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Tooth bacteria rarely exist in a baby’s mouth before the presence of a tooth. Therefore, the origin of these bacteria is necessarily someone else’s tooth. DNA studies have illustrated that a parent, usually the mother, is most often the person who passes tooth bacteria from her mouth to the baby’s mouth when his or her first tooth erupts.1 Most people imagine a genetic link or something in mother’s milk that passes on dental disease. The truth is that dental disease is transferred directly to a child’s new tooth, often during a loving cuddle or a kiss.
Most often, parents and caregivers share their mouth germs with their children (vertical transmission),2 but it is also possible for mouth germs to spread between siblings or from spouse to spouse (horizontal transmission).3 Parents should also be aware that children born by caesarean section appear to be infected by mouth germs earlier—possibly because they lack some kind of protection—than do vaginally delivered infants.4
Bacteria travel to the new baby tooth most often in a droplet of saliva. The bacteria can transfer during a kiss, from a drop of saliva on spoons or pacifiers, or from food shared with a baby. I would never suggest that parents stop kissing their baby or worry about sharing food. Think about this: If the bacteria do not come from your mouth, they will be transferred from the mouth of someone else who comes into contact with your child. Since this bacteria transfer cannot be stopped, it makes more sense to control the kind of bacteria passed to children.
Obviously, you want a baby to be infected with healthy, dentally protective bacteria rather than aggressive, cavity-forming ones.5 The fact is that once a particular kind of bacteria reaches a baby’s first tooth, this bacteria will then colonize or spread to the other baby teeth as they erupt. It has also been shown that whenever there are many harmful bacteria in a parent’s mouth, the chances that they will transfer to the child are greater.6 It has also been shown that the first kind of bacteria to infect the biting surfaces of molar teeth usually become the dominant strain in the mouth, because the grooves of these teeth become reservoirs of bacteria for the mouth. Changing the kind of bacteria in a child’s mouth after molar teeth have erupted becomes more difficult. This fact can also be used to a parent’s advantage—as you will see later on. To give children the best advantage, make sure that healthy bacteria are established in their mouths before the molar teeth erupt. This simple change can provide your child with many years of dental protection.
Research during the 1980s illustrated how bacteria were transferred between family members and from mouth to mouth. A simple and successful method of controlling this transmission was found just a few years later. For twenty years we have known how to reduce both the inheritance of bad tooth bacteria and the chance of a parent infecting their child with the bacteria that cause cavities. Parents with bad teeth can get rid of aggressive and harmful bacteria from their mouths, and even without traditional dental treatment. You may be shocked to discover that it is possible to remove harmful bacteria even if you still have cavities or cannot go to the dentist, for whatever reason. When the bad bacteria are gone from your mouth, protective ones will take their place.7
From a parent’s point of view, it is important to know that the earlier a child is infected with harmful mouth bacteria, the greater the child’s risk for having cavities later in life. As mentioned earlier, changing the kind of bacteria in your mouth becomes more difficult when molar grooves have become reservoirs of mouth bacteria.8 Baby molar teeth erupt during the second year of life. Consistent with this fact are the results of studies showing that children who are infected with harmful bacteria by age two have the most cavities at age four.9 When parents have healthy mouths during the first year of their baby’s life, their children will have less chance of infection from harmful bacteria and a better chance for oral health. Studies have also shown that at five years of age, children from parents with healthy mouths have 70 to 80 percent less chance of developing cavities, and the benefits may last into adulthood.10
Preventing the passage of harmful germs to the next generation may be the most promising method of preventing cavities in children’s teeth. If this is the first time you have heard about this kind of bacterial transfer, it will be natural for you to wonder why there has been no media attention and no national education on the topic.
For many years, dental associations in Europe and Scandinavia have been promoting such control of infant mouth bacteria as a means of improving oral health. Recently, a few state health organizations in the United States have begun to educate health professionals about oral bacteria transmission. Unfortunately, some of their recommendations seem unrealistic.
In 2007, for instance, the New York State Department of Health published a guide for oral care during pregnancy and early childhood.11 The department’s advice for preventing harmful bacterial contamination between mothers and infants and between siblings is that families should avoid saliva-sharing activities. Basically, they recommend that a mother not kiss her baby and that children not be allowed to share their toys. As a mother of five, I look at these recommendations and shake my head, wondering how anyone could even think of suggesting that a mother not kiss or share meals with her baby, or how anyone could recommend that toddlers not be allowed to play with one another’s toys.
Even if a mother avoids kissing her baby, inevitably someone else will infect the child. Most parents would prefer to take ownership of this duty and prepare to pass healthy bacteria from their own mouths to their child. In daycare centers there are risks of contamination among children and also from caretakers. A study from a daycare center in Brazil suggests that horizontal transmission occurred among children in such situations.12 Parents should understand these risks if their infant is in daycare and take some simple steps (as outlined in chapter 14) to keep their baby’s teeth healthy and safe.

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