title: Early childhood caries and mutans streptococci: a systematic review.
abstract: OBJECTIVE
  The aim of the present study was to undertake a systematic review to investigate whether mutans streptococci levels are a strong risk indicator/factor for ECC, based on the current quality of the literature regarding the relationship between early childhood caries (ECC) and these microorganisms.
  
  
  METHODS
  The authors searched PubMed, Scopus and Cochrane Library databases for papers from 1951 to 2007. The minimal inclusion requirements were assessment of preschool children reporting mutans streptococci counts, mainly in saliva and biofilm samples, and caries assessment. Since the heterogeneity of the studies did not allow a meta-analysis (chi(2) test), a qualitative analysis was conducted.
  
  
  RESULTS
  The electronic search yielded 120 articles, but only 16 scientific papers were critically appraised. Of the 16 scientific papers included in the review, only one cross-sectional study achieved a high value of evidence.
  
  
  CONCLUSIONS
  It was concluded that mutans streptococci levels are a strong risk indicator for ECC. However, further well designed longitudinal studies with high evidence values are required to confirm mutans streptococci levels as a significant ECC risk factor.
authors.affiliation: Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil.
authors.forename: Thaís Manzano
authors.initials: TM
authors.lastname: Parisotto
authors.forename: Carolina
authors.initials: C
authors.lastname: Steiner-Oliveira
authors.forename: Cíntia Maria
authors.initials: CM
authors.lastname: Silva
authors.forename: Lidiany Karla
authors.initials: LK
authors.lastname: Rodrigues
authors.forename: Marinês
authors.initials: M
authors.lastname: Nobre-dos-Santos
mesh_terms: D016009:Chi-Square Distribution; D002675:Child, Preschool; D003731:Dental Caries / Q000453:epidemiology / Q000382:microbiology*; D003773:Dental Plaque / Q000382:microbiology*; D006801:Humans; D007223:Infant; D012307:Risk Factors; D012463:Saliva / Q000382:microbiology*; D013295:Streptococcus mutans / Q000302:isolation & purification