knowledge was observed among 75.5% of the pregnant mothers. Oral health problems were reported by 63.2% of them. Low priority for oral health (59.4%) and fear for fetal safety (17.5%) were the reasons for delaying dental services. Oral examination showed that more than half of the study subjects had a high prevalence of dental caries (67.5%) and low gingival bleeding status (26.2%). The study highlights that more than half of the study population (60.8%) were influenced by the elderly in the family to avoid certain food items. A better oral health knowledge was observed among the upper middle class (OR - 2.8) who had visited dentists within the last six months (OR - 3.6) and child bearing mothers (OR- 0.46) (p ≤ 0.05).

Oral health behaviour, attitude towards, and knowledge of dental caries among mothers of 0- to 3-year-old children living in Kaunas, Lithuania

OBJECTIVES

This study aimed to investigate the oral health behaviours of mothers with young children and their attitudes towards dental caries.

METHODS

The survey targeted all mothers with children under 3 years attending a primary healthcare centre (Department of Family Medicine at the Lithuanian University of Health Sciences [LSMU] Hospital) in Kaunas, Lithuania. The Bioethics Centre of the LSMU approved the study (No. BEC-OF-14). Of 176 mothers, 123 (69.9%) took part in the 2016-2017 study. The self-administered questionnaire enquired about mothers' attitudes towards oral health and behaviours related to the potential transmission of oral bacteria to their children, dietary habits, tooth brushing, smoking, and background factors. The chi-squared test and univariate/multivariate logistic regression analyses served for the statistical analysis. (p values ≤ .05 indicated statistically significant differences).

RESULTS

Most (76; 68.5%) of the mothers brushed their teeth twice daily, and 97 (87.4%) reported themselves as nonsmokers. We found a statistically significant association between mothers who brushed their own teeth twice daily and those who cleaned their children's teeth likewise (OR = 5.42, 95% CI [1.28-6.63]; p = .005). We observed significant associations among mothers who gave their children sugar-sweetened beverages (SSBs) daily and the mothers' college or lower education (OR = 6.51, 95% CI [1.59-27.19]; p = .01) and maternal tooth brushing less than twice daily (OR = 3.88, 95% CI [0.99-15.18]; p = .05).

CONCLUSIONS

A majority of mothers who took part in this survey did not brush their children's teeth as recommended. Mothers with a lower education and who brushed their teeth less than twice daily offered their children SSBs more frequently.

Exploring the Maternal and Infant Oral Microbiomes: A Pilot Study

Setting the stage for good oral health early in life is critical to long-term oral and overall health. This exploratory study aimed to characterize and compare maternal and newborn oral microbiota among mother-infant pairs. Oral samples were collected from 34 pregnant African American women and their infants at 1 to 3 months of age. Extracted 16SrRNA genes were matched to the Human Oral Microbiome Database. Alpha and beta diversity differed significantly between overall maternal and infant microbiomes. Maternal or infant alpha diversity, however, was not differentiated by maternal gingival status. Several demographic and behavioral variables were associated with, but not predictive of, maternal oral microbiome alpha diversity. There was no association, however, among birth mode, feeding mode, and the infant oral microbiome. Megasphaera micronuciformis was the only periodontal pathogen detected among the infants. Notably, maternal gingival status was not associated with the presence/absence of most periodontal pathogens. This study provides an initial description of the maternal and infant oral microbiomes, laying the groundwork for future studies. The perinatal period presents an important opportunity where perinatal nurses and providers can provide oral assessment, education, and referral to quality dental care.

Frequent consumption of sugar-sweetened beverages and sweets starts at early age

OBJECTIVES

We aimed to investigate the habitual consumption of sugar-sweetened beverages (SSBs) and sweets in relation to mothers' behaviours and practices with their infants.

METHODS

We targeted mothers with children 1-24 months (N = 200) visiting Public Child Health clinics in Finland. During routine visits mothers (N = 179) volunteered to complete a self-administered anonymous questionnaire about their child's health-related behaviours (consumption of sweets and SSBs, tooth brushing frequency). The questionnaires also included questions about the mothers' background (age, education) and health-related behaviours (consumption of sweets, tooth brushing frequency and smoking habits). The children were categorised by age, and Chi-squared tests, Fischer's exact test, ANOVA and correlation coefficient served for the statistical analyses.

RESULTS

Of those under 6 months, almost half (44%) received SSBs, and 45% of them more than once a week. Their use gradually increased by age such that by 19-24 months, all received SSBs at least sometimes, and 56%, frequently. Fewer than half of the mothers (33-43%) gave sweets to their children between the ages of 10-15 months, but 92% by the age of 2 years. Children's twice-a-day tooth brushing increased from 14% to 33%. The child's age and tooth brushing frequency correlated with the consumption of sugar-sweetened products (r = 0.458).

CONCLUSIONS

Infants frequent consumption of sugar-sweetened products begins early in childhood. Thus, tackling these common risk factors in the first years of life is essential and calls for health-promoting actions in multiple areas that target primarily the parents of infants.

Oral microbiota transplant: a potential new therapy for oral diseases

Dental caries and periodontitis are amongst the most common diseases affecting humans worldwide. There is an evolving trend for dental and medical research to share knowledge on the etiology and promising therapies for human diseases. Inspired by the success of fecal microbiota transplant to manage gastro-intestinal disordes, oral microbiome transplant has been proposed but not yet tested in humans. This article critically reviews the potential of oral microbiome transplant for managing oral diseases.

Experience of maintaining tooth brushing for children born with a cleft lip and/or palate

BACKGROUND

Children with a Cleft Lip and/or Palate (CL/P) have been reported to have poorer oral health than those without the condition. The consequences for these children can be particularly problematic due to implications for future treatments. Tooth brushing is an important behaviour contributing to children's oral health, but is under researched in the CL/P population. The aim of the study is to explore the experience of maintaining tooth brushing among children in the United Kingdom (UK) with a CL/P and their parents.

METHODS

Semi-structured interviews were carried out with twenty-two parents and sixteen children with a CL/P (5-11 years), recruited at a cleft centre in the UK. Thematic analysis was used for data analysis.

RESULTS

Three key themes were drawn from the qualitative data: first, parents of children with a CL/P generally had strong motivation to look after their children's teeth but children's motivation was inconsistent. Second, parents were primary enablers of children's tooth brushing behaviour, often employing approaches adapted to their child's characteristics to encourage tooth brushing. Third, a range of obstacles were encountered by parents and children in maintaining regular tooth brushing behaviours. They reported obstacles such as issues related to CL/P, 'forgetting' and childhood illness.

CONCLUSIONS

The paper suggests that parents of children with a CL/P need support to enact their intention to maintain regular tooth brushing and prioritise tooth brushing within the context of demanding and dynamic family life.

Salivary microflora and mode of delivery: a prospective case control study

Background

Previous cross-sectional studies have suggested that the mode of delivery can influence the composition of oral microflora. The aim of this prospective study was to compare the salivary colonization in vaginally delivered children with children delivered by Caesarian section (C-section) during their first 6 months of life.

Methods

The study group consisted of 149 consecutively enrolled infants, delivered either vaginally (n = 96) or by C-section (n = 53) that volunteered after consent of their parents. Saliva samples were collected within 2 days after birth and then after 1, 3, and 6 months. A saliva sample from the mothers was obtained 6 months after delivery. The parents were asked to complete a questionnaire on socioeconomic factors, lifestyle, and hygiene at baseline and throughout the study period. All samples were analyzed with 13 pre-determined bacterial probes using checkerboard DNA-DNA hybridization.

Results

The groups were balanced at baseline concerning all relevant background factors. Gram-positive streptococci (S. mitis, S. salivarius) displayed the highest counts in both groups but a greater diversity was observed in the vaginally delivered group. A. naeslundi, A. odontolytics, F. nucleatum and L. salivarius were only detected among the vaginally delivered infants. The prevalence of S. sanguinis, S. gordoni, R. denticariosa, and B. dentinum increased by age in both groups but the prevalence was significantly lower in the C-section group (p < 0.05). There was a link between the mothers and their offspring’s concerning the salivary microbial profile.

Conclusion

The microbial composition in saliva differs by the mode of delivery during the first six months of life.