› Additional risk factors for dental caries include
• high levels of S. mutans in the oral cavity. Transmission of S. mutans commonly occurs
by sharing utensils, which places children at risk of developing dental caries when
mothers or siblings have a high level of the bacterium
• frequent consumption of foods that are high in refined carbohydrates (e.g., sugars
[sucrose, fructose, glucose]) and use of unfluoridated water. Other diet-related factors
that increase the risk of developing dental caries include
–prolonged bottle feeding or bedtime feeding
–bottlefeeding with sweetened milk or fruit juice
–a maternal diet high in refined carbohydrates
• lack of or irregular dental visits, delay in professional teeth cleaning, ineffective
toothbrushing (e.g., infrequent), and using unfluoridated toothpaste