title: Long-term effects of maternal prevention on children's dental decay and need for restorative treatment.
abstract: OBJECTIVE
  In a Finnish study carried out in 1990s, high-caries-risk mothers used xylitol gum on daily basis when their child was 3-24-month old, whereas the high-risk control mothers received biannual fluoride or chlorhexidine treatments. The maternal prevention reduced colonization of mutans streptococci and early childhood caries in children. The present retrospective study aimed to extend the post-trial follow-up to 10-year-old children (n = 148). Additionally, the dental health of these high-caries-risk children was compared with a reference group comprising the rest of the children in the same age cohort (n = 359).
  
  
  METHODS
  The annual data on dental health and treatments were gathered from public dental care registers.
  
  
  RESULTS
  The median caries-free age (dmft = 0 and DMFT = 0) was 8.2 in the xylitol, 5.8 in the control, and 8.1 in the reference group (xylitol versus control, P = 0.005, HR = 1.75; 95% CI 1.18-2.60, reference versus xylitol, P = 0.410, HR = 1.13; 95% CI 0.84-1.51 Cox regression). Thus, the children in the xylitol group had caries-free teeth longer than the control group. Compared to the reference group, the xylitol group did not show notable difference. Up to 4 years of age, figures for cumulative restorative treatment visits were 0.2 in the xylitol, 0.7 in the control, and 0.4 in the reference group (xylitol versus control P = 0.006, Student's t-test).
  
  
  CONCLUSIONS
  The reduced mother-child transmission of mutans streptococci seems to have long-term effects on children's dental health. The maternal use of xylitol reduces caries occurrence and need for restorative treatment in assumed high-caries-risk children to the average level of the whole age cohort.
authors.affiliation: Department of Pedodontics, Cariology and Endodontology, University of Oulu, Oulu, Finland; Department of Community Dentistry, University of Turku, Turku, Finland; Ylivieska Public Health Center, Ylivieska, Finland.
authors.forename: Marja L
authors.initials: ML
authors.lastname: Laitala
authors.forename: Pentti
authors.initials: P
authors.lastname: Alanen
authors.forename: Pauli
authors.initials: P
authors.lastname: Isokangas
authors.forename: Eva
authors.initials: E
authors.lastname: Söderling
authors.forename: Kaisu
authors.initials: K
authors.lastname: Pienihäkkinen
mesh_terms: D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009035:Mothers; D011313:Preventive Dentistry / Q000379:methods*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013295:Streptococcus mutans; D013549:Sweetening Agents / Q000627:therapeutic use; D014993:Xylitol / Q000627:therapeutic use
chemical_list: D013549:Sweetening Agents; D014993:Xylitol
keywords: dental caries; longitudinal study; mutans streptococci; primary teeth; public dental health; xylitol