RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / Name of the Candidate
And Address (in block letters) /

Dr. JOGANI VIVEK CHAMPALAL

POSTGRADUATE STUDENT
DEPARTMENT OF PEDODONTICS AND PREVENTIVE DENTISTRY,
COLLEGE OF DENTAL SCIENCES,
DAVANGERE – 577 004,
KARNATAKA, INDIA.
2. /
Name of the Institution
/ COLLEGE OF DENTAL SCIENCES, DAVANGERE – 577 004,
KARNATAKA, INDIA.
3. / Course of THE Study
AND SUBJECT / MASTER OF DENTAL SURGERY IN PEDODONTICS AND PREVENTIVE DENTISTRY.
4. / Date of admission to THE COURSE / 31/05/2008
5. /

Title of the dissertation:

/ RELATIONSHIP OF STREPTOCOCCUS MUTANS COUNTS IN SALIVA OF MOTHER-CHILD PAIRS AND ASSOCIATION OF MATERNAL-CHILD CHARACTERISTICS AS A FACTOR IN EARLY CHILDHOOD CARIES.
6. / BRIEF RESUME OF INTENDED WORK

6.1 Need for the study:

Early childhood caries is a chronic, transmissible, infectious disease whose etiology is complex and multifactorial.1 Mutans streptococci play a major role in the development of caries in infants and children.2
The presence of teeth or other non-desquamating surfaces is a pre-requisite for stable colonization of mutans streptococci. Infants acquire mutans streptococci after their teeth emerge3, i.e. during a discreet period of around two years of age called the window of infectivity [Caufield et al., 1993] and that the source of this initial infection is principally the infants’ mother [Li Caufield 1995].4 Berkotwitz et al. found that the acquisition of mutans streptococci occurs between 19 and 31 months of age, although other studies reported that younger children may also be colonized.2
Some European studies report significant reductions in the incidence of mutans streptococci infection and caries in children, when their mothers, before the child was born, received preventive and restorative interventions aimed at reducing mutans streptococci.5 The question as to how and from whom infants acquire mutans streptococci has not been definitively answered because most studies showing homologies among strains are cross-sectional and thus compare isolates after their initial acquisition.3
This study will be undertaken to investigate the salivary counts of streptococcus mutans and establish a relationship in mother-child pairs. The prevalence of early childhood caries (ECC) in 15-35 months children and the association with the mothers’ characteristics will also be assessed.
6.2 Review of literature:
A study was conducted to investigate the caries-related microorganisms in saliva and the prevalence of early childhood caries in 15- to 35-month-old Turkish children and their association with the maternal characteristics.6
A study was conducted to investigate the transmission of Streptococcus mutans in a group of Turkish families using AP-Polymerase chain reactions (PCR) detection. They concluded that the mothers or fathers could be the source for the transmission of Streptococcus mutans to their children.2
A study was conducted to investigate those factors that could be correlated with mutans streptococcus transmission among Chinese children whose nurturing histories were known. The data suggested that breast-feeding, especially prolonged breast-feeding, may correlate with the fidelity of transmission and that prolonged breast-feeding may contribute to a higher caries rate.4
A thirty month study was conducted to know whether caries prevention can be done during the pregnancy period of mother itself and found that it is possible to reduce caries risk over the long term by initiating a regimen of simple, inexpensive and well adopted preventive measure.7
A study was conducted to determine whether early childhood caries is a risk factor for future dental caries and found that a significant relationship exist between primary incisor caries as an indication of nursing caries and future caries in the same individual. The study also investigated the relationship between recall examinations and caries experience and high correlation was found between the number of regular check-up appointments and a lower incidence of subsequent caries.8
A study was carried out to investigate the prevalence of mutans streptococci and lactobacilli in breast-fed children with and without rampant caries. The study indicated that breast-feeding allows the colonization and proliferation of mutans streptococci and lactobacilli on teeth of young children and that rampant caries can occur in breast-fed children in the absence of nursing bottle or any other form of feeding abuse during weaning.9
6.3 Aims and Objectives of the Study:
1) To investigate streptococcus mutans count in saliva of mother and child and establish a relationship in mother-child pairs,
2) Prevalence of early childhood caries in 15 to 35 month old children and
3) The association of early childhood caries with the mother characteristics, socioeconomic criteria, and feeding habits of the children.
7. / MATERIALS AND METHODS:
7.1 Source of Data :
Patients reporting to the Department of Pedodontics and Preventive Dentistry at College of Dental Sciences, Davangere and Department of Pediatrics at Bapuji Child Health Institute, Davangere will be considered for the study.
7.2 Method of Collecting Data
Fifty patients aged 15-35 months accompanied by their mothers i.e. fifty mother-child pairs will be selected.
Inclusion criteria:
·  Children accompanied by their mothers.
·  Parent consent.
·  Loss of mineral substance with cavitations will be recorded as caries.
Exclusion criteria:
·  White spot decalcifications without cavitations will not be considered to be caries.
·  Children on antibiotic therapy will not be considered for the study.
Materials used in the study:
·  Questionnaire recording forms
·  Disposable gloves and mouth mask
·  Sterile gauze pads, cotton
·  Mouth mirror
·  Probe
·  Saline
·  Mitis Salivarius Bacitracin(MSB) agar
·  Test tubes
·  Petriplates
·  Pipettes
Equipments:
·  Incubator
·  Colony counter
Method:
Fifty mother-child pairs will be considered with the child age between 15-35 months.
Questionnaire: The mothers will be interviewed based on a questionnaire, regarding the characteristics of the mothers, socioeconomic criteria, and feeding habits of the children.
Dental examination: The children and their mothers will be examined by the same examiner. The mothers’ caries status will be recorded according to the World Health Organization criteria. The child caries status will be recorded as dfs scores based on the presence of one or more primary teeth affected. Plaque scores of mother-child pairs will be evaluated using the Silness and Loe criteria.
Bacterial examination: Whole non-stimulated saliva samples will be obtained from each mother and child for isolation of streptococcus mutans. The saliva samples will be transported to the laboratory in buffered saline and processed within 2 hours. The samples will be sonicated for 20-30 seconds for homogenization and diluted with buffered saline. Samples will then be plated on Mitis Salivarius Bacitracin (MSB) agar. The agar plates will be incubated anaerobically at 37oC for 48 hours. The numbers of S mutans will be identified by colony morphology and recorded using colony counter.
Statistical analysis: Mann-Whitney test and Spearman rank correlation tests will be used for comparison and correlation between groups. Chi-square or Fisher exact test will be used to analyze the categorical variables.
7.3: Does the study require any investigation or interventions to be conducted on patients or other humans or animal? if so, please describe briefly.
Yes
Non- stimulated saliva samples will be obtained from fifty mother-child pairs to investigate the salivary streptococcus mutans count after obtaining the written consent from parents.
7.4 : Has ethical clearance been obtained from your institution in case of 7.3
Yes
8. / List of References :
1.  Francisco J. Ramos-Gomez, Jane A. Weintraub, Stuart A. Gansky, Charles I. Hoover, John D. B. Featherstone: Bacterial, behavioral and environmental factors associated with early childhood caries. The Journal of Clinical pediatric dentistry 2002; 26(2): 165-173.
2.  Ersin NK, Kocabas EH, Alpoz AR, Uzel A: Transmission of Streptococcus mutans in a group of Turkish families. Oral Microbiology immunology 2004; 19: 408-410.
3.  Y. Li and P.W. Caufield: The fidelity of initial acquisition of mutans streptococci by infants from their mothers. J Dent Res 1995 Feb; 74(2): 681-685.
4.  Y. Li, W. Wang and P.W. Caufield: The fidelity of mutans streptococci transmission and caries status correlate with breast-feeding experience among Chinese families. Caries Res 2000; 34: 123-132.
5.  Smith RE, Badner VM, Morse DE, Freeman K: Maternal risk indicators for childhood caries in an inner city population. Community Dent Oral Eepidemiol 2002: 30:176-181.
6.  Nazan Kocatas Ersin, Nesrin Eronat, Dilsah Cogulu, Atac Uzel, Sadik Aksit: Association of maternal-child characteristics as a factor in early childhood caries and salivary bacterial counts. Journal of Dentistry for children 2006; 73(2): 105-111.
7.  Bramilla E: Caries prevention during pregnancy: results of a thirty month study. JADA 1998; 129: 871-877.
8.  Snalan TAA et al.: Primary incisor decay before age four as a risk factor for future dental caries. Pediatric Dent 1997; 19(1).
9.  M.I.N Matee, F.H.M Mikx, S.Y.M Maselle, W.H Van Palenstein Helderman: Mutans streptococci and lactobacilli in breast-fed children with rampant caries. Caries Res 1992; 26: 183-187.
9 / SIGNATURE OF CANDIDATE / Dr. JOGANI VIVEK C
10 / REMARKS OF THE GUIDE
11 / NAME AND DESIGNATION OF
(IN BLOCK LETTERS)
11.1 GUIDE
11.2 SIGNATURE / Dr. POORNIMA P., M.D.S.
ASSOCIATE -PROFESSOR,
DEPARTMENT OF PEDODONTICS & PREVENTIVE DENTISTRY,
COLLEGE OF DENTAL SCIENCES,
DAVANGERE – 577 004,
KARNATAKA.
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF DEPARTMENT
11.6 SIGNATURE / Dr. V.V. SUBBA REDDY, M.D.S.
PROFESSOR, PRINCIPAL & HOD,
DEPARTMENT OF PEDODONTICS & PREVENTIVE DENTISTRY,
COLLEGE OF DENTAL SCIENCES,
DAVANGERE – 577 004,
KARNATAKA.
12 / 12.1 REMARKS OF THE CHAIRMAN AND PRINCIPAL.
12.2 SIGNATURE