An important caries prevention strategy for children includes measures to interfere with transmission of mutans streptococci (MS). This study confirmed the effectiveness of maternal early exposure to xylitol chewing gum on mother-child transmission of MS. After screening, 107 pregnant women with high salivary MS were randomized into two groups: xylitol gum (Xylitol; n = 56) and no gum (Control; n = 51) groups. Maternal chewing started at the sixth month of pregnancy and terminated 13 months later in the Xylitol group. Outcome measures were the presence of MS in saliva or plaque of the children until age 24 months. The Xylitol-group children were significantly less likely to show MS colonization than Control-group children aged 9–24 months. The Control-group children acquired MS 8.8 months earlier than those in the Xylitol group, suggesting that maternal xylitol gum chewing in Japan shows beneficial effects similar to those demonstrated in Nordic countries.

This study aimed to assess the relationship of dietary patterns, such as frequency, timing, and cariogenicity of food/beverage consumption, with plaque acidogenicity and early childhood caries (ECC) in Japan. A total of 118 children aged 1–4 years who had visited the pediatric dental clinic were enrolled. We retrospectively reviewed their records to collect data including age, sex, medical history, medication, caries status, and plaque acidogenicity level at the first dental visit. The plaque acidogenicity level was measured using Cariostat^®. Dietary data were collected from 3-day dietary records, and the dietary cariogenicity score was calculated from these data. Children with ECC or high plaque acidogenicity consumed between-meal sugars more frequently than did their counterparts (p = 0.002 and p = 0.006, respectively). Children with ECC or high plaque acidogenicity drank juices between meals more frequently than at mealtimes (p = 0.02). Frequent consumption of between-meal sugars was associated with higher plaque acidogenicity and ECC, and frequent breast/bottle feeding was associated with ECC. No differences were found in the dietary cariogenicity scores between these groups. Therefore, the frequency and timing of sugar consumption, might affect plaque acidogenicity and ECC, and reducing the frequency of sugar intake could prevent ECC.

The first stage of early childhood caries (ECC) is infection by mutans streptococci, of which the primary infection source is the child's mother. Early intervention programs including antenatal and postnatal phases are effective for reducing ECC. This study was conducted to assess the respective effects of antenatal health care and postnatal care such as regular dental check-ups on reducing ECC among 3-year-old Japanese children. This nested case-control study of 155 three-year-old children (49.0% boys) was conducted at a dental clinic that provides collaborative health services with the Obstetrics and Gynecology Clinic, Okayama. Child characteristics and the mothers' antenatal data were collected retrospectively from the dental charts. They were divided into two groups: caries-free children (n = 77) and children without ECC (n = 78). Most of the children (81.9%) received regular check-ups with topical fluoride application. Most of the mothers reported morning sickness during pregnancy (81.3%), normal delivery (72.9%), and used antenatal health care (80.6%). Over half (55.5%) were primigravida. Adjusted odds ratio (AOR) and 95% confidential interval (95% CI) were computed to assess the strength of association using logistic regression analysis. Receiving antenatal health care (AOR, 3.27; 95% CI, 1.30-8.24) and child's having regular check-ups (AOR, 3.42; 95% CI, 1.35-8.69) were significantly associated with caries-free status among three-year old children. For ECC prevention, antenatal health care is as effective as regular check-ups up to three years of age. The results of this retrospective study demonstrate that maternal health education during pregnancy is effective for ECC prevention.

To assess mutans streptococci (MS) during xylitol gum chewing (mean 3.8 g/day, 2.9 times/day) for 13 months and then for 15 months after the intervention, Japanese mothers with high salivary MS were randomized into two groups: xylitol gum (n = 56) and no gum (n = 51). The proportion of low MS levels was highest at 3 months of consumption (48.8%), but was significantly lower compared to baseline at the end of the intervention (p < 0.001). MS levels did not change during the postintervention period. The data suggest that in the xylitol group 23.3% showed persistent carryover effects by xylitol gum chewing in the postintervention period.