The First Cavity: Why it Matters more than you Think
presented by Trisha O’Hehir

This course equips dental hygienists to prevent the very first cavity by intervening before disease begins—starting with the reduction of vertical transmission of Streptococcus mutans from mother to child. Participants will examine how lowering maternal S. mutans levels through routine xylitol gum use can significantly reduce bacterial transmission to infants during the earliest window of colonization. The course then expands to pediatric prevention, exploring how frequent sugar exposure fuels pathogenic bacteria and contributes to early childhood caries, systemic diseases, mouth breathing, malocclusion, bad breath, and recurrent ear infections. Emphasis is placed on two high-impact, evidence-based strategies: reducing dietary sugar frequency and strategically introducing xylitol to disrupt S. mutans and support a healthier oral microbiome. Practical chairside messaging and behavior-change strategies will empower hygienists to guide expectant parents and caregivers toward simple, sustainable actions that protect oral and airway health during critical stages of development.

Learning Objectives:
At the completion of this course, the participant will be able to:

1. Explain the process of vertical transmission of Streptococcus mutans from caregiver to child and its role in the development of early childhood caries.

2. Describe how maternal xylitol gum use reduces S. mutans levels and lowers the risk of bacterial transmission to infants.

3. Identify the connections between sugar exposure, pathogenic oral bacteria, and childhood conditions including caries, halitosis, mouth breathing, malocclusion, and ear infections.

4. Apply effective, parent-centered communication strategies to support maternal xylitol use, sugar reduction, and age-appropriate xylitol introduction as practical preventive interventions.