Prevalence of Streptococcus mutans and lactobacilli in 18-month-old children with cleft lip and/or palate.

The prevalence of Streptococcus mutans and lactobacilli was determined in 62 18-month-old Dutch children with a cleft lip and/or palate. Plaque and saliva samples were collected, a dental examination was performed, and the parents were interviewed with a structured questionnaire regarding general health, dietary habits, fluoride exposure, and socioeconomic class. Appropriate dilutions of the plaque and saliva samples were cultured on selective media to count all viable bacteria, S. mutans and lactobacilli. S. mutans was detected in the saliva of 45% of the children, and lactobacilli was detected in 16%. Also, S. mutans was detected in 48% of the plaque samples and lactobacilli in 8%. Of all of the variables examined, consumption of more than three snacks and beverages between main meals was significantly associated with presence of S. mutans in saliva. Preoperative infant orthopedic treatment (i.e., wearing an acrylic plate from shortly after birth) was significantly associated with presence of lactobacilli in saliva. The presence of S. mutans in the plaque samples was also significantly associated with presence of lactobacilli in saliva. These results indicate that children with oral cleft are at an increased risk of being infected by S. mutans and lactobacilli at a very early age. Such early colonization indicates a high risk for caries in the primary dentition.