The Potential Effect of Probiotic Lactobacilli Strains and Miswak on the Inhibition of Microbiota of Severe Early Childhood Caries

Abstract

Severe early childhood caries (S-ECC) is a form of dental caries affecting primary teeth of young children, and is a common health problem worldwide.(1) Children with S-ECC have higher risk of developing new carious lesions, diminished ability to eat, and to live a normal healthy life. (2) Its complex etiology has intrigued research about certain feeding practices, levels of oral hygiene and plaque, active dental problems in parents/caregivers, and certain demographic factors which all apparently contribute to the risk of developing the disease.(3) Identifying the specific risk factors of the disease is crucial in order to reduce the incidence and severity of dental caries in future generations. Vertical transmission of pathogenic microorganisms including Streptococcus mutans (Sm) from the caregiver to the child plays an 2 Introduction important role in caries development.(4) Although Sm has been known to be the primary ecological factor of dental caries, differences in the plaque microbiota among children suffering from S-ECC were observed suggesting wide microbial diversity. (5) The isolation of different microbial species in children will allow the discovery of new pathogens responsible for causing the disease.(6) The required treatment costs and expertise of highly skilled professionals needed to treat the disease, made it necessary to follow a preventive economic approach,(7) such as promoting for traditional inexpensive means of teeth cleaning or the use of antibacterial agents.(8) Among the natural products used in tooth cleansing, miswak was the first to be used by mankind as early as 5000 BC. Miswak has been reported to impart an essential antibacterial role, particularly on cariogenic bacteria and periodontal pathogens. (9) Yet more research is needed to emphasize its effect on bacteria causing S-ECC. 3 Introduction