The Association Between Exclusive Breastfeeding, Bottle-Feeding, and Oral Rothia on Early Childhood Caries

Purpose: To investigate associations between feeding practices and the prevalence of oral Rothia, at the species and genus level, with early childhood caries (ECC). Methods: A total of 438 children were included in this cross-sectional study. A questionnaire was completed by the parent of each participant. Based on the feeding history, participants were classified as exclusively breastfed, exclusively bottle-fed, or mixed (both feeding). Supragingival plaque samples were collected, and 16S rRNA sequencing was used to assess Rothia genus and species' relative abundances. The association between feeding practices and Rothia prevalence with ECC was analyzed using multivariable logistic regression. Results: Low relative abundance of Rothia aeria was significantly associated with ECC, whereas there were no significant associations between the relative abundance of Rothia dentocariosa or Rothia mucilaginosa with caries status. Feeding practices were not associated with ECC. However, bedtime bottle use, bedtime snacking, living in a rural area, older age, use of fluoridated toothpaste, and having less-educated guardians were significantly associated. Conclusions: The findings suggest that low relative abundances of Rothia aeria and Rothia (genus) are associated with early childhood caries. Social environment and bedtime habits were also associated with ECC; however, feeding practices were not. Prospective studies examining Rothia and feeding practices with ECC would be beneficial to understand the relationship between Rothia and ECC and to help reach a consensus on the effect of different feeding practices on ECC risk.