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Streptococci and actinomyces inhibit regrowth of Streptococcus mutans on gnotobiotic rat molar teeth after chlorhexidine varnish treatment.

Clinical studies suggest that the long-term suppression of mutans streptococci on tooth surfaces after intensive chlorhexidine therapy is mainly due to bacterial interference. Other streptococci and also Actinomyces naeslundii are proposed to inhibit regrowth of mutans streptococci after suppression by the agent. We have tested this hypothesis in gnotobiotic rats associated with Streptococcus mutans alone, or associated with S. mutans and strains of Streptococcus oralis, Streptococcus sanguis, Streptococcus gordonii, Streptococcus mitis biovar I, and A. naeslundii. Left lower jaws in these rats were treated with concentrated chlorhexidine varnish, and the return of S. mutans on the treated jaws monitored. In mono-associated rats, S. mutans regained the level of the untreated right lower jaw in approximately 1 week. In contrast, S. mutans remained suppressed for several weeks in rats multi-associated with other streptococci and actinomyces strains. The suppression was more pronounced in the rats fed on basal diet with little free sugars than in rats fed on a sucrose-containing diet. Counts of other streptococci recovered quickly from the intensive chlorhexidine treatment, but A. naeslundii remained suppressed for at least 1 week. The findings demonstrate the crucial importance of the oral microflora in controlling regrowth of mutans streptococci after chemotherapy.

Actinomyces↗

Passive immunization against dental plaque formation in humans: effect of a mouth rinse containing egg yolk antibodies (IgY) specific to Streptococcus mutans.

Passive immunization involving the delivery of antibodies specific to pathogens of infectious diseases to the host has been an attractive approach to establish protective immunity against a variety of microbial pathogens, including Streptococcus mutans, which is the principal etiologic agent of dental caries in humans. The overall purpose of the present study was to determine the effectiveness of a mouth rinse containing antibodies to S. mutans in preventing the establishment of this bacterium in dental plaque of humans. The antibodies were derived from egg yolks obtained from hens immunized with whole cells of S. mutans grown in sucrose-containing medium. The immunoglobulin derived from the yolks (IgY) of immunized hens was characterized in vitro and in vivo in human volunteers. Cross-reactivity tests showed that immune IgY reacted with every serotype, except serotype b, which had lost its GTase activity, when the bacteria were cultured in sucrose-containing medium. Immune IgY inhibited S. mutans adherence to saliva-coated hydroxyapatite discs by 59.2%, while control IgY caused an inhibition of only 8.2%. In the short-term (4-hour) test using a mouth rinse containing 10% sucrose, immune IgY decreased the ratio of the percentage of S. mutans per total streptococci in saliva. In the long-term (7-day) test using a mouth rinse without sucrose, the ratio in saliva was not significantly reduced in the volunteers using the immune IgY due to the large standard deviation. However, comparing the ratios of the percentage of S. mutans per total streptococci in plaque of individual subjects, there was a tendency for a reduction of the ratios in the volunteers receiving the mouth rinse containing immune IgY. These results support the effectiveness of IgY with specificity to S. mutans grown in the presence of sucrose as an efficient method to control the colonization of mutans streptococci in the oral cavity of humans.

Antibodies, Bacterial↗

Mutans streptococci, oral hygiene, and caries in an adult Swedish population.

The objective of the present study was to describe the distribution of salivary mutans streptococci in a randomly selected adult population and to relate the distribution to the prevalence of caries. The aim was also to study the association between caries and different levels of oral hygiene (OH). The results were based on the assessment of caries, dental plaque, and concentration of salivary mutans streptococci in 914 subjects who represented 95% of an age- and gender-stratified population sample of 967 individuals, randomly selected from the total adult population living in Alvsborg County, Sweden. The results showed that the distribution of mutans streptococci among dentate adults not wearing any kind of removable denture(s) was similar to that previously reported from studies on Swedish schoolchildren, while a comparably higher proportion of subjects with high levels of mutans streptococci was found among the dentate individuals wearing some kind of removable denture(s). Even higher proportions were found among edentulous individuals with complete denture(s). There was a correlation between mutans streptococci concentration in saliva and caries. The subjects with lower concentrations showed a significantly lower mean number of decayed surfaces, compared with the individuals with higher concentrations of mutans streptococci in their saliva. The median OH standard was lower in the older age groups, and there was a higher ratio of decayed surfaces per remaining tooth in those age groups, in comparison with the younger groups. However, for individuals without mutans streptococci, no relation between OH standard and caries could be found and, regardless of OH standard, higher numbers of decayed surfaces were found with an increasing concentration of mutans streptococci in saliva.

Adult↗

A longitudinal study of Streptococcus mutans colonization in infants after tooth eruption.

We previously reported that, before tooth eruption, over one-half of infants aged 6 mos were already infected with Streptococcus mutans. The aim of this investigation was to determine the colonization of S. mutans after tooth eruption in the same cohort of 111 infants (35 pre-term, 76 full-term). Our results showed that S. mutans colonization increased with increasing age, so that by 24 mos of age, 84% harbored the bacteria (p < 0.01). The mean and median ages of S. mutans colonization in dentate infants were 15.7 mos and 16.0 mos, respectively. Factors associated with S. mutans colonization were sweetened fluids taken to bed (p < 0.01), frequent sugar exposure (p < 0.03) and snacking (p < 0.03), sharing of foods with adults (p < 0.03), and maternal S. mutans levels of > 10(5) CFU/mL (p < 0.02). In contrast, non-colonization of S. mutans was associated with toothbrushing (p < 0.03) and multiple courses of antibiotics (p < 0.001). Analysis of our data establishes the timing of S. mutans colonization in children from birth to 24 mos of age.

Age Factors↗

[Assessment of gene associated with Streptococcus mutans biofilm formation].

Streptococcus mutans, the primary etiological agent of human dental caries and an obligate biofilm-forming bacterium, has developed a variety of mechanisms to colonize the tooth surface. Oral transmission of S. mutans through contact between mother and child is thought to be one of the risks of developing dental caries. In this study, I surveyed oral transmission frequency of S. mutans from mother to a 3-year-old child. In 19 (10.9%) of 174 mother-child pairs, S. mutans was isolated from both mother and chihld. The identities of genomic DNA from S. mutans in 5 (45.5%) of the 11 mother-child pairs were presented. Among those, the biofilms formed by S. mutans 3 c and 4 c, respectively, which had high and low ability of biofilm formation, were examined by confocal laser scanning microscopy (CLSM). Microscopic analysis revealed that the volume of biofilm formation in 3 c was higher than that in 4 c biofilm in the bottom. Furthermore, DNA microarrays were used to study the gene expression profiles of 3 c and 4 c biofilms. In this paper we describe that about 3.8% of genes showed differential expression; about 2.2% of genes were activated and about 1.6% were repressed in 3 c biofilm compared with 4 c biofilm. The present study suggests that biofilm gene expression is strongly associated with differential biofilm formation. Our identification of biofilm-involved genes points to mechanisms of the virulence of S. mutans and provides a first foothold for studying the natural history of S. mutans infections in mother and child.

Biofilms↗

Prevalence of salivary Streptococcus mutans in mothers and in their preschool children.

OBJECTIVES: To establish the prevalence and possible relationship of oral Streptococcus mutans colonization in mother-child pairs. DESIGN AND SETTING: An analytical cross-sectional study was carried out at a well-baby evaluation clinic held at the Public Dental Clinic, Varberg, Sweden. SAMPLE AND METHODS: Two hundred preschool children, 100 of which were 18 months old and the remaining 100 were 3 years old, and their mothers attended the clinic. All mothers were interviewed and their children's medical history, oral hygiene routines and dietary habits established. All children were clinically examined. The presence and level of S. mutans was estimated in the mother-child pairs with the aid of the Strip mutans chair-side test. RESULTS: Nearly 50% of mothers exhibited high levels of salivary S. mutans, prevalence among the 18-month- and 3-year-olds was 30% and 42%, respectively. A statistically significant (P < 0.01) mother-child relationship was found; a greater presence in mothers led to a higher number of children found harbouring the bacteria. Logistic regression analysis found that high maternal S. mutans levels (P < 0.001), daily sweet intake (P < 0.01) and sugary drinks in feeding bottles (P < 0.05) were significant factors for S. mutans colonization in children. Absence of daily toothbrushing and use of feeding bottles at night failed to fit into the model. Caries prevalence (initial and manifest decayed surfaces) was significantly related to S. mutans colonization (P < 0.01). CONCLUSION: The results support the concept of vertical transmission (mother-child), emphasizing the importance of the dietary component, and justifying a primary preventive approach with targeted action directed at mothers with high levels of S. mutans colonization.

Adult↗

[Evaluation of cariogenic potential of Streptococcus mutans isolated from caries-free and -active persons: adherence properties to saliva-coated hydroxyapatite].

OBJECTIVE: In this study, authors used saliva-coated hydroxyapatite to simulate tooth surface in oral cavity to evaluate adherence of different Streptococcus mutans isolated from caries-free and -active persons to saliva-coated hydroxyapatite. METHODS: Streptococcus mutans isolated from people with different carious experiences were divided into two groups: the caried-free group (DMFS = 0) including 19 persons and the caries-active group (DMFS > or = 6) including 40 persons. Totally 105 genotype Streptococcus mutans strains were obtains, including 22 strains from the caries-free group, and 83 strains from the caries-active group. The adhering properties of Streptococcus mutans (serotype c) strains were investigated, and different adhering properties were compared between the caries-free group and the caries-active group in order to find the correlationship between carious experiences and adhering properties of Streptococcus mutans. Saliva-coated hydroxyapatite was used to simulated tooth surface in oral cavity. Streptococci mutans were cultured in TPY liquid medium containing 3H-TDR in the same radioactive concentration. After being cultured in an anaerobic incubator for 18 hours, Streptococci mutans were radiolabelled by 3H-TDR. Saliva-coated hydroxyapatite and bacterial liquid(BSA = 0.52) were mixed for 90 minutes. Samples were assayed by using liquid scintillation counter, and binding abilities of strains were evaluated by the count per minute(cpm). RESULTS: Binding abilities of strains were significantly different in two groups, Caries-active people harbored more Streptococci mutans with high binding abilities(cpm > 2000) than caries-free people did(P < 0.05). The binding abilities to saliva-coated hydroxyapatite were different between strains of differing genotypes isolated from the same person. Each person always harbored one or two strains with high binding abilities(cpm > 2000) in the caries-active group. CONCLUSION: 1. Different genotypes have different adhering properties. 2. In caries-active group, different genotype strains have synergic effects, and adhesion of high binding ability strains cause caries susceptibility. 3. The differences in binding properties of isolates might relate to differences in carious experiences.

Bacterial Adhesion↗

[Effects of para-aminobenzoic acid (PABA) on growth of Streptococcus mutans].

OBJECTIVE: The aim of this study is to examine effects of para-aminobenzoic acid (PABA) on the growth of Streptococcus mutans (S. mutans). METHODS: Different concentrations of PABA (10(-10)-10(-3) g/L) were separately transferred to modified Carlsson medium. S. mutans (ATCC 25175) grew in modified Carlsson medium with different concentrations of PABA. All cultures were incubated at 37 degrees C anaerobically in an atmosphere of 80% of nitrogen (v/v), 10% of hydrogen (v/v) and 10% of carbon dioxide (v/v) for 48 hours. The absorbance values of S. mutans were measured by using a spectrometer (UV-1601). The colony forming units (CFU) were obtained by growing S. mutans in media with different concentrations of PABA (10(-10)-10(-3) g/L). RESULTS: Different concentrations of PABA had different stimulating effects on the growth of S. mutans (P < 0.05). But this kind of stimulating effects declined when the concentration of PABA was 10(-3) g/L. CONCLUSION: This experiment indicates PABA has stimulating effects on the growth of S. mutans, and PABA can promote growth of S. mutans.

4-Aminobenzoic Acid↗

[Effects of topical application of immunoglobulin yolk on mutans streptococci in dental plaque].

OBJECTIVE: To evaluate the inhibitory effects of topical application of specific immunoglobulin yolk antibodies (IgY) to mutans streptococci on composition of human dental plaque. METHODS: A total of 24 healthy adult volunteers were selected and randomly distributed into three experimental groups. After a supragingival scaling, the subjects were treated with an application of IgY containing spray (test group, n = 9), a 0.15% chlorhexidine(CH) spray(positive control group, n = 9) or a placebo phosphate buffered saline(PBS) spray without any active ingredients(negative control group, n = 6) three times daily for three weeks. Pooled plaque samples from the smooth surfaces of teeth were collected for microbiologic analysis before administration (baseline, day 0), during treatment(days 7, 14 and 21) and after withdrawal of the agents(days 28, 42 and 56) and plaque index were recorded. Microbial cultivation were performed by serially diluting the samples with PBS solution an cultivating the aliquots on mitis salivarius agar(MS) and MS supplemented with bacitracin (MSB) for oral streptococci and mutans streptococci respectively. The number of colony-forming unit (CFU) per plate was counted and the percentage of mutans streptococci per oral streptococci in dental plaque were determined. The effect of IgY on colonization of mutans streptococci were analyzed by an analysis of variance (ANOVA). RESULTS: The plaque indexes remained unchanged, but mutans streptococci in dental plaque was suppressed significantly following a short term(three weeks) application of IgY, and low level of mutans streptococci persisted for at least 5 weeks after withdrawal of IgY. CONCLUSION: The results suggest that the immunization with specific immunoglobulin yolk against mutans streptococci could be useful for long term suppression of mutans streptococci colonization in human dental plaque.

Adult↗

[Study on the horizontal transmission of oral Streptococcus mutans in children].

OBJECTIVE: To find out horizontal transmission of oral Streptococcus mutas (S. mutans) in nursery children through analyzing the similarity of S. mutans genotypes. METHODS: The study group included 24 nursery children between 3 and 4 years of age. Dental plaque samples were collected with sterile toothpick and cultured on MSB plates for 48 h. Individual Streptococcus mutans group colonies representative of the colonial morphologies were subcultured on TPY plates. These strains were identified to species level biochemically. AP-PCR fingerprinting was preformed after identification. S. mutans isolates from different children with very similar fingerprinting profiles were examined by chromosomal DNA fingerprinting analysis. RESULTS: Streptococcus mutans group were isolated in oral cavities of 66.7% children, 58.3% in caries-free and 75.0% in caries children. A total of 4' S. mutans isolates from 24 subjects were analyzed by AP-PCR, and 29 different amplitypes were identifyied, 45.8% carried tw. genotypes. There were 2 genotypes of S. mutans isolated repeatedly among 12 nursery children. CONCLUSION: The presence of matching genotypes of S. mutans among nursery children suggests horizontal transmission.

Child, Preschool↗

[A study of genetic diversity in lactate dehydrogenase of Streptococcus mutans from clinical isolates].

OBJECTIVES: Lactate dehydrogenase (LDH) is shown to be an important virulence factor resulting in acid production of Streptococcus mutans (S. mutans), on which the cariogenic potential of S. mutans depends. Differences in cariogenic abilities of S. mutans isolates may be determined by genetic heterogeneity from virulent factors. The relationship between LDH activity or genetic diversity and cariogenicity of S. mutans (serotype c) isolates was studied in this research. METHODS: The genome DNA of S. mutans isolates were isolated and LDH gene (ldh) were amplified with specific primers. These isolates came from 34 caries-active individuals and 36 caries-free ones, in which 24 strains showed the high LDH activity and 21 strains showed the low LDH activity. Then genetic diversity of PCR products were analyzed or assessed by restriction fragment-length polymorphism (RFLP). Some of amplified LDH genes from different group were sequenced and assayed. RESULTS: It is testified that two genotypes A and B of ldh-RFLP were revealed when LDH genes were digested with Mse I, but Hph I, Mnl I, Dde I, Nla III and Alu I digesting fragments of Idh gene did not show different pattern. Furthermore, Fisher Exact one-Tail Test showed that the proportion of genotype B among strains from caries-free individuals was higher than that from caries-active ones (P = 0.033), while the distribution of genotypes with different LDH activity was different between two groups (two-Tail Test P = 0.017). The sequencing DNA testified that the specific base mutation would lead to multiple kind of genotype resulted. CONCLUSION: This study indicated that LDH gene of S. mutans clinical strains from different individuals is conservative, while there still is the gene mutation in. The ldh genetic diversity may be related to the low caries sensitivity, and closely correlated with the differences in LDH enzyme activity of S. mutans strains.

DNA, Bacterial↗

Effect of chlorhexidine-sodium fluoride gel applied by tray or by toothbrush on salivary mutans streptococci.

A chlorhexidine (1%)-sodium fluoride (0.2%) gel applied using a dental tray six times during two consecutive days significantly decreased salivary levels of mutans streptococci but had only a slight effect on salivary levels of lactobacilli. The same gel used as a dentifrice for one week (twice a day) also significantly reduced salivary levels of mutans streptococci. However, this treatment was somewhat less effective than that using trays, on the basis of the ratio of mutans streptococci to total aerobes. With both treatments baseline salivary levels of mutans streptococci were re-attained after 70 days. One day after the gel treatment, mutans streptococci were unable to adhere to plastic strips (Dentocult SM Strip mutans) but detectable growth was found on mitis-salivarius-bacitracin agar. This suggests that not only are numbers of mutans streptococci reduced after chlorhexidine-sodium fluoride gel treatment but also mutans streptococci adherence.

Administration, Topical↗

Association between dental caries prevalence and Streptococcus mutans among 13-year-old children.

The prevalence of caries associated prevalence with Streptococcus mutans in saliva and pooled plaque was investigated among 13-year-old Chinese children. In conjunction with saliva sampling simplified greatly by adopting the oral rinse method, an initial threshold value of 10(4) colony forming units (cfu) per ml of rinse was established on the basis of the S. mutans counts from 27 caries-free individuals. The results of the present study showed that, of the total 58 children, 67.3% had S. mutans counts above the threshold value in their saliva, and they developed significantly more decayed surfaces (D) and decayed, missing, filled surfaces (DMFS) than did the children below this value. The association between caries activity and S. mutans counts either in saliva or in pooled plaque samples was even stronger when only decayed surfaces were taken into account. In addition, the detection frequency of S. mutans (81.8%) was higher in saliva than in the pooled plaque samples (43.2%). This may demonstrate that saliva is more sensitive than dental plaque in predicting caries activity. The most prevalent biotypes of the S. mutans strains observed in this study were c and d. The results of this study indicate a significant association of S. mutans levels with caries prevalence. In the estimation of salivary S. mutans levels, the rinse method offered an easy and rapid identification for children with high caries risk and proved to be very practicable for epidemiological study on a larger scale.

Adolescent↗

Scanning electron microscopy of dentin caries. Experimental in vitro studies with Streptococcus mutans.

This study was performed to gain better insight into the mechanisms involved in carious destruction of human dentin by Streptococcus mutans. In particular, bacterial colonization of dentin surfaces and bacterial invasion in dentin were studied. Streptococcus mutans (S. mutans), strain NCTC 10449, was grown on sterile dentin blocks in a 10% CO2 atmosphere at 37 degrees C. After 72, 120, 144 and 288 h of incubation the specimens were processed for scanning electron microscopic examination. The colonization of the dentinal surface progressed slowly and was nearly complete after 288 h. Invasion of S. mutans into the dentinal tubules was found occasionally and was limited to the initial 5 micron of the tubular lumen. The acid metabolites produced by S. mutans, caused lesions of the dentinal structures in the close proximity of the bacteria. From the results of this in vitro study it appears that carious destruction of exposed dentinal surfaces by S. mutans mainly occurs at the exposed dentin after it has been colonized by bacteria. Destruction of the deeper dentinal layers by bacteria invading the dentinal tubules may play a less important role. However, in the few cases where S. mutans invaded the dentinal tubules, rapid destruction of the peritubular dentin sheath occurred. In addition, the possibility remains that acid metabolites produced by S. mutans diffuse into the dentinal tubules and cause tissue damage in the deeper parts of the dentin.

Dental Caries↗

Transformation of naturally competent Streptococcus mutans with replicative and non-replicative Tn916-containing plasmids: implications for a mechanism of transposition.

Based on the observations reported here and what is known concerning transformation of naturally competent strains of S. mutans and other streptococcal species such as S. gordonii, we propose the model shown in Figure 2. The Tn916-intermediate transforms S. mutans as originally proposed for B. subtilis by Scott and coworkers [8]. It is not clear in either system (B. subtilis or S. mutans) whether the Tn916 intermediate enters the cell as ds-DNA or ss-DNA. Because it is likely that transformation of B. subtilis via formation of protoplasts involves a mechanism quite different from natural transformation in S. mutans, it would be unwise to extrapolate findings from their studies. If Tn916 enters S. mutans in a manner similar to plasmid or chromosomal DNA, we would assume that Tn916 binds to a cell receptor and as one strand enters, the other is degraded [9]. This leaves open the question of whether Tn916 recircularizes as ds-DNA before it inserts into the chromosome or whether it remains as ss-DNA, if, indeed, it enters as ss-DNA. The transformation efficiency for the Tn916 intermediate (approximately 10(-7) precluded kinetics studies such as those performed with pAM118. Poyart-Salmeron and coworkers [11] however, described a model in which Tn1545 inserts into the target site as a ds-DNA circular molecule, similar to that seen with lambda phage. Perhaps the most interesting finding presented here is that the predominant mechanism of insertion of Tn916 into the chromosome of the recipient occurs after Tn916 enters the cell. The replicative plasmid pAM118 evidently forms by two-hit kinetics followed by intracellular excision and transposition of Tn916. The helper-rescue experiment shows that in this system, the formation of Tcr transformants, and hence the integration of Tn916, was a function of the transformation efficacy of plasmid pAM118. Since intracellular excision of Tn916 probably follows the re-formation of the plasmid pAM118, the rate-limiting step in this system would be the formation of the transient, intracellular plasmid pAM118. (The transient white colony phenotype probably denotes the slower growth rate of transformants that acquire the large replicative plasmid pAM118). Our findings demonstrate that a practical way of promoting Tn916 insertions into chromosomal DNA for the purpose of obtaining mutations is to use a helper-rescue system. Our model supports the concept that the majority of Tn916 inserts arise from a mechanism similar to 'zygotic induction' as proposed for S. sanguis (gordonii) [1]. However, the frequencies for the co-establishment of the replicative plasmid (Emr) and Tn916 inserts (Tcr) in their paper (10(-6)) differ from our observations for S. mutans. We found nearly 100% of Tcr white colonies to be Emr whereas in S. gordonii, only a fraction (approximately 1%) exhibited the TcrEmr phenotype. If both phenotypes arose independently, the frequency of the TcrEmr phenotype would be 10(-8) rather than 10(-6) survivors/recipients as observed. It was surmised that both Tcr and Emr transformants arise dependently [1] where both the Tn916 intermediate and pAM118 contribute to the formation of Tn916 inserts. We conclude from their data, however, that most Tcr arose from the Tn916-intermediate formed in the donor, in agreement with the explanation of these data by Scott [12]. Support for the contention that the Tcr arose in S. gordonii from transformation by the Tn916-intermediate as in S. mutans (yellows), and not from intracellular excision from pAM118, comes from the observation that so few Tcr are Ems and because pAM150 (rep-) yields Tcr at the same frequency as the rep+ pAM118 in their experiments. In summary, the Tn916 intermediate is capable of transforming S. mutans. In contrast to the hypothesis of Scott [12], however, the Tn916 intermediate is not the only form involved in the transformat++t

Chromosomes, Bacterial↗

Mutans streptococci caries and chlorhexidine.

Mutans streptococci, particularly Streptococcus mutans and Streptococcus sobrinus, can be shown to be highly associated with caries in humans. Together with Lactobacillus spp., they are regarded as significant odontopathogens. Because of their association with dental disease, an evaluation of the numbers of Mutans streptococci organisms in plaque and saliva may aid in the diagnosis of caries activity. In conjunction with this concept, control and prevention of caries has been sought by reducing the numbers of bacteria colonizing an individual. Despite the associations between dental disease and Mutans streptococci, which can be demonstrated in groups of people, these methods have not been entirely successful. Because of the wide range of factors involved, counts are not very effective in diagnosing caries activity or risk in an individual. Nevertheless, counts may be used to establish a normal pattern of colonization for a patient, and deviation from this pattern will indicate a change in their oral status, which can be included as a parameter in diagnosis. Accurate and relatively simple commercial tests for counting mutans streptococci and lactobacilli are available. In patients with high caries activity and high counts of mutans streptococci, chlorhexidine may be employed as an adjunct to other preventive measures. Chlorhexidine delivered in a gel form has been shown to be effective in the control and prevention of caries. Combinations of chlorhexidine with fluoride may be even more effective. Sustained release devices, like varnishes, reduce the numbers of mutans streptococci in a patient's mouth to levels below detection for long periods, but their effectiveness in preventing and controlling caries has not yet been assessed. The decision to use microbiological methods to aid diagnosis, and chlorhexidine to reduce or eliminate mutans streptococci, rests with the practitioner. Although the microbiological tests for caries activity or prediction are not 100 per cent accurate, they can be useful in certain situations. In addition, chlorhexidine as an adjunct in control and prevention of caries has been shown to have value. This short review introduces readers to the literature, so that they will not dismiss microbiology, but make decisions on the use of microbiological methods based on their own experience and the experience of others.

Chlorhexidine↗

Role of sucrose in colonization of Streptococcus mutans in conventional Sprague-Dawley rats.

The role of sucrose in the colonization of S mutans strain 6715 in conventional Sprague-Dawley rats was studied. A diet with 56% sucrose favored the oral colonization of the test strain compared to diets with 56% glucose or fructose or to laboratory chow as determined by recoveries from extracted teeth ground in tissue grinders. S mutans strain 6715 cells became well established in all rats fed a high sucrose diet with cell inoculums ranging from 10(8) to the lowest effective dose of 10(5) CFU once orally administered; in rats on nonsucrose diets, inoculation with even the highest dose only infrequently resulted in the establishment of S mutans strain 6715. Sucrose- and glucose- grown cells appeared to behave similarly. Colonization of S mutans strain 6715 occurred in all rats fed diets with a sucrose content ranging from 56 to as low as 1%. The establishment of S mutans strain 6715 on the teeth of rats fed diets with a sucrose concentration of 0.1 or 0.01% was impaired and comparable to the diet containing 56% glucose. In rats fed a high glucose diet, uniform establishment and persistence of the test strain occurred after frequent inoculations with about 5 X 10(8) CFU. The colonization under these conditions appeared to be independent of the intestinal canal as a bacterial cell source. These data suggest the possibility that S mutans can establish itself in the human mouth in the absence of dietary sucrose. In rats fed a high glucose diet and inoculated with 10(7) CFU or less, the cells gradually disappeared from the teeth; in contrast, the test strain implanted well in rats fed the sucrose favors firmer attachment of initially weakly attached cells via in situ new glucan synthesis. S mutans strain 6715 also appeared to have some affinity for teeth in the absence of dietary sucrose that may be of ecological significance. Once firmly established in rats fed a high sucrose diet, S mutans strain 6715 maintained itself in high numbers on the teeth after a switch to a high glucose diet during a 14-week period.

Animals↗

Effect of a new variety of Apis mellifera propolis on mutans Streptococci.

The effects of a new variety of propolis, from Northeastern Brazil (BA), on growth of mutans streptococci, cell adherence, and water-insoluble glucan (WIG) synthesis were evaluated. Propolis from Southeastern (MG) and Southern (RS) Brazil were also tested as an extension of our previous work. Ethanolic extracts of propolis (EEP) were prepared and analyzed by reversed-phase HPLC. For the antibacterial activity assays, minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of EEPs against Streptococcus mutans, S. sobrinus, and S. cricetus were determined. Cell adherence of S. mutans and S. sobrinus to a glass surface was measured spectrophotometrically at 550 nm. WIG synthesized from sucrose by glucosyltransferase (Gtf) was extracted and quantified by the phenol-sulfuric method. The HPLC profile of the new variety of propolis was entirely different from Southeastern and Southern propolis. Neither flavonoid aglycones nor p-coumaric acid were detected in EEP BA. All EEPs demonstrated biological activities against mutans streptococci; EEP BA showed the highest potency in all in vitro parameters evaluated in this study. The ranges of MIC values were 50 (EEP BA)-400 microg/ml (MG), for S. mutans; and 25 (BA)-400 microg/ml (MG), for S. sobrinus and S. cricetus. The bactericidal concentration of EEPs was four to eight times the MIC values. The adherence of S. mutans and S. sobrinus cells and WIG synthesis were markedly inhibited by EEPs, demonstrating significant inhibition at all concentrations compared with the control (80% ethanol) (p<0.05). EEP BA showed 80% inhibition of cell adherence and WIG synthesis at concentrations as low as 12.5 and 7.8 microg/ml, respectively. The results show that the new variety of propolis was exceptionally effective in all in vitro parameters tested against mutans streptococci; biological effects of propolis are likely not to be due solely to flavonoids and (hydroxy)cinnamic acid derivatives.

Animals↗