Hospital acquired aspergillus keratitis.
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Biomedical subjects
Publications and source records attributed to B Burt.
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The decline in dental caries in children in North America, Scandinavia, Britain, Ireland and many Commonwealth nations is well documented. The multiple uses of fluoride can account for most, but not all, of this reduction. In this investigation, data are provided which suggest a relationship between antibiotic usage for medical purposes and a decline in both mutans streptococci (MS) and caries. Children attending Grades 1 and 2 in the Coldwater, Michigan school system and who reportedly never received antibiotics had significantly higher proportions of MS in the fissure plaques of first molars than subjects who received antibiotics. The level of decay in the primary dentition was inversely related to the reported usage of antibiotics. The frequent usage of antibiotics could reduce the incidence of dental caries by delaying the colonization of the teeth by the MS. This was evaluated by a prospective study in infants to determine what effect reported antibiotic usage would have on the colonization of newly erupting primary teeth. Only 2 of 10 infants cultured at 2 to 3 week intervals for periods up to 1 year after tooth eruption became colonized by the MS. One had never received antibiotics and the second had been on antibiotics for a single 5-day period. Seven of the 8 non-colonized infants had received antibiotic therapy for periods ranging from 10 to 181 days. Both the Coldwater study and the prospective study of infants suggested a relation between frequency of antibiotic usage for medical purposes and the MS levels on the teeth.
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In the present investigation, the proportions of Streptococcus mutans, lactobacilli, Streptococcus sanguis, veillonellae, and an unidentified actinomyces-like organism in dental plaque on occlusal fissures of first mandibular molars were monitored at 6-month intervals over a 3-year period in 368 children who were initially in grades 1 or 2. Teeth destined to become decayed exhibited a significant increase in the proportions of S. mutans from 6 to 24 months before the diagnosis of dental decay. Lactobacilli were sporadically detected but when present were associated with dental decay. Children whose teeth exhibited the greatest number of decayed surfaces had, at all time periods, significantly higher proportions of S. mutans than did children who were caries free. Many teeth had high proportions of S. mutans at their entry into the study. About 10% of the monitored teeth erupted during the period of observation, and in these teeth both S. mutans and lactobacilli could be significantly associated with decay. In these newly erupted teeth S. mutans outnumbered lactobacilli by ca. 20 to 1. S. sanguis, veillonellae, and the unidentified actinomyces-like organism could not be associated with the development of decay. These findings strongly implicate S. mutans and possibly lactobacilli as dental pathogens and suggest that if decay is to be controlled by strategies based upon a S. mutans infection, then the various tactics used probably will have to be performed on primary teeth, as these teeth are the most likely sources of infection for the permanent teeth.