Can you give your baby cavities by kissing?

In our playgroup there has been much discussion about kissing babies and possible cavity transmission. Is it possible to give your baby cavities if you kiss them on the mouth?

Question:

Numerous studies indicate that Streptococcus mutans, the main bacteria implicated in causing dental decay, or caries, is transmissible. While this bacteria can be transmitted between various family members, there appears to be a strong link between mother and child. The mode of transmission appears to be through either direct or indirect contact. Direct contact occurs most commonly via kissing. Streptococcus mutans can be transmitted by saliva. Indirect contact occurs through shared contaminated objects such as eating utensils, toothbrushes, cups, and even toys.

Transmission occurs after teeth have begun erupting as Streptococcus mutans has difficulty colonizing other oral surfaces. The main time frame for susceptibility by the child appears to be between about 19 to 31 months with a median age of 26 months. Parents should be aware that transmission is not necessarily limited to this window of time. Mothers tend to carry several strains of Streptococcus mutans. These additional strains can be transmitted as the children mature. This transmission of bacteria is not necessarily limited to mother and child. Any caretakers (e.g. fathers, grandparents, babysitters, day-care providers) or playmates can also infect a child with this potentially destructive bacteria. The degree of transmission will vary based on the degree of infection of parent, caregiver or playmate, the frequency of contact with each of these people, and the diet and immune status of the child.

There are many studies which show that dental caries is an infectious and transmissible disease. For example, one study shows that mutacins (substances produced by Streptococcus mutans) can vary among strains of bacteria. This study was done to determine if the degree of mutacin activity was related to transmission between mother and child. At least 9 of the 20 mother-child pairs showed probable transmission based on the presence of identical strains of mutacins. This study also showed that the stability of the mutacin factor may be important in early colonization by Streptococcus mutans (Gronroos et al., "Mutacin production by Streptococcus mutans may promote transmission of bacteria from mother to child " Infection and Immunity 66 (6), 1998, pp. 2595-2600).

Another study chose first-time mothers who had high counts of S. mutans in their saliva. Half of these mothers underwent specific programs to significantly reduce the amount of S. mutans in their saliva. Out of the 28 mothers which were successfully treated, only three of their children (at three years old) were infected with S. mutans. As both groups of children got older, the number of infected children increased, but the number of infected children from the successfully treated mothers was significantly less than those of the untreated mothers (Kohler et al., "Preventive measures in mothers influence the establishment of the bacterium Streptococcus mutans in their infants," Archives of Oral Biology 28 (3), 1983, pp. 225-232).

Preventing the transmission of Streptococcus mutans will result in less cavities. Transmission can be decreased by avoiding direct contact with the baby's mouth through kissing and by avoiding indirect contact through sharing of utensils, cups, toothbrushes, and toys. Mothers who have a high content of S. mutans in their saliva may also find it helpful to follow a program designed by their dentists to decrease the count in the saliva. This program may include dietary counselling, professional cleanings, oral hygiene instruction, topical fluoride application, and removal of any caries. If necessary, chlorhexidine gel can be prescribed and placed in the mouth daily for about two weeks.

We love our babies and it is natural to show them this love and affection. However, kissing babies on the mouth is harmful to their dental health.

Other sources:

Newbrun, Ernest, "Preventing dental caries: breaking the chain of transmission" The Journal of the American Dental Association, June 1993, pp. 79-86.

Slavkin HC, "First encounters: transmission of infectious oral diseases from mother to child" The Journal of the American Dental Association 128 (6), 1997, pp. 773-778.

Rogers A H, "The source of infection in the intrafamilial transfer of Streptococcus mutans" Caries Research 15 (1), 1981, pp. 26-31.

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