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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Factors in Development

The primary bacteria involved in the pathogenesis of caries is Streptococcus mutans, but many other bacteria have also been implicated, including S sobrinus, Actinomyces sp, and Lactobacillus sp.

High levels of cariogenic bacteria are indicative of active caries process and are associated with increased risk of new caries development

Plaque is composed of salivary proteins that adhere to teeth, as well as bacteria and their byproducts.

Plaque harbors the bacteria that initiate the demineralization process.

Adequate plaque control can reduce the likelihood of developing dental caries.

S Mutans
S mutans is concentrated in the pits and fissures of teeth, so the grooved surfaces of the molars are the most common site for caries.

The virulence patterns of Strep mutans vary with the strain, and families usually have the same strains. The type of S mutans cannot be modified, but the number of bacteria present can be altered.

The following methods can be used to decrease the number of bacteria and minimize caries:

Brushing with fluoride toothpaste
Professional dental cleanings
Exposure to topical fluoride (See Chapter 6: Fluoride)
Chlorhexidine mouthrinses and
Xylitol: A crystalline alcohol C5H12O5 that is a derivative of xylose, used as a sweetener.
Xylitol use.

S mutans is transmitted from the primary caregiver to infant by saliva.

Transmission rates increase when parents:


Sharing utensils or toothbrushes.


Tasting the infant’s food or drink before serving it.

“Cleaning” a dropped pacifier with saliva.

Allowing a child to place their fingers into an adult's mouth.

Fast Facts
Streptococcus mutans is the primary bacteria involved in caries development and is transmitted from the mouth of a caregiver to the infant.
The virulence of Strep mutans varies with the strain; although you cannot modify the type, you can alter the number of bacteria present.
Brushing, flossing, professional cleanings, Xylitol, fluoride, and special mouthrinses can decrease the number of bacteria in a child's mouth.
S mutans is transmitted through saliva, such as when a caregiver tastes a child's drink before serving or shares utensils.
Chapter Photo Gallery
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