Chemical aids in the prevention of dental diseases in the elderly.
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Aged↗
Biomedical subjects
J Tenovuo
Publications and source records attributed to J Tenovuo.
Antimicrobial factors of saliva in relation to dental caries and salivary levels of mutans streptococci.
The possible association between salivary non-immunoglobulin (lysozyme, lactoferrin, hypothiocyanite, agglutinins) or immunoglobulin (total IgA, anti-Streptococcus mutans IgA) antimicrobial factors, and the prevalence of dental caries was studied in 59 young adults. These antimicrobial factors were also analysed in relation to the salivary levels of mutans streptococci (MS). The amount of MS correlated significantly (+0.31, p less than 0.05) with the number of initial caries lesions (Di) but not with other caries indices (DMFT, DMFS, DS). The group with no Di (N = 17) had significantly (p less than 0.05) more hypothiocyanite (HOSCN/OSCN-) and anti-S. mutans IgA antibodies in whole saliva than those with initial caries lesions (N = 42). None of the antimicrobial factors alone showed any significant association with salivary MS counts. Our results suggest that HOSCN/OSCN- and anti-S. mutans IgA may be involved in the prevention of the early phases of dental caries.
Adult↗
Sensitive immunometric assays for secretory peroxidase and myeloperoxidase in human saliva.
We have developed specific immunoassays for secretory peroxidase (SP) and for myeloperoxidase (MP) (polymorphonuclear leukocyte-derived peroxidase) in human saliva. Antibodies against SP and MP were produced using bovine milk lactoperoxidase (LP) and human MP as the immunogens, respectively. The methods developed are non-isotopic immunometric assays using biotinylated antibodies and avidin-enzyme conjugate. The detection limit was 0.1 ng/ml and the performance time less than 3 h for both assays. The determination ranges were 0.5-100 ng LP (SP)/ml and 0.5-200 ng MP/ml with intra- and interassay CVs of 4.3% and 15.6% for SP and 3.7% and 10.8% for MP, respectively. The mean analytical recoveries were 108.9% (SP) and 91.5% (MP). These assays correlated well (r = 0.849-0.871) with the colorimetric assays based on the oxidation of thiocyanate or chloride by peroxidases. However, compared to the colorimetric methods the new immunometric assays are much more sensitive and specific for salivary SP and MP. The assays are also more rapid since extensive dialysis to remove endogenous thiocyanate is not required.
Adult↗
Inhibition of the growth of Streptococcus mutans, Streptococcus sobrinus and Lactobacillus casei by oral peroxidase systems in human saliva.
Streptococcus mutans, Strep. sobrinus and Lactobacillus casei were grown in glucose-supplemented, sterilized, human whole saliva, adjusted to pH 5, 6 or 7. Components of the antibacterial peroxidase system--hypothiocyanous acid (HOSCN) and hypothiocyanite ions (OSCN-)--were generated by adding exogenous H2O2 to sterilized saliva containing endogenous peroxidases and thiocyanate (SCN-) ions. HOSCN/OSCN- generation was proportional to the amount of H2O2 added, and more HOSCN/OSCN- was detected in saliva at pH 7 than at pH 5. However, the growth of mutans streptococci and L. casei was inhibited at pH 5 by HOSCN/OSCN-, whereas no inhibition was found at pH 7. The findings show that (a) sufficient amount of HOSCN/OSCN- will inhibit the growth of cariogenic bacteria in human saliva at pH 5; (b) this amount of HOSCN/OSCN- can be generated in saliva by exogenously added H2O2; and (c) peroxidase systems have stronger antistreptococcal effects in human whole saliva than in phosphate buffer.
Anti-Bacterial Agents↗
Effects of low-dose oral contraceptives on female whole saliva.
The composition and flow rate of paraffin-stimulated whole saliva were analysed in 22 women, of whom 11 used oral contraceptives and 11 did not. Ten men served as the controls. The salivary samples were collected during one month (oral contraceptive users and men), or during one menstrual cycle (non-users). The saliva analyses included flow rate, pH, buffer effect, sialic acid, thiocyanate, peroxidase, lysozyme, amylase, immunoglobulins A, G and M, total protein, mutans streptococci, lactobacilli, yeasts and total numbers of aerobic bacteria. The salivary buffer effect of oral contraceptive users was significantly (p less than 0.005) higher than that of non-users. All the other constituents showed intra- and interindividual variation in all groups, but with no apparent hormone-dependency.
Adult↗
Metabolism of 17 beta-estradiol by oral Streptococcus mutans, Streptococcus sanguis, Bacillus cereus and Candida albicans.
The ability of oral isolates of Streptococcus mutans, Streptococcus sanguis, Bacillus cereus and Candida albicans to metabolize 17 beta-estradiol was analyzed by thin-layer chromatography using 4-14C-estradiol as the substrate. All test microorganisms metabolized 17 beta-estradiol. Estrone was the main metabolic product, except for B. cereus, which converted 17 beta-estradiol mainly to unidentified, more polar metabolites. S. sanguis and B. cereus had the most active metabolism but S. mutans and C. albicans were also active.
Bacillus cereus↗
Comparative antibacterial effects of chlorhexidine and stannous fluoride-amine fluoride containing dental gels against salivary mutans streptococci.
Forty-five young adults were divided into three groups of equal size and given a professional toothcleaning (3 times during 1 wk) with dental gels containing either chlorhexidine (CHX, 1%), or a SnF2-amine fluoride (AmF) combination (F- content 1.20%). The control group received toothcleaning with a placebo gel. The study was done double blind. The number of salivary mutans streptococci was monitored for 11 wk after the gel treatment using both mitis-salivarius-bacitracin agar plates and the chairside method based on the adhesion of mutans streptococci on plastic strips (Dentocult-SM Strip mutans). Professional toothcleaning with a CHX gel was clearly most effective (P less than 0.001) but the baseline levels of streptococci returned in 11 wk. SnF2-AmF gel also reduced significantly (P less than 0.001) mutans streptococci but recolonization occurred already in 7 wk. Placebo gel, i.e. professional toothcleaning as such, did not show any statistically significant effect on the numbers of salivary mutans streptococci. None of the treatments affected the levels of lactobacilli or the total aerobic flora in saliva samples. Professional toothcleaning with a CHX gel, or with a SnF2-AmF gel, can be regarded as an alternative to the commonly used, but more patience demanding, application of gel in mouth trays at home for individuals with high caries activity.
Adult↗
Combined inhibitory effect of lactoferrin and lactoperoxidase system on the viability of Streptococcus mutans, serotype c.
We have studied the effects of iron-free lactoferrin (apo LF) and lactoperoxidase system (lactoperoxidase, LP/SCN-/H2O2), separately and together, on the viability of Streptococcus mutans (serotype c) in vitro. The bacteria were incubated in buffered KCl (pH 5.5) with and without the above components which were used at concentrations normally present in human saliva. Both apo LF and LP-system had a bactericidal effect against S. mutans at low pH. Together they showed an additive, but not a synergistic, antibacterial effect against S. mutans. Apo LF enhanced the LP enzyme activity but decreased the yield of the antimicrobial component, hypothiocyanite (HOSCN/OSCN-), when incorporated into the reaction mixtures. This decrease, which was most pronounced at low pH, was due to an LP-independent reaction between apo LF and HOSCN/OSCN-. Our study indicates that the LP-system and apo LF can be combined to combat oral S. mutans.
Anti-Bacterial Agents↗
Long-term xylitol consumption and mutans streptococci in plaque and saliva.
The effect of 4 to 6 years of habitual use of xylitol gum (greater than or equal to 2 times per day) on the viable counts of mutans streptococci in both plaque and saliva was evaluated in a cross-sectional study of participants of the Ylivieska xylitol study (Finland, 1982-1984). Paraffin-stimulated saliva was collected first, whereafter the remaining plaque was collected from all available tooth surfaces and pooled. The habitual xylitol consumers (n = 15) had less plaque than the controls (n = 21). The total viable counts of mutans streptococci in the plaque collected from the habitual xylitol users were about 10% of those determined in controls (p less than 0.01). The salivary mutans streptococci levels were relatively high in both habitual xylitol consumers and controls, as determined using a plate count and with an adhesion-based assay; no significant differences were detected between these groups. Thus, habitual xylitol consumption appeared not to be associated with a reduction in the total numbers of mutans streptococci in saliva. The plaque and the mutans streptococci were, however, more loosely bound to the tooth surfaces of the habitual xylitol users. The results of the plate count and the adhesion-based assay for salivary mutans streptococci were in good agreement for both habitual xylitol consumers and the controls. This suggests that it was the accumulation of plaque rather than the adhesiveness of mutans streptococci that was affected by the habitual consumption of xylitol.
Adolescent↗
Dental caries and mutans streptococci in the proximal areas of molars affected by the habitual use of xylitol chewing gum.
The relationship between the caries status and the microbiological status [mutans streptococci (MS)] in the proximal areas of lower right and upper left molars was investigated in subjects of the Ylivieska xylitol study in Finland (1982-1985) in a cross-sectional follow-up in 1988. Those children who had used xylitol chewing gum regularly since 1982 showed significantly lower caries indices in 1988, including the proximal caries scores. The presence of MS (expressed in log10 colony-forming units) in the proximal areas studied was significantly lower in habitual xylitol consumers. Carious interproximal areas of all subjects had significantly higher total levels of MS than clinically and radiographically sound interproximal areas. The present study supports the idea of a close association between MS and dental caries, and shows that the total level of MS in the human dentition can be influenced by xylitol. It is likely that the long-term (between 1982 and 1988) habitual xylitol consumption had decreased the prevalence of MS in the interproximal areas of the present subjects and, subsequently, decreased the proximal and overall caries indices.
Chewing Gum↗
Effects of lysozyme-thiocyanate combinations on the viability and lactic acid production of Streptococcus mutans and Streptococcus rattus.
Effects of human lysozyme (HLZ) combined with thiocyanate (SCN-) ions on mutans streptococci, both in physiologic salivary concentrations, were studied. The bacteria were incubated for 75 min either in HLZ-supplemented sterilized human whole saliva (pH 5 and 7) or in neutral buffer in the presence or absence of HLZ (30 mg/l)-SCN- (1-5 mM) combinations. HLZ had no inhibitory effect on the viability of Streptococcus mutans, serotype c, either in saliva or in buffer, not even at pH 5, in the presence of salivary bicarbonate or in higher (up to 240 mg/l) concentrations of HLZ. In contrast, HLZ significantly decreased the viability of S. rattus in both media. HLZ also effectively blocked the lactic acid production of S. rattus but not that of S. mutans. Thiocyanate ions, which have been proposed to enhance the antimicrobial activity of lysozyme, did not affect the antibacterial activity of HLZ or HLZ-HCO3- combinations. It is concluded that the in vivo levels of SCN- ions, which constitute an integral part of the peroxidase antimicrobial system in saliva, may not be high enough to trigger the lysis of S. mutans by lysozyme in human saliva. The very low prevalence of S. rattus compared with S. mutans in human populations may be associated with their different susceptibility to lysozyme-mediated inhibition in saliva.
Buffers↗
Antibody responses to mutans streptococci in children.
Because mutans streptococci (Streptococcus mutans, S. sobrinus) are considered the main causative bacteria in human dental caries, immune responses to these bacteria have aroused much research interest over the last two decades. Studies in man have focused mainly on salivary and serum antibodies developing naturally in response to oral colonization by mutans streptococci, or in relation to the development of dental caries. Although both salivary (IgA) and serum-derived (IgG) antibodies have been shown in many studies to protect against the adherence of and to interfere with the metabolism of mutans streptococci, no conclusive evidence relating to their clinical significance is available. In young children, serum IgG antibodies to S. mutans seem more important than salivary IgA antibodies in relation to protection against dental caries. In studies in animals and, recently, in man, monoclonal IgG antibodies to S. mutans protein antigen I/II ("adhesin") have provided effective protection against mutans streptococci. Whether they could also prevent dental caries in man is not yet known.
Antibodies, Bacterial↗
Salivary lysozyme, lactoferrin and peroxidases: antibacterial effects on cariogenic bacteria and clinical applications in preventive dentistry.
Many antimicrobial agents in human saliva are known to have bacteriostatic or bactericidal effects on cariogenic bacteria, in particular against Streptococcus mutans. Studies have usually been conducted with purified agents (proteins) in vitro. Very little proof exists to show that they also affect oral cariogenic flora in vivo. Recent studies have shown that some salivary systems can act synergistically against Streptococcus mutans. Such synergistic antibacterial activity is likely to exist in the human mouth. Attempts to enhance the anticariogenic properties of saliva have been made by adding antimicrobial proteins such as peroxidase, lactoferrin and lysozyme to oral health products. Although clinical evidence is still limited, the idea of using such antimicrobial agents--"natural antibiotics"--rather than synthetic agents against cariogenic bacteria seems promising.
Dental Caries↗
Patients with locally and generally reduced host defence.
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Humans↗
Maternal caries incidence and salivary close-contacts with children affect antibody levels to Streptococcus mutans in children.
Serum and salivary immunoglobulins and antibodies reactive with Streptococcus mutans were determined in 67 5-8-year-old children. The children of mothers whose caries incidence rates exceeded the median value had significantly more serum IgG antibodies to S. mutans than those with a lower maternal caries activity (p less than 0.05). The children (n = 14) who had been exposed to frequent maternal salivary close-contacts in their first year had significantly higher (p less than 0.05) serum total specific IgG antibodies but significantly lower (p less than 0.01) high-avidity IgG antibodies to S. mutans than the other children (n = 53) with less frequent close-contacts. The maternal caries incidence rates were significantly positively associated with children's dfs/DFS-indices (r = 0.41; p less than 0.001). However, the high maternal caries incidence did not increase the risk of caries in those children whose mothers' saliva contained high amounts of lactobacilli during the first nursing year, when compared with matched children with a low maternal level of lactobacilli. This was possibly due to the fact that the former children had significantly (p less than 0.05) more anti-S. mutans IgG antibodies in their sera than the latter.
Adult↗
Antibacterial activity of dental gels containing combinations of amine fluoride, stannous fluoride, and chlorhexidine against cariogenic bacteria.
The in vitro susceptibility of Streptococcus mutans, S. sobrinus and Lactobacillus casei to dental gels containing various combinations of amine fluoride (AmF 297), stannous fluoride (SnF2), and chlorhexidine (CHX) was studied. The combination of AmF-SnF2 with a total fluoride content of 1.2% was the most effective against mutans streptococci but not against L. casei. At notably lower total fluoride concentration (0.4%), AmF as such or combined with SnF2, was significantly less effective against mutans streptococci than CHX or CHX-AmF-SnF2 combinations. CHX-AmF combination was a slightly more potent inhibitor of streptococcal growth than CHX-NaF. With L. casei the differences between various gels were small but CHX alone seemed to be the most effective. Of the studied agents, CHX seemed to be the most potent individual chemotherapeutic compound whose activity against S. mutans could be enhanced by combining it with AmF. However, clinical experiments are required to test the in vivo antibacterial efficacy of CHX-AmF and AmF-SnF2 combinations which were most effective in our in vitro experiments.
Amino Alcohols↗
Caries development in children in relation to the presence of mutans streptococci in dental plaque and of serum antibodies against whole cells and protein antigen I/II of Streptococcus mutans.
Twenty-eight children, aged 0.8-3.8 years, were studied with respect to the presence of mutans streptococci (MS) in dental plaque and the amount and avidity of specific serum IgG and IgM antibodies against whole cells and streptococcal protein antigen I/II (SA I/II) of Streptococcus mutans. The presence or absence of MS in dental plaque at the median age of 1.9 years predicted the caries development during a 2.7-year follow-up period with a sensitivity and specificity of 73 and 92%, respectively. The caries predictive value of a positive finding of MS at this age was as high as 92%. Almost all children had detectable amounts of serum IgG and IgM antibodies against whole cells and SA I/II of S. mutans, irrespective of the presence of detectable levels of this bacterium in dental plaque. These antibodies increased with age. The antibody levels did not differ significantly between children who were MS-negative or MS-positive. However, in MS-free children as well as in the whole study group, total specific and high-avidity antibodies of IgG class against whole cells correlated positively with antibodies against SA I/II. In MS-infected children such an association was observed for IgM but not for IgG antibodies. This different serum antibody profile in MS-negative and -positive children may be related to the mode of immunization with S. mutans.
Analysis of Variance↗