{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:31:33Z","timestamp":1787020293719,"version":"build-2736575974"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009827","name":"Alexandria University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009827","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Xylitol is widely used in caries prevention and has been shown to reduce cariogenic activity in children. However, limited evidence exists regarding the effectiveness of xylitol wipes in infants and toddlers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the effect of xylitol wipes on cariogenic activity in infants and toddlers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This prospective, longitudinal, single\u2013arm interventional study included 20 healthy, caries\u2013free children aged 9 months to 1.5 years. Mothers were instructed to wipe their children\u2019s teeth with xylitol wipes (Spiffies Baby Tooth Wipes\u2122) three times daily for four weeks. Salivary samples were collected at baseline and weekly follow\u2013up visits. Cariogenic activity was assessed by measuring lactic acid production using a chairside kit (Clinpro Cario L\u2013Pop), and salivary mutans streptococci (MS) levels were determined using the CRT bacteria caries risk test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A highly significant reduction in salivary lactic acid levels was observed after one week of xylitol wipe use (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). A significant reduction in MS counts was observed by the fourth week (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Daily application of xylitol wipes reduced cariogenic activity in young children, suggesting that this delivery method may be a practical preventive approach during early childhood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>This trial was registered at ClinicalTrials.gov (Identifier: NCT07245433) on 14 November 2025.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-08018-x","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T03:35:38Z","timestamp":1774582538000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating the effect of xylitol wipes on cariogenic bacteria in infants and toddlers: a longitudinal clinical trial"],"prefix":"10.1186","volume":"26","author":[{"given":"Laila M.","family":"El\u2013Habashy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Abd El Sadek","family":"El Meligy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliaa Abdelsalam","family":"Hamouda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"issue":"3","key":"8018_CR1","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1111\/j.1600-0528.2009.00472.x","volume":"37","author":"M Kishi","year":"2009","unstructured":"Kishi M, Abe A, Kishi K, Ohara\u2013Nemoto Y, Kimura S, Yonemitsu M. Relationship of quantitative salivary levels of Streptococcus mutans and S. sobrinus in mothers to caries status and colonization of mutans streptococci in plaque in their 2.5\u2013year\u2013old children. Community Dent Oral Epidemiol. 2009;37(3):241\u20139.","journal-title":"Community Dent Oral Epidemiol"},{"issue":"1","key":"8018_CR2","doi-asserted-by":"publisher","first-page":"44","DOI":"10.4103\/0970-4388.127054","volume":"32","author":"PH Ramamurthy","year":"2014","unstructured":"Ramamurthy PH, Swamy HS, Bennete F, Rohini M, Nagarathnamma T. Relationship between severe\u2013early childhood caries, salivary mutans streptococci, and lactobacilli in preschool children of low socioeconomic status in Bengaluru city. J Indian Soc Pedod Prev Dent. 2014;32(1):44\u20137.","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"8018_CR3","first-page":"114","volume-title":"Policy on the Use of Xylitol in Pediatric Dentistry. The Reference Manual of Pediatric Dentistry","author":"American Academy of Pediatric Dentistry","year":"2024","unstructured":"American Academy of Pediatric Dentistry. Policy on the Use of Xylitol in Pediatric Dentistry. The Reference Manual of Pediatric Dentistry. Chicago, III.: American Academy of Pediatric Dentistry; 2024. pp. 114\u20136."},{"issue":"4","key":"8018_CR4","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1111\/j.1399-302X.2006.00273.x","volume":"21","author":"H Miyasawa\u2013Hori","year":"2006","unstructured":"Miyasawa\u2013Hori H, Aizawa S, Takahashi N. Difference in the xylitol sensitivity of acid production among Streptococcus mutans strains and the biochemical mechanism. Oral Microbiol Immunol. 2006;21(4):201\u20135.","journal-title":"Oral Microbiol Immunol"},{"issue":"1","key":"8018_CR5","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1177\/0895937409335642","volume":"21","author":"EM S\u00f6derling","year":"2009","unstructured":"S\u00f6derling EM. Xylitol, mutans streptococci, and dental plaque. Adv Dent Res. 2009;21(1):74\u20138.","journal-title":"Adv Dent Res"},{"issue":"1","key":"8018_CR6","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1111\/j.1875-595X.2008.tb00175.x","volume":"58","author":"KK M\u00e4kinen","year":"2008","unstructured":"M\u00e4kinen KK, Alanen P, Isokangas P, Isotupa K, S\u00f6derling E, M\u00e4kinen P\u2013L, et al. Thirty\u2013nine\u2013month xylitol chewing\u2013gum programme in initially 8\u2013year\u2013old school children: a feasibility study focusing on mutans streptococci and lactobacilli. Int Dent J. 2008;58(1):41\u201350.","journal-title":"Int Dent J"},{"issue":"4","key":"8018_CR7","doi-asserted-by":"publisher","first-page":"435","DOI":"10.14219\/jada.archive.2002.0201","volume":"133","author":"MC Roberts","year":"2002","unstructured":"Roberts MC, Riedy CA, Coldwell SE, Nagahama S, Judge K, Lam M, et al. How xylitol\u2013containing products affect cariogenic bacteria. J Am Dent Assoc. 2002;133(4):435\u201341.","journal-title":"J Am Dent Assoc"},{"issue":"4","key":"8018_CR8","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1177\/154405910608500417","volume":"85","author":"JM Tanzer","year":"2006","unstructured":"Tanzer JM, Thompson A, Wen ZT, Burne RA. Streptococcus mutans: Fructose transport, xylitol resistance, and virulence. J Dent Res. 2006;85(4):369\u201373.","journal-title":"J Dent Res"},{"issue":"5","key":"8018_CR9","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1080\/1040841X.2021.1915959","volume":"47","author":"Y Lin","year":"2021","unstructured":"Lin Y, Chen J, Zhou X, Li Y. Inhibition of Streptococcus mutans biofilm formation by strategies targeting the metabolism of exopolysaccharides. Crit Rev Microbiol. 2021;47(5):667\u201377.","journal-title":"Crit Rev Microbiol"},{"issue":"1","key":"8018_CR10","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1038\/sj.bdj.4809535","volume":"184","author":"WM Edgar","year":"1998","unstructured":"Edgar WM. Sugar substitutes, chewing gum and dental caries: a review. Br Dent J. 1998;184(1):29\u201332.","journal-title":"Br Dent J"},{"issue":"1","key":"8018_CR11","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1345\/aph.19020","volume":"34","author":"MA Gales","year":"2000","unstructured":"Gales MA, Nguyen TM. Sorbitol compared with xylitol in prevention of dental caries. Ann Pharmacother. 2000;34(1):98\u2013100.","journal-title":"Ann Pharmacother"},{"issue":"4","key":"8018_CR12","doi-asserted-by":"publisher","first-page":"587","DOI":"10.14219\/jada.archive.1984.0390","volume":"108","author":"WJ Loesche","year":"1984","unstructured":"Loesche WJ, Grossman NS, Earnest R, Corpron R. The effect of chewing xylitol gum on the plaque and saliva levels of Streptococcus mutans. J Am Dent Assoc. 1984;108(4):587\u201392.","journal-title":"J Am Dent Assoc"},{"key":"8018_CR13","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/1472-6831-5-6","volume":"5","author":"JL Castillo","year":"2005","unstructured":"Castillo JL, Milgrom P, Coldwell SE, Castillo R, Lazo R. Children\u2019s acceptance of milk with xylitol or sorbitol for dental caries prevention. BMC Oral Health. 2005;5:6.","journal-title":"BMC Oral Health"},{"issue":"1","key":"8018_CR14","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1186\/s12903-025-06602-1","volume":"25","author":"E S\u00f6derling","year":"2025","unstructured":"S\u00f6derling E, Pienih\u00e4kkinen K. Specific effects of xylitol chewing gum on mutans streptococci levels, plaque accumulation and caries occurrence: a systematic review. BMC Oral Health. 2025;25(1):1275.","journal-title":"BMC Oral Health"},{"issue":"3","key":"8018_CR15","first-page":"257","volume":"31","author":"M Fontana","year":"2009","unstructured":"Fontana M, Catt D, Eckert GJ, Ofner S, Toro M, Gregory RL, et al. Xylitol: Effects on the acquisition of cariogenic species in infants. Pediatr Dent. 2009;31(3):257\u201366.","journal-title":"Pediatr Dent"},{"issue":"12","key":"8018_CR16","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.14219\/jada.archive.2008.0102","volume":"139","author":"A Deshpande","year":"2008","unstructured":"Deshpande A, Jadad AR. The impact of polyol\u2013containing chewing gums on dental caries: A systematic review of original randomized controlled trials and observational studies. J Am Dent Assoc. 2008;139(12):1602\u201314.","journal-title":"J Am Dent Assoc"},{"issue":"3","key":"8018_CR17","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1177\/00220345990780031301","volume":"78","author":"PP Hujoel","year":"1999","unstructured":"Hujoel PP, M\u00e4kinen KK, Bennett CA, Isotupa KP, Isokangas PJ, Allen P, et al. The optimum time to initiate habitual gum\u2013chewing for obtaining long\u2013term caries prevention. J Dent Res. 1999;78(3):797\u2013803.","journal-title":"J Dent Res"},{"issue":"5","key":"8018_CR18","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1080\/00016350410001676","volume":"62","author":"I Thorild","year":"2004","unstructured":"Thorild I, Lindau B, Twetman S. Salivary mutans streptococci and dental caries in three\u2013year\u2013old children after maternal exposure to chewing gums containing combinations of xylitol, sorbitol, chlorhexidine, and fluoride. Acta Odontol Scand. 2004;62(5):245\u201350.","journal-title":"Acta Odontol Scand"},{"issue":"2","key":"8018_CR19","doi-asserted-by":"publisher","first-page":"190","DOI":"10.14219\/jada.archive.2006.0144","volume":"137","author":"BA Burt","year":"2006","unstructured":"Burt BA. The use of sorbitol\u2013 and xylitol\u2013sweetened chewing gum in caries control. J Am Dent Assoc. 2006;137(2):190\u20136.","journal-title":"J Am Dent Assoc"},{"issue":"2","key":"8018_CR20","doi-asserted-by":"publisher","first-page":"163","DOI":"10.17796\/jcpd.37.2.261782tq73k4414x","volume":"37","author":"NM Alamoudi","year":"2012","unstructured":"Alamoudi NM, Hanno AG, Sabbagh HJ, Masoud MI, Almushayt AS, El Derwi DA. Impact of maternal xylitol consumption on mutans streptococci, plaque and caries levels in children. J Clin Pediatr Dent. 2012;37(2):163\u20136.","journal-title":"J Clin Pediatr Dent"},{"key":"8018_CR21","first-page":"318","volume-title":"Perinatal and Infant Oral Health Care. The Reference Manual of Pediatric Dentistry","author":"American Academy of Pediatric Dentistry","year":"2024","unstructured":"American Academy of Pediatric Dentistry. Perinatal and Infant Oral Health Care. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2024. pp. 318\u201322."},{"issue":"4","key":"8018_CR22","first-page":"337","volume":"29","author":"A Galganny\u2013Almeida","year":"2007","unstructured":"Galganny\u2013Almeida A, Queiroz MC, Leite AJ. The effectiveness of a novel infant tooth wipe in high caries\u2013risk babies 8 to15 months old. Pediatr Dent. 2007;29(4):337\u201342.","journal-title":"Pediatr Dent"},{"issue":"6","key":"8018_CR23","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.acap.2009.09.001","volume":"9","author":"P Milgrom","year":"2009","unstructured":"Milgrom P, Zero DT, Tanzer JM. An examination of the advances in science and technology of prevention of tooth decay in young children since the Surgeon General\u2019s Report on Oral Health. Acad Pediatr. 2009;9(6):404\u20139.","journal-title":"Acad Pediatr"},{"issue":"5","key":"8018_CR24","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1159\/000231568","volume":"43","author":"KK M\u00e4kinen","year":"2009","unstructured":"M\u00e4kinen KK. An end to crossover designs for studies on the effect of sugar substitutes on caries? Caries Res. 2009;43(5):331\u20133.","journal-title":"Caries Res"},{"issue":"5","key":"8018_CR25","doi-asserted-by":"publisher","first-page":"553","DOI":"10.14219\/jada.archive.2008.0215","volume":"139","author":"KA Ly","year":"2008","unstructured":"Ly KA, Milgrom P, Rothen M. The potential of dental\u2013protective chewing gum in oral health interventions. J Am Dent Assoc. 2008;139(5):553\u201363.","journal-title":"J Am Dent Assoc"},{"issue":"7","key":"8018_CR26","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1001\/archpediatrics.2009.77","volume":"163","author":"P Milgrom","year":"2009","unstructured":"Milgrom P, Ly KA, Tut OK, Mancl L, Roberts MC, Briand K, et al. Xylitol pediatric topical oral syrup to prevent dental caries: a double\u2013blind randomized clinical trial of efficacy. Arch Pediatr Adolesc Med. 2009;163(7):601\u20137.","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"3","key":"8018_CR27","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1034\/j.1600-0528.2000.280308.x","volume":"28","author":"P Alanen","year":"2000","unstructured":"Alanen P, Isokangas P, Gutman K. Xylitol candies in caries prevention: Results of a field study in Estonian children. Community Dent Oral Epidemiol. 2000;28(3):218\u201324.","journal-title":"Community Dent Oral Epidemiol"},{"issue":"6","key":"8018_CR28","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1159\/000095650","volume":"40","author":"E Honkala","year":"2006","unstructured":"Honkala E, Honkala S, Shyama M, Al\u2013Mutawa SA. Field trial on caries prevention with xylitol candies among disabled school children. Caries Res. 2006;40(6):508\u201313.","journal-title":"Caries Res"},{"issue":"2","key":"8018_CR29","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/BF03262581","volume":"8","author":"T Taipale","year":"2007","unstructured":"Taipale T, Pienih\u00e4kkien K, Alanen P, Jodela J, S\u00f6derling E. Dissolution of xylitol from a food supplement administered with a novel slow\u2013release pacifier: Preliminary results. Eur Arch Paediatr Dent. 2007;8(2):123\u20135.","journal-title":"Eur Arch Paediatr Dent"},{"issue":"Suppl 7","key":"8018_CR30","doi-asserted-by":"publisher","first-page":"S85","DOI":"10.1177\/0022034511434354","volume":"91","author":"L Zhan","year":"2012","unstructured":"Zhan L, Cheng J, Ngo M, Beston PK, Hoover CI, Featherstone DB. Effect of xylitol wipes on cariogenic bacteria and caries in young children. J Dent Res. 2012;91(Suppl 7):S85\u201390.","journal-title":"J Dent Res"},{"issue":"1","key":"8018_CR31","doi-asserted-by":"publisher","first-page":"13","DOI":"10.5005\/jp-journals-10005-1476","volume":"11","author":"G Kayalvizhi","year":"2018","unstructured":"Kayalvizhi G, Nivedha D, Sajeev R, Prathima GS, Suganya M, Ramesh V. Evaluating the efficacy of xylitol wipes on cariogenic bacteria in 19\u2013 to 35\u2013month\u2013old children: A double\u2013blind randomized controlled trial. Int J Clin Pediatr Dent. 2018;11(1):13\u20137.","journal-title":"Int J Clin Pediatr Dent"},{"key":"8018_CR32","first-page":"33","volume":"50","author":"S Kneist","year":"1999","unstructured":"Kneist S, Heinrich\u2013Weltzien R, Fischer T, Klein C, Rupf S, Eschrich K. Commercially available saliva tests for mutans detection: review and efficiency evaluation. Quintessence Int. 1999;50:33\u201343.","journal-title":"Quintessence Int"},{"issue":"5","key":"8018_CR33","first-page":"439","volume":"52","author":"S Kneist","year":"2001","unstructured":"Kneist S, Richter A, Finke C. Validation of saliva tests for the cultivation of mutans streptococci. Quintessence Int. 2001;52(5):439\u201347.","journal-title":"Quintessence Int"},{"issue":"11","key":"8018_CR34","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1177\/00220345000790111201","volume":"79","author":"P Isokangas","year":"2000","unstructured":"Isokangas P, S\u00f6derling E, Pienih\u00e4kkinen K, Alanen P. Occurrence of dental decay in children after maternal consumption of xylitol chewing gum, a follow\u2013up from 0 to 5 years of age. J Dent Res. 2000;79(11):1885\u20139.","journal-title":"J Dent Res"},{"issue":"2","key":"8018_CR35","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1111\/j.1600-0722.2006.00345.x","volume":"114","author":"V Gerardu","year":"2006","unstructured":"Gerardu V, Heijnsbroek M, van der Buijs M, Ten Cate B, van Loveren C. Comparison of Clinpro Cario L\u2013Pop estimates with CIA lactic acid estimates of the oral microflora. Eur J Oral Sci. 2006;114(2):128\u201332.","journal-title":"Eur J Oral Sci"},{"issue":"4","key":"8018_CR36","first-page":"e213","volume":"38","author":"WA Bretz","year":"2007","unstructured":"Bretz WA, Corby PMA, Costa S, Quadros M, Tavares VS, Moreira G, et al. Microbial acid production (Clinpro Cario L\u2013Pop) and dental caries in infants and children. Quintessence Int. 2007;38(4):e213\u20137.","journal-title":"Quintessence Int"},{"issue":"4","key":"8018_CR37","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1128\/mr.50.4.353-380.1986","volume":"50","author":"WJ Loesche","year":"1986","unstructured":"Loesche WJ. Role of Streptococcus mutans in human dental decay. Microbiol Rev. 1986;50(4):353\u201380.","journal-title":"Microbiol Rev"},{"issue":"2","key":"8018_CR38","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1177\/00220345930720020701","volume":"72","author":"C Sansone","year":"1993","unstructured":"Sansone C, Van Houte J, Joshipura K, Kent R, Margolis HC. The association of mutans streptococci and non\u2013mutans streptococci capable of acidogenesis at a low pH with dental caries on enamel and root surfaces. J Dent Res. 1993;72(2):508\u201316.","journal-title":"J Dent Res"},{"issue":"4","key":"8018_CR39","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1177\/00220345960750040201","volume":"75","author":"J Van Houte","year":"1996","unstructured":"Van Houte J, Lopman J, Kent R. The final pH of bacteria comprising the predominant flora on sound and carious human root and enamel surfaces. J Dent Res. 1996;75(4):1008\u201314.","journal-title":"J Dent Res"},{"issue":"4","key":"8018_CR40","first-page":"276","volume":"16","author":"L Koroluk","year":"1994","unstructured":"Koroluk L, Hoover JN, Komiyama K. The sensitivity and specificity of a colorimetric microbiological caries activity test (Cariostat) in preschool children. Pediatr Dent. 1994;16(4):276\u201381.","journal-title":"Pediatr Dent"},{"issue":"12","key":"8018_CR41","first-page":"e6504","volume":"11","author":"V Babu","year":"2019","unstructured":"Babu V, Hegde S, Bhat S, Sargod S. Evaluation of Efficacy of Three Different Commercially Available Kit for Chairside Cariogenic Bacteria Test \u2013 Caries Risk Test, Saliva\u2013check Mutans and CariScreen. Cureus. 2019;11(12):e6504.","journal-title":"Cureus"},{"issue":"13","key":"8018_CR42","first-page":"501","volume":"58","author":"SA Badr","year":"2012","unstructured":"Badr SA, Alharthi FD, Shams SH. The effect of salivary bacterial count methods on the Cariogram caries risk assessment model. Egypt Dent Assoc J. 2012;58(13):501.","journal-title":"Egypt Dent Assoc J"},{"issue":"3","key":"8018_CR43","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1128\/JCM.40.3.1001-1009.2002","volume":"40","author":"MR Becker","year":"2002","unstructured":"Becker MR, Paster BJ, Leys EJ, Moeschberger ML, Kenyon SG, Galvin JL, et al. Molecular analysis of bacterial species associated with childhood caries. J Clin Microbiol. 2002;40(3):1001\u20139.","journal-title":"J Clin Microbiol"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-026-08018-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08018-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08018-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:58:01Z","timestamp":1781643481000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12903-026-08018-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8018"],"URL":"https:\/\/doi.org\/10.1186\/s12903-026-08018-x","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"assertion":[{"value":"4 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for this study was obtained from the Faculty of Dentistry, Alexandria University Ethical Committee (IRB No. 00010556\u2013IORG 0008839). The Manuscript Ethics Committee approval number was 1185\u201310\/2025. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. This trial was also registered at ClinicalTrials.gov (Identifier: NCT07245433) on 14 November 2025. Written informed consent was obtained from the mothers prior to enrollment, after the study objectives, procedures, and their right to withdraw at any time without consequence had been explained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"631"}}