Journal of Clinical and Diagnostic Research. 2019 Sep, Vol-13(9): ZC09-ZC13 9 9 DOI: 10.7860/JCDR/2019/40860.13132 Original Article Dentistry Section Oral Health of Babies and Mothers during the Breastfeeding Period INTRODUCTION Previous systematic reviews highlight the need to improve the oral health of caregivers and mothers to impact in their babies [1-3]. Preventive measures should be taught to the whole family to improve oral hygiene habits, based on instructions for oral health promotion [4-6]. Gingivitis is one of the most common clinical periodontal conditions among women during pregnancy and breastfeeding period [7-9]. It is well known that oral hygiene is related to gingival health [9], and the frequency of preventive measures during pregnancy as well as after the postpartum period, most of the time are neglected by women [7]. The aim of this study is to describe the oral health conditions and saliva profiles of mothers and their respective babies in the breastfeeding period, including the breast milk. MATERIALS AND METHODS Sample Subjects After approval of the Local Ethical Committee (CAAE: 0197.0.314.000-09), 47 pairs of mothers and babies were selected from two maternity hospitals and a outpatient public clinic ((Fernando Magalhães Hospital, Federal Hospital of Bonsucesso and the Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro). The sample was a convenience sample that was obtained during 19 months. The inclusion criteria were: mothers breast-feeding with clinically healthy babies that were attending hospital for follow-up. Exclusion criteria: smoking and/or the presence of systemic disease. Each woman signed a written consent authorising her own participation and also her babies participation-as legal guardians. Data Collection The study was cross-sectional, which analysed oral health status and profile of salivary metabolites of 47 women and their babies (0-28- months-old). The anamnesis of mothers and babies were performed in order to obtain information about age and socioeconomic conditions [7], as well as general health, delivery type, Body Mass Index (BMI) and breastfeeding. All participants provided 2 mL of unstimulated saliva by spitting into a sterilise plastic tube on ice. Mothers were required to refrain from eating and drinking for 2 hours and babies for 1 hour before saliva collection. For saliva collection of babies, a pipette was positioned at the floor of the mouth to collect 0.5 mL of unstimulated whole saliva. Thereafter, the breast milk was collected. We used the same methodology in the study as described by Fidalgo TK et al., [10]. During the collection period, the individuals were comfortably seated in a ventilated and lighted room. All salivary samples were centrifuged at 4°C and 10,000 g for 60 minutes (Cientec, CT-15000R, Brazil), and the supernatants were stored at -80°C until NMR (nuclear magnetic resonance spectroscopy) analysis as recommended by Silwood [11]. The intraoral examination was performed by a calibrated examiner, and periodontal exam was performed (Kappa=0.83), DMF-T suggested by the World Health Organisation [10] (Kappa=0.84). The mothers examination started with mucosa examination, followed by periodontal examination, which included the presence of plaque, LUCIANA PEREIRA DA SILVA 1 , VALÉRIA DE ABREU DA SILVA BASTOS 2 , TATIANA KELLY DA SILVA FIDALGO 3 , CARLA MARTINS DE OLIVEIRA 4, LUCIANA POMARICO 5 , ANA PAULA VALENTE 6 , LIANA BASTOS FREITAS-FERNANDES 7 , IVETE POMARICO RIBEIRO DE SOUZA 8 Keywords: Child, Mother-child relationship, Nuclear magnetic resonance spectroscopy, Oral hygiene, Saliva ABSTRACT Introduction: Puerperal woman and new-born children are vulnerable and frequently have neglected health conditions. Aim: The objective is to describe the oral health and saliva profiles of women and their babies during the breastfeeding period, including breast milk. Materials and Methods: Forty-seven mothers were interviewed and demographic data were recorded. The mother-baby pairs underwent intraoral examination. The mothers were submitted to examination of oral mucosa, oral hygiene status by O’Leary, periodontal condition and caries (DMF-T: decayed, missing and filled teeth) in order to establish buccal conditions. The babies had their oral mucosa and teeth examined. Salivary samples of babies and mothers as well the breastmilk of mothers were collected and analysed by 1 H-NMR through a 600 MHz spectrometer. The data were analysed in a statistical program SPSS.21 (IBM Statistics). Results: The mothers’ mean age was 27-years-old and 53.9% of mothers were overweight. The oral condition revealed poor oral health: DMF-T=8.20, 72.4% had gingivitis and 62% had dental plaque. The babies presented 4.18% cases of oral candidiasis and 2.08% cases of Bohn nodules, with no caries. The salivary 1 H-NMR spectra from babies with more than six months of age showed increased levels of lactate, ethanol, acetate, propionate, N-butyrate and N-acetyl sugars and reduced levels of other sugars. The 1 H-NMR analysis of salivary samples from the mothers showed metabolites such as propionate, ethanol, lactate, acetate, butyrate and N-acetyl and sugar region. The 1 H-NMR breast milk demonstrated high quantity of lactose in a region of spectra characteristic from sugars. It was concluded that the mothers had low levels caries activity; however, though they had past dental caries history. This may have an impact on the oral health of their children. Conclusion: Our study focused on the oral health and saliva profiles of women and their babies during breastfeeding period. This data could design a preventive programme that would improve the oral health and quality of life.