Background: Oral colonization starts at birth by vertical transmission.
Objective: To determine whether mode of delivery influences the oral colonization of infants
and contributes to the risk of childhood dental caries.
Methods: A systematic review was conducted in the electronic database Web of Science
for articles published from January 1995 to December 2015 by using a set of keywords.
Results: From 2,644 citations identified through electronic search, ten studies met the
inclusion criteria. According to the studies mode of delivery influences oral microbial density,
oral microbial profile and the timing of oral colonization by cariogenic microbiota. However,
there are no consistent results concerning either the prevalence of children harboring
cariogenic microbiota or the prevalence of early childhood caries by mode of delivery.
Conclusion: Mode of delivery influences early oral colonization. However, it seems
that other determinants rather than mode of delivery could be major contributors to the
development of early childhood caries.
Keywords: Early childhood caries, early oral colonization, acquisition of oral microflora,
mode of delivery
This review investigated whether mode of delivery influences the colonization of infant’s oral cavity and the risk of early
childhood caries (ECC). The search strategy included systematic searching of electronic databases (Web of Science and
PubMed) for articles published (1995–2015) and hand
searching of references lists. Outcomes of interest were the
presence of oral caries-related microorganisms, oral species
considered protective against caries, and dental caries. Other outcomes included severity of dental caries, dental claims,
and age at first dental visit. Study quality was assessed using
the EPHPP tool. For each study, we present odds ratios and
respective 95% confidence intervals for the association between these outcomes and the mode of delivery. Fourteen
studies were identified. In 5 out of 8 studies addressing oral
colonization, children born by cesarean section were less
likely to harbor caries-related microorganisms as well as protective bacteria against caries and acquired caries-related
microorganisms earlier, when compared with vaginally delivered children. No consistent results were obtained for the
association between mode of delivery and dental caries. Although there were differences in oral colonization by mode
of delivery, it seems that other determinants rather than
mode of delivery could be major contributors to the development of ECC.
