Abstract
Purpose: The purpose of this systematic review was to assess whether prenatal use of fluoride, chlorhexidine mouthrinses, and xylitol could alter the mutans streptococci levels in children.
Methods: A systematic search of clinical trials was implemented for the Cochrane Oral Health Group’s Trials Register, PubMed, PMC, NCBI, ClinicalKey, Google Scholar, LILACS, and Science Direct. A search for ongoing trials was also undertaken in the clinicaltrial.gov database to identify eligible studies. Data regarding methodology, participants, types of interventions, and outcomes were extracted, and the risk of bias was also assessed independently by two review authors.
Results: Only two clinical trials fulfilled the inclusion criteria. Although one study showed significant results, the overall result of this systematic review showed no statistical significance. A risk ratio and 95 percent confidence interval of 0.1 (0.01 to 1.89) were obtained.
Conclusions: Statistically significant results were reported in both the included studies; however, systematic analysis revealed a dearth of current evidence to support the general recommendation of pharmacological interventions for expectant mothers resulting in altered mutans streptococci levels in their children.
*Original abstract online at https://pubmed.ncbi.nlm.nih.gov/26531084/
Excerpt:
… The efficacy of postnatal interventions in expectant mothers for preventing dental caries and MS transmission in their children has been thoroughly studied18; however, data regarding the efficacy of prenatal interventions remain unclear. Therefore, the purpose of this paper was to provide a systematic review of the current literature assessing the efficacy of maternal administration of fluoride, chlorhexidine mouthrinses, and xylitol in altering the mutans streptococci levels in children.
… Leverett et al.18 conducted a trial to test the caries preventive efficacy of prenatal fluoride supplementation in 798 children followed until five years old but found no statistically significant difference in the study group with respect to caries in the primary dentition. Maturo et al. concluded that fluoride administration during pregnancy and postpartum had no significant impact on caries incidence. Prenatal administration of xylitol gums, fluoride (in tablet or rinse form), and chlorhexidine rinses have shown to reduce the transmission of MS [mutans
streptococci] in mothers to their offspring.13,15,16,18-20
… In another study,18 fluoride supplements in the form of tablets were given to the mothers during pregnancy, while fluoride supplementation as drops was given to the infants. This trial was not included, since the reviewers believed that it may have tended not to answer the exact review question.
… We found scarce information regarding the effects of sodium fluoride and chlorhexidine mouthrinse on outcomes such as the number of children developing caries.
Conclusions
The results of this investigate support the following conclusion:
1. Statistically significant results were reported in both the included studies.
2. However, systematic analysis revealed a dearth of current evidence to support the general recommendation of pharmacological interventions for expectant mothers resulting in altered mutans streptococci levels in their children.
References cited above
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15. Nakai Y, Shinga-Ishihara C, Kaji M, Moriya K, Murakami-Yamanaka K, Takimura M. Xylitol gum and maternal transmission of mutans streptococci. J Dent Res 2010;89:56-60.
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18. Leverett DH, Adair SM, Vaughan BW, Proskin HM, Moss ME. Randomized clinical trial of the effect of prenatal fluoride supplements in preventing dental caries. Caries Res 1997;31:174-9.
19. Thorild I, Lindau B, Twetman S. Caries in 4-year-old children after maternal chewing of gums containing combinations of xylitol, sorbitol, chlorhexidine, and fluoride. Eur Arch Paediatr Dent 2006;7:241-5.
20. Trahan L, Néron S, Bareil M. Intracellular xylitol-phosphate hydrolysis and efflux of xylitol in Streptococcus sobrinus. Oral Microbiol Immunol 1991;6:41-50.
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