Turkiye Klinikleri Journal of Dental Sciences

.: REVIEW
Koruyucu Ağız Diş Sağlığı Programlarında Annenin Eğitimi ve Ağız Sağlığının İyileştirilmesi ile Erken Çocukluk Çağı Çürüklerinin Önlenmesi
Prevention of Early Childhood Caries with Education and Oral Health Promotion of Mothers at Preventive Oral Health Programs
Abidin T. MUTLUAYa, Merve MUTLUAYb
aRestoratif Diş Tedavisi AD,
bÇocuk Diş Hekimliği AD, Kırıkkale Üniversitesi Diş Hekimliği Fakültesi, Kırıkkale, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2019;25(2):175-81
doi: 10.5336/dentalsci.2017-57401
Article Language: TR
Full Text
ÖZET
 Diş çürüğü; biyolojik, davranışsal ve sosyoekonomik faktörlerle ilişkili toplumsal bir hastalık olarak tanımlanmaktadır. Çocukluk döneminin en yaygın enfeksiyöz hastalığı olan diş çürüğünün bakteriyel kaynaklı bir hastalık olması gerçeği hastalığa bakış açısını değiştirmiştir. Güncel çalışmalar bakteriyel enfeksiyonun bireyden bireye taşınmasının engellenmesi, bireyin diyet alışkanlığının değiştirilmesi ve ağız hijyeninin iyileştirilmesi ile diş çürüğünün önlenebileceğini vurgulamaktadır. Doğumdan önce, annenin kötü ağız sağlığına sahip olması medikal risklere yol açmasının yanında, erken dönemde bebeklerde diş çürüğü gelişim riskini de artırmaktadır. Annelerin yenidoğan ve bebeklere çürük enfeksiyonunun geçişi için ilk kaynak olduğu ve bakteriyel geçişin 1,5-3 yaş arasında olduğu düşünülmektedir. "Enfektivite penceresi" olarak adlandırılan bu dönemde aynı zamanda yenidoğanların annelerinden ya da bakıcılarından enfekte olma riski de artmaktadır. Çürükten sorumlu başlıca bakteri grubu olan Streptococcus mutans (S. mutans)'ların annelerden edinildiği öne sürülmekte ve annede yüksek seviyede karyojenik flora bulunması, S. mutans'ların anneden bebeğe geçiş riskini artırmaktadır. Diş yüzeyine kolonize olabilme yeteneğinin bir sonucu olarak, S. mutans'lar şeker varlığında ağız pH'sında belirgin bir düşüşe neden olmakta ve diş sert dokularının demineralize olmasına yol açmaktadır. Annelere uygulanacak koruyucu müdahalelerle bebeklere S. mutans'ın geçişi engellenebilmekte, bu sayede toplumda orta ve uzun vadede diş çürüğü prevalansı azaltılabilmektedir. Bu çalışmada; diş çürüğünün etiyolojisinden yola çıkılarak anneden bebeğe bakteri geçişinin, uygulanabilecek önlemlerin sunulması ve bu amaçla yürütülen koruyucu programların öneminin tartışılması amaçlanmıştır.

Anahtar Kelimeler: Koruyucu diş hekimliği; diş çürükleri; Streptococcus mutans
ABSTRACT
 Dental caries has been described as a social disease that's progress is associated with biological, behavioural, and socioeconomic factors. The fact that dental caries, the most common childhood infectious disease, is bacterial originated has changed the standpoint to it. Current studies emphasize that progress of tooth decay can be avoided by preventing bacteria transmission person to person, changing individual's dietary habits and improving oral hygiene. Mother' bad oral health prior to birth lead to medical risks, as well as the risk of developing tooth decay in infants during the childhood period. Mothers are considered to be the primary source of transmission of caries infection to new-borns and infants can be infected between 1.5 and 3 years of age. This period is also defined as "infectivity window", and new-borns are at greater risk of becoming infected from their mothers and caregivers. It is claimed that Streptococcus mutans (S. mutans) which primer bacteria group cause the dental caries were acquired from mother and high level cariogenic flora in the mother improves transmission S. mutans from mother to infant. As a result of its ability to colonize at the tooth surface, S. mutans can cause a marked reduction in oral pH in the presence of a sugar substrate and thus induce demineralization of dental hard tissues. Preventive interventions to mothers could inhibit the transmission of S. mutans to infants so that reduce middle and long-term caries prevalence in the community. This article was aimed to present the precautions conducted for the prevention of bacteria transmission from mother to baby based on dental caries etiology and discuss significance of preventive oral health programs.

Keywords: Preventive dentistry; dental caries; Streptococcus mutans
REFERENCES:
  1. Tinanoff N, Reisine S. Update on early childhood caries since the Surgeon General's Report. Acad Pediatr. 2009;9(6): 396-403. [Crossref] [PubMed][PMC]
  2. Doğan D, Dülgergil CT, Mutluay AT, Yıldırım I, Hamidi MM, Colak H. Prevalence of caries among preschool-aged children in a central Anatolian population. J Nat Sci Biol Med. 2013;4(2):325-9. [Crossref] [PubMed] [PMC]
  3. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83(9):661-9.
  4. Günay H, Dmoch-Bockhorn K, Günay Y, Geurtsen W. Effect on caries experience of a long-term preventive program for mothers and children starting during pregnancy. Clin Oral Investig. 1998;2(3):137-42. [Crossref] [PubMed]
  5. Meyer K, Geurtsen W, Günay H. An early oral health care program starting during pregnancy: results of a prospective clinical longterm study. Clin Oral Investig. 2010;14(3): 257-64. [Crossref] [PubMed]
  6. Sanders AE, Spencer AJ, Slade GD. Evaluating the role of dental behaviour in oral health inequalities. Community Dent Oral Epidemiol. 2006;34(1):71-9. [Crossref] [PubMed]
  7. Hamasha AA, Warren JJ, Levy SM, Broffitt B, Kanellis MJ. Oral health behaviors of children in low and high socioeconomic status families. Pediatr Dent. 2006;28(4):310-5.
  8. Douglass JM, Li Y, Tinanoff N. Association of mutans streptococci between caregivers and their children. Pediatr Dent. 2008;30(5):37587.
  9. Marsh PD. Role of oral microflora in health. Microb Ecol Health Dis. 2000;12(3):130-7. [Crossref]
  10. Siqueira JF. Pulpal infections, including caries. In: Hargreaves KM, Goodis HE, Tay FR, eds. Seltzer and Bender?s Dental Pulp. 2nd ed. Chicago: Quintessence; 2012. p.205-40.
  11. Gábris K, Nagy G, Madléna M, Dénes Z, Márton S, Keszthelyi G, et al. Associations between microbiological and salivary caries activity tests and caries experience in Hungarian adolescents. Caries Res. 1999;33(3): 191-5. [Crossref] [PubMed]
  12. Al Shukairy H, Alamoudi N, Farsi N, Al Mushayt A, Masoud I. A comparative study of Streptococcus mutans and lactobacilli in mothers and children with severe early childhood caries (SECC) versus a caries free group of children and their corresponding mothers. J Clin Pediatr Dent. 2006;31(2):80-5. [Crossref] [PubMed]
  13. Filoche SK, Anderson SA, Sissons CH. Biofilm growth of Lactobacillus species is promoted by Actinomyces species and Streptococcus mutans. Oral Microbiol Immunol. 2004;19(5): 322-6. [Crossref] [PubMed]
  14. Kumar S, Konde S, Raj S, Agarwal M. Effect of oral health education and fluoridated dentifrices on the oral health status of visually impaired children. Contemp Clin Dent. 2012;3(4):398-401. [Crossref] [PubMed] [PMC]
  15. Ferreira-Nóbilo Nde P, Tabchoury CP, Sousa Mda L, Cury JA. Knowledge of dental caries and salivary factors related to the disease: influence of the teaching-learning process. Braz Oral Res. 2015;29. [Crossref] [PubMed]
  16. Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc. 2009;140(6):650-7. [Crossref][PubMed]
  17. Kawashita Y, Kitamura M, Saito T. Early childhood caries. Int J Dent. 2011;2011:725320.[Crossref] [PubMed] [PMC]
  18. Caufield PW, Griffen AL. Dental caries. An infectious and transmissible disease. Pediatr Clin North Am. 2000;47(5):1001-19, v. [Crossref]
  19. Schwartz SS, Rosivack RG, Michelotti P. A child's sleeping habit as a cause of nursing caries. ASDC J Dent Child. 1993;60(1):22-5.
  20. al-Dashti AA, Williams SA, Curzon ME. Breast feeding, bottle feeding and dental caries in Kuwait, a country with low-fluoride levels in the water supply. Community Dent Health. 1995;12(1):42-7.
  21. Krol DM. Dental caries, oral health, and pediatricians. Curr Probl Pediatr Adolesc Health Care. 2003;33(8):253-70. [Crossref]
  22. Qin M, Li J, Zhang S, Ma W. Risk factors for severe early childhood caries in children younger than 4 years old in Beijing, China. Pediatr Dent. 2008;30(2):122-8.
  23. Madianos PN, Lieff S, Murtha AP, Boggess KA, Auten RL Jr, Beck JD, et al. Maternal periodontitis and prematurity. Part II: maternal infection and fetal exposure. Ann Periodontol. 2001;6(1):175-82. [Crossref] [PubMed]
  24. Brambilla E, Felloni A, Gagliani M, Malerba A, García-Godoy F, Strohmenger L. Caries prevention during pregnancy: results of a 30month study. J Am Dent Assoc. 1998;129(7): 871-7. [Crossref][PubMed]
  25. Dasanayake AP, Wiener HW, Li Y, Vermund SH, Caufield PW. Lack of effect of chlorhexidine varnish on Streptococcus mutans transmission and caries in mothers and children. Caries Res. 2002;36(4):288-93. [Crossref] [PubMed]
  26. Caufield PW, Cutter GR, Dasanayake AP. Initial acquisition of mutans streptococci by infants: evidence for a discrete window of infectivity. J Dent Res. 1993;72(1):37-45.[Crossref] [PubMed]
  27. Kawabata K, Kawamura M, Sasahara H, Morishita M, Bachchu MA, Iwamoto Y. Development of an oral health indicator in infants. Community Dent Health. 1997;14(2):79-83.
  28. Messer LB. Assessing caries risk in children. Aust Dent J. 2000;45(1):10-6. [Crossref] [PubMed]
  29. Reisine S, Douglass JM. Psychosocial and behavioral issues in early childhood caries. Community Dent Oral Epidemiol. 1998;26(1 Suppl):32-44. [Crossref] [PubMed]
  30. Lindquist B, Emilson CG. Colonization of Streptococcus mutans and Streptococcus sobrinus genotypes and caries development in children to mothers harboring both species. Caries Res. 2004;38(2):95-103. [Crossref] [PubMed]
  31. Berkowitz RJ, Jones P. Mouth-to-mouth transmission of the bacterium Streptococcus mutans between mother and child. Arch Oral Biol. 1985;30(4):377-9. [Crossref]
  32. Köhler B, Andréen I. Mutans streptococci and caries prevalence in children after early maternal caries prevention: a follow-up at eleven and fifteen years of age. Caries Res. 2010;44(5):453-8. [Crossref] [PubMed]
  33. Gomez SS, Weber AA, Emilson CG. A prospective study of a caries prevention program in pregnant women and their children five and six years of age. ASDC J Dent Child. 2001;68(3):191-5, 52.
  34. Güler E, Köprülü H. Preventive measures to reduce the transfer of Streptococcus mutans from pregnant women to their babies. J Dent Sci. 2011;6(1):14-8. [Crossref]
  35. Türksel Dülgergil C, Satici O, Yildirim I, Yavuz I. Prevention of caries in children by preventive and operative dental care for mothers in rural Anatolia, Turkey. Acta Odontol Scand. 2004;62(5):251-7. [Crossref] [PubMed]
  36. Köhler B, Andréen I. Mutans streptococci and caries prevalence in children after early maternal caries prevention: a follow-up at 19 years of age. Caries Res. 2012;46(5):474-80.[Crossref] [PubMed]
  37. Dasanayake AP, Caufield PW, Cutter GR, Stiles HM. Transmission of mutans streptococci to infants following short term application of an iodine-NaF solution to mothers' dentition. Community Dent Oral Epidemiol. 1993;21(3):136-42. [Crossref] [PubMed]
  38. Gripp VC, Schlagenhauf U. Prevention of early mutans streptococci transmission in infants by professional tooth cleaning and chlorhexidine varnish treatment of the mother. Caries Res. 2002;36(5):366-72. [Crossref] [PubMed]
  39. Köhler B, Andréen I. Influence of caries-preventive measures in mothers on cariogenic bacteria and caries experience in their children. Arch Oral Biol. 1994;39(10):907-11.[Crossref]
  40. Ercan E, Dülgergil CT, Yildirim I, Dalli M. Prevention of maternal bacterial transmission on children's dental-caries-development: 4-year results of a pilot study in a rural-child population. Arch Oral Biol. 2007;52(8):748-52.[Crossref] [PubMed]
  41. Ramos-Gomez FJ, Gansky SA, Featherstone JD, Jue B, Gonzalez-Beristain R, Santo W, et al. Mother and youth access (MAYA) maternal chlorhexidine, counselling and paediatric fluoride varnish randomized clinical trial to prevent early childhood caries. Int J Paediatr Dent. 2012;22(3):169-79. [Crossref] [PubMed] [PMC]
  42. Söderling E, Isokangas P, Pienihäkkinen K, Tenovuo J. Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. J Dent Res. 2000;79(3): 882-7. [Crossref] [PubMed]
  43. Isokangas P, Söderling E, Pienihäkkinen K, Alanen P. Occurrence of dental decay in children after maternal consumption of xylitol chewing gum, a follow-up from 0 to 5 years of age. J Dent Res. 2000;79(11):1885-9. [Crossref] [PubMed]
  44. Söderling E, Isokangas P, Pienihäkkinen K, Tenovuo J, Alanen P. Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci: 6-year follow-up. Caries Res. 2001;35(3):173-7. [Crossref] [PubMed]
  45. Söderling EM. Xylitol, mutans streptococci, and dental plaque. Adv Dent Res. 2009;21(1): 74-8. [Crossref] [PubMed]
  46. Straetemans MM, van Loveren C, de Soet JJ, de Graaff J, ten Cate JM. Colonization with mutans streptococci and lactobacilli and the caries experience of children after the age of five. J Dent Res. 1998;77(10):1851-5.[Crossref] [PubMed]
  47. Varsio S, Vehkalahti M. Evaluation of preventive treatment by risk of caries among 13-yearolds. Community Dent Oral Epidemiol. 1996;24(4):277-81. [Crossref] [PubMed]
  48. Finlayson TL, Siefert K, Ismail AI, Sohn W. Psychosocial factors and early childhood caries among low-income African-American children in Detroit. Community Dent Oral Epidemiol. 2007;35(6):439-48. [Crossref] [PubMed]
  49. Harris NO. Introduction to primary preventive dentistry. In: Harris NO, Garcia-Godoy F, eds. Primary Preventive Dentistry. 6 th ed. New Jersey: Pearson Education; 2004. p.1-23.

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-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

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