Delay transfer of streptococcus to babies for as long as possible!

Professor Lutz Stößer is director of the Polyclinic for Preventative Dental Medicine at the University Medical Centre, Friedrich Schiller University, Jena

This article was previously published in a Wrigley publication in Germany.

You are one of the still very small number of clinic directors for preventative dental medicine in Germany. What are the causes of caries? Is there a predisposition?

Prof. Stößer : Caries is multi-factoral in origin, involving the combined effects of meals containing large amounts of carbohydrates, poor oral hygiene and the composition of bacteria in plaque – above all Streptococcus mutans. There is no predisposition in terms of the resistance of the tooth enamel, apart from crowding that leads to problems with ensuring hygiene, for example. The inheritance of a tendency to suffer from caries can be related to the time when the mouth becomes infected with streptococcus - babies are born without streptococcus in the mouth. These bacteria are transmitted in the first two to three years by the persons closest to the child.

It is scientifically proven that children are born without Streptococcus mutans. It is only during the first two to three years that these bacteria can be transmitted to the child by the persons in closest contact with it - typically the mother. Delaying infection for as long as possible helps prevent the child suffering from caries later. Is this the first opportunity to take preventative action against the factors that cause caries?

Prof. Stößer : Indeed. The prevalence of caries in children has been seen to be higher the earlier children are infected with Streptococcus mutans. For that reason, parents should be told during pregnancy about ways of delaying the transmission of streptococcus to their child for as long as possible. So testing baby's food with the same spoon is just as much a "no-no" as licking a dropped dummy before it goes back in the baby's mouth. By regularly reducing the level of germs in the mouth - something to which chewing sugarfree chewing gum containing xylitol contributes - mothers can also significantly delay the transfer of streptococcus to their child in the first two years of its life². Generally speaking, using sugarfree chewing gum during the day in addition to brushing the teeth twice a day can reduce the risk of caries by up to 40%³.

How does caries come about?

Prof. Stößer : After eating foods containing carbohydrates – which by the way are not just foods that taste sweet, but include crisps, ketchup and cola – the pH level in the mouth falls because the streptococcus in the plaque on the teeth create acids when breaking down the carbohydrates. When the pH drops below 5.5, demineralisation of the tooth enamel starts to occur. If this demineralisation phase lasts more than a short time, or if many such acid attacks take place at short intervals throughout the day, the enamel and later the dentine is eaten away. This is the beginning of caries.

How does sugarfree chewing gum work to prevent this?

Prof. Stößer : Sugarfree chewing gum with xylitol stimulates saliva flow by 300%^4-6. This leads to rapid neutralisation of the acid and remineralisation of the enamel via the calcium and phosphate ions that naturally occur in saliva. Especially after eating or drinking during the day outside the home, when the toothbrush in the bathroom remains unused, chewing gum is a good aid to prevention. Think of long mornings at school, which children can then survive without dangerous effects on their delicate teeth, despite break-time snacks and sweets.

Are special sugarfree chewing gums available for children?

Prof. Stößer : Yes. Wrigley’s Extra for Kids with Calcium. Children's teeth need extra protection because the enamel layer is only about half as thick as on permanent teeth⁷. Various studies indicate that chewing gum containing calcium further enriches saliva that is already saturated with calcium and phosphate and can thereby have a positive impact on the remineralisation of tooth enamel^8,9. In addition, children enjoy chewing gum - it tastes good and provides an excellent opportunity to teach them about the link between caries and ensuring the best possible oral hygiene, although chewing gum is no substitute for proper oral hygiene.

References:

1. Tenovuo et al.: Caries Res 24 (1990).

2. Söderling et al.: J Dent Res 79 (2000).

3. Kandelman et al.: J Dent Res 69 (1990).

4. Leach, SA et al.: J Dent Res 68: 1064-1068 (1989).

5. Creanor, SL et al.: J Dent Res 71: 1895-1900 (1992).

6. Edgar, WM et al.: Brit Dent J 168: 173-177 (1990).

7. Mortimer, KV: Caries Res 4: 206 (1970).

8. Chow, S et al.: Dent Res 73 (1994).

9. Vogel, GL et al.: J Dent Res 77 (1998).