Pregnancy Clinical Trial
Official title:
Effect of Atraumatic Restorative Treatment on Streptococcus Mutans Count in Saliva of Pregnant Women, A Randomized Control Trial
S. mutans counts have been found to be high in women with high level of untreated caries. In Pakistan 95% of all carious lesions are untreated that is an alarming situation. A majority of mother's have high level of caries and pose an increase risk of vertically transmitting it to their children. Therefore, the aim of this study is to determine the effect of A Traumatic Restorative Treatment(ART) in reducing S. mutans count in pregnant women and indirectly reduce the vertical transmission of S. mutans to their children so that ART as a preventive program may be provided and promoted in periurban areas where there is a lack of accessibility to oral health care.
Dental caries is a multifactorial bacterial disease that is a significant public health
problem in many countries.Microbiological and molecular studies show that there are increase
chances of caries development in pregnant women.The reason is that Pregnancy is a condition
involving many physical and physiological changes that may lead to many temporary adaptive
changes in the body structure. This occurs due to release of number of hormones as estrogen,
progesterone, relaxin and gonadotropin.
Studies using phenotyping and genotyping techniques have strongly proposed that mother is
the primary source of infection for children who carry S. mutans strains and saliva is the
main source of S. mutans transfer.The rate and degree of transmission depends on degree of
infection of the parent, caretaker or playmate, the frequency of contact with the infant and
his/her diet and immune status.Recent studies show that infants can get colonize by S.
mutans from their mothers before the eruption of their primary teeth.
Hames et al (2006) has found that there is a positive correlation between the infected
children and their parents with high S. mutans count.It was found that parents who had high
levels of S. mutans in their saliva were the source of transmission of S. mutans in their
children concluding that several preventive programs could be beneficial to prevent vertical
transmission from mothers to infants.
Studies have also shown that preventive care measures in pregnant women or mother with
younger children leads to reduction in S. mutans levels in them with subsequent decrease in
colonization of these microorganisms and caries development.Recent research work has also
reported that preventive program applied to the pregnant women reduce both the amount of
plaque and S. mutans colonization and thus has a positive effect.
There are few interventional studies to determine the effect of oral environment
stabilization (OES) procedure on S. mutans count in pregnant women through ART. Volpato et
al (2011) found that there is a decrease in S. mutans colony forming units counts ,with a
statistically significant difference (p<0.0001),between pregnant women's saliva samples
before and after OES.And he concluded that OES is an effective clinical procedure in
diminishing the number of Streptococcus mutans colony forming units in the saliva of
high-caries risk pregnant women. This management is simple and effective, equivalent to the
basic treatment needs of pregnant women that look for dental care in public service.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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