Abstract Background: Early childhood caries (ECC) is a highly prevalent chronic oral disease affecting children under six years of age, with significant implications for general health, growth, quality of life, and healthcare systems. Emerging evidence highlights maternal oral health as a key upstream determinant influencing the development of ECC through biological, behavioural, and socio-environmental mechanisms. Objective: This review aims to summarize and critically appraise existing evidence on the influence of maternal oral health and related factors on the development of early childhood caries. Methods: A narrative review of the literature was conducted using evidence from cohort, case–control, cross-sectional, systematic review, and meta-analytic studies examining associations between maternal oral health status, behaviours, psychosocial and sociodemographic factors, and ECC outcomes in children. Results: Maternal caries experience, poor oral hygiene, elevated salivary levels of cariogenic microorganisms, and limited utilization of dental services were consistently associated with increased ECC risk. Vertical transmission of Streptococcus mutans, inappropriate feeding practices, delayed initiation of oral hygiene, inadequate fluoride exposure, and low maternal oral health literacy contributed to the establishment of a cariogenic oral environment in early childhood. Socioeconomic disadvantage, psychosocial stress, and cultural factors further intensified ECC risk. However, evidence from longitudinal and intervention studies remains limited. Conclusion: Maternal oral health plays a central role in the initiation and progression of early childhood caries. Preventive strategies targeting maternal oral health during pregnancy and early infancy, including oral health education, behavioural interventions, and improved access to preventive dental care, are essential for reducing ECC prevalence and promoting long-term oral health in children.
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