Horizontal Transmission of Streptococcus mutans in Children and its Association with Dental Caries: A Systematic Review and Meta-Analysis

Abstract

Purpose: To systematically evaluate the horizontal transmission of Streptococcus mutans in children and analyze its relationship with dental caries. Methods: Seven databases were searched for observational studies that have determined the transmission of S. mutans among children younger than seven years. Selection of included studies, data extraction, and quality assessment using Downs and Black's (1998) scoring system were performed. The inverse variance random-effect approach was used to pool the results, and statistical heterogeneity was evaluated using I-squared statistics. Results: Fifteen studies were included for qualitative synthesis, five of which were pooled for quantitative analysis. The risk ratio (RR) of sharing only one genotype in caries-free children versus children with caries was found to be 0.60 (95 percent confidence interval [95% CI] equals 0.45 to 0.80; P ≤ 0.001). The RR of sharing more than one genotype was 1.46 (95% CI equals 1.13 to 1.89; P=0.004) in children with caries versus caries-free children. These findings imply that children sharing only one genotype have a 40 percent lesser risk, and children sharing more than one genotype have a 46 percent higher risk of having dental caries. Conclusions: The systematic review provides evidence of the horizontal transmission of S. mutans and its association with dental caries.