Maternal influences on oral microbiome development and implications for early childhood health: a systematic review
Clinical Snapshot
PICO Framework
| P — Population | Healthy mother-child dyads from birth to 5 years of age |
| I — Intervention | Maternal oral microbiome exposure and transmission |
| C — Comparator | Not applicable (descriptive systematic review) |
| O — Outcomes | Oral microbiome development, diversity, composition, and maternal-infant microbiome resemblance over time |
Bottom Line
This systematic review confirms that maternal oral microbiomes significantly influence infant oral microbiome development from birth through early childhood, with stabilisation occurring around 3-5 years. However, the review has significant methodological limitations including a restricted search strategy, absence of quality assessment, and lack of quantitative synthesis. While the findings support the biological plausibility of maternal-infant microbiome transmission, the evidence is insufficient to guide specific clinical interventions. The review highlights important knowledge gaps regarding delivery mode, tooth eruption timing, and parental lifestyle factors. For Australian clinicians, this reinforces the importance of maternal oral health in pregnancy and early childhood, aligning with existing RACGP recommendations for integrated maternal-child health care. Future research with robust methodology and larger sample sizes is needed before translating these findings into evidence-based clinical practice guidelines.
Key Findings
Effect Size: Not quantified - narrative synthesis only
Primary Outcome: Maternal oral microbiome significantly influences infant oral microbiome establishment and development
Nnt Or Sensitivity: Microbiome stabilisation occurs around 3-5 years of age
Confidence Interval: Not provided
Clinical Application
Limited immediate clinical application due to descriptive nature and lack of specific interventions Relevant to Australian maternal and child health programs, particularly in preventive dentistry and early childhood health surveillance through RACGP guidelines Healthy mother-child dyads in developed healthcare settings
Abstract
A deeper understanding of how maternal-infant interactions shape the establishment and diversification of the oral microbiome could have significant clinical applications; however, relatively few studies emphasize early maternal-infant microbial connections. This systematic review provides a longitudinal analysis of oral microbiome development from birth to five years, focusing on the relationship between maternal and infant microbiomes. We conducted a systematic search (June 2025) using keywords "mother," "children," "oral microbiome," and "longitudinal" across PubMed, Cochrane Library, and Embase. Twelve studies fulfilled the inclusion criteria: longitudinal design, healthy mother-child dyads, saliva sample collection, and relevant age range. We excluded review articles, non-English publications, and studies with overlapping data. Results were synthesized by developmental stage and topic. Overall, current literature agrees that the mother is an important source of exposure for initial colonization of the newborn's oral microbiome. Several studies indicated that the oral microbiome at birth is diverse and unspecialized, composed mostly of maternally derived strains. Rapid selection occurs over the first few weeks, as the relative abundances of typical oral bacterial species increase. Throughout the first year, increases in diversity strengthen the resemblance between infant and maternal microbiomes. The microbiome appears to stabilize around 3-5 years. In conclusion, maternal-infant connections play a significant role in influencing oral microbiome development during the first 5 years of life. This review highlights the need for future studies to incorporate larger, longitudinal designs with metadata and advanced tools to clarify the roles of delivery mode, tooth eruption, and parental lifestyle habits in shaping early oral microbiome development.
References
- 1.Wang, A., Dao, L. Q., Ramos-Gomez, F., & Wang, Y. (2026). Maternal influences on oral microbiome development and implications for early childhood health: a systematic review. Infection and Immunity. https://doi.org/10.48550/arXiv.2502.10513
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