Prevention of Transmission of Bacteria That Cause Cavities From Mothers to Their Children
Condition: Caries, Dental
MeSH terms: Dental Caries
Study type: Interventional

Summary: 
      The purpose of this study is to control the levels of bacteria that causes cavities in
      mothers by a combination of treatments that include fluoride and chlorhexidine varnishes and
      xylitol-chewing gum before the appearance of teeth in the mouth of their children. By doing
      that we expect to reduce the acquisition of the bacteria that causes cavities (the mutans
      streptococci) by the children which in turn will reduce the development of cavities.
    

Detailed description: 
      Dental decay is the most prevalent affliction in children worldwide. In recent years the
      occurrence of dental decay has declined dramatically in many industrialized countries
      subsequent to the widespread availability of fluoride in the water supply and dentifrices.
      However, in newly industrialized countries such as Brazil, the occurrence of decay is still
      high, especially among lower income groups. The mutans streptococci (MS) have been
      convincingly associated with human dental decay and clinical protocols, which seek to reduce
      the levels of MS invariably, thus resulting in a significant reduction in decay. One of the
      most important observations from these studies is the possibility that decay and the
      establishment of MS can be reduced and/or prevented in young children by treating those
      mothers who are highly infected with MS prior to the eruption of the primary teeth. Other
      studies indicate that if the MS does not colonize the primary teeth in the first year after
      their eruption, they are likely to remain caries free during the following years. These
      findings indicate that delaying the colonization of the MS in the primary dentition may
      prevent dental decay. The ideal population for such a study can be found in communities
      without water fluoridation, with a high level of unmet dental care, and who would have
      frequent access to sugar. Populations in many newly industrialized countries would meet these
      qualifications. However, it is difficult to perform an interceptive study, such as preventing
      the transmission of the MS from mother to infant in such countries, as the local dental
      community has neither the financial and physical resources nor the trained dental personnel.
      We have found an exception to this in the city of Bauru, Sao Paulo, Brazil. This community of
      250,000 residents is situated in the sugar cane growing region of Brazil and boasts the
      leading dental school in South and Central America. In the investigation described, we will
      collaborate with the Bauru investigators in a longitudinal randomized clinical trial with the
      following specific aims: 1) to determine whether the salivary levels of the MS can be reduced
      in mothers of young infants by an intervention program consisting of restorations, topical
      fluorides, the use of xylitol chewing gum, chlorhexidine varnishes and oral hygiene
      instructions; 2) to determine whether this intervention reduces or delays the acquisition of
      MS in the infants and whether this in turn reduces the subsequent caries incidence in
      children
    

Intervention name(s): Cervitec chlorhexidine varnish; Duraphat fluoride varnish; xylitol gum from Fennobon, Finland
Intervention type(s): Drug; Drug; Drug
Intervention MeSH terms: Chlorhexidine; Chlorhexidine, thymol drug combination; Fluorides; Fluorides, Topical; Sodium fluoride topical preparation
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Double
Primary purpose: Treatment
Keywords: mutans streptococci infections