title: Genotypic characterization of initial acquisition of Streptococcus mutans in American Indian children.
abstract: BACKGROUND
  Severe-early childhood caries (S-ECC) is one of the most common infectious diseases in children and is prevalent in lower socio-economic populations. American Indian children suffer from the highest levels of S-ECC in the United States. Members of the mutans streptococci, Streptococcus mutans, in particular, are key etiologic agents in the development of caries. Children typically acquire S. mutans from their mothers and early acquisition is often associated with higher levels of tooth decay.
  
  
  METHODS
  We have conducted a 5-year birth cohort study with a Northern Plains Tribe to determine the temporality and fidelity of S. mutans transmission from mother to child in addition to the genotypic diversity of S. mutans in this community. Plaque samples were collected from 239 mother/child dyads at regular intervals from birth to 36 months and S. mutans were isolated and genotyped by arbitrarily primed-polymerase chain reaction (AP-PCR).
  
  
  RESULTS
  Here we present preliminary findings from a subset of the cohort. The focus for this paper is on initial acquisition events in the children. We identified 17 unique genotypes in 711 S. mutans isolates in our subset of 40 children, 40 mothers and 14 primary caregivers. Twelve of these genotypes were identified in more than one individual. S. mutans colonization occurred by 16 months in 57.5% of the children and early colonization was associated with higher decayed, missing and filled surface (DMFS) scores (p=0.0007). Children colonized by S. mutans shared a common genotype with their mothers 47.8% of the time. While multiple genotypes were common in adults, only 10% of children harbored multiple genotypes.
  
  
  CONCLUSIONS
  These children acquire S. mutans at an earlier age than the originally described 'window of infectivity' and often, but not exclusively, from their mothers. Early acquisition is associated with both the caries status of the children and the mothers.
authors.affiliation: Dows Institute for Dental Research, University of Iowa, College of Dentistry, Iowa City, IA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lynch
authors.affiliation: Dows Institute for Dental Research, University of Iowa, College of Dentistry, Iowa City, IA, USA.
authors.forename: Alissa L
authors.initials: AL
authors.lastname: Villhauer
authors.affiliation: Preventive and Community Dentistry, University of Iowa, College of Dentistry, Iowa City, IA, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Warren
authors.affiliation: Preventive and Community Dentistry, University of Iowa, College of Dentistry, Iowa City, IA, USA.
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Marshall
authors.affiliation: Dows Institute for Dental Research, University of Iowa, College of Dentistry, Iowa City, IA, USA.
authors.forename: Deborah V
authors.initials: DV
authors.lastname: Dawson
authors.affiliation: Dows Institute for Dental Research, University of Iowa, College of Dentistry, Iowa City, IA, USA.
authors.forename: Derek R
authors.initials: DR
authors.lastname: Blanchette
authors.affiliation: Oral Health Research Consultant, Morro Bay, CA, USA.
authors.forename: Kathy R
authors.initials: KR
authors.lastname: Phipps
authors.affiliation: Area Regional Dental Prevention/Research Director, Pine Ridge, SD, USA.
authors.forename: Delores E
authors.initials: DE
authors.lastname: Starr
authors.affiliation: Dows Institute for Dental Research, University of Iowa, College of Dentistry, Iowa City, IA, USA; david-drake@uiowa.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Drake
keywords: American Indian; Streptococcus mutans; caries; children; etiologic agents; genotypes; genotypic diversity; oral microbiology; severe early childhood caries
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