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Antimicrobial effect of a dental varnish, in vitro.

The effects of a polymer based antimicrobial releasing varnish Cervitec were investigated against different gram-positive and gram-negative bacterial strains as well as a yeast using the agar diffusion inhibitory test (ADT-test in vitro). As positive controls a 1% chlorhexidine gel and 1% aqueous solution of thymol and a placebo polymer varnish without active agents were employed. The test experimental varnish containing 1% chlorhexidine and 1% thymol showed antimicrobial activity against all gram-positive and gram-negative microorganisms tested including one Candida strain. The positive controls were similar in effect compared to the test varnish. No antimicrobial effect was observed with the placebo varnish without active ingredients. Toothpicks and dental floss treated with the test varnish showed an antimicrobial effect against S. mutans even after storing in room temperature up to 12 months. The results from this study support earlier laboratory studies that chlorhexidine and thymol diffuse out of the experimental varnish and that the varnish is active against various of oral pathogens. The possibility to use toothpicks or dental floss impregnated with the varnish with the aim to become chemotherapeutically active against periodontal diseases as well as against dental caries, is promising and should be tested in vivo.

Actinomyces viscosus↗

Anticaries efficacy of a new dentifrice for hypersensitivity.

PURPOSE: To evaluate the expected anticaries efficacy of a new dentifrice containing stannous fluoride as the anticaries agent and potassium nitrate as the antihypersensitivity agent using a series of laboratory and animal studies. METHODS: Four surrogate studies were performed in this assessment including fluoride uptake in sound enamel, enamel solubility reduction, fluoride bioavailability and animal caries. RESULTS: Each of these studies indicated the new dentifrice for hypersensitivity (Colgate Sensitive Maximum Strength) was effective in inhibiting the caries process. The data demonstrate that this new dentifrice is predicted to be highly effective against caries and equivalent to a positive control dentifrice.

Acid Etching, Dental↗

[Immunization with targeted fusion anticaries DNA vaccine via intramuscular route:experiment with murine].

OBJECTIVES: To observe the expression of a targeted fusion anticaries DNA vaccine pGJA-P in muscular in vivo. To compare the levels of specific antibodies and anticaries efficacy generated by pGJA-P and fusion anticaries DNA vaccine pGLUA-P in gnotobiotic rats, and observe the kinetics of antibody responses in BALB/c mice. METHODS: (1) Twelve 28-day-old female Wistar rats were randomly divided into 2 groups of 6 rats to be injected with the plasmid pGJA-P containing the signal peptide and extracellular regions of human CTLA(4), hinge and Fc regions of human IgG, the glu sequence of gtfB gene and A-P fragment of pac gene of Streptococcus mutans or the eukaryotic expression plasmid pCI into the quadriceps muscle of thigh respectively. Three days after the rats were killed and specimens of quadriceps muscles of thigh were taken. Immunohistochemical SP staining was used to examine the in situ expression of pGJA-P. (2) Twenty-four 18-day-old female Wistar rats were randomly divided into 4 groups of 6 rats. The rats were fed with cariogenic food. During the age of 20 - 22 days cariogentic food containing broad-spectrum antibiotics was fed. Then aseptic cotton stick was used to swab the oral cavity and be smeared onto the solid medium so as to observe the growth of bacteria under anaerobic culture for 48 hours. During the age of 24 - 26 days, S. mutans Ingbritt cultured anaerobically was swab onto the surface of teeth of the rats twice with an interval of 30 minutes. After the inoculation aseptic cotton stick was used to wipe the oral cavity and be smeared onto the solid medium so as to observe the growth of bacteria under anaerobic culture for 48 hours. When the gnotobiotic rats were 28 days old they were injected with pGJA-P, pGLUA-P, fusion anticaries DNA vaccine against both PAc, cell surface protein antigen, and glucosyltransferase (GTF), pCI or normal saline into the quadriceps muscle of thigh respectively, 2 weeks later a booster shot was given. When the rats were 63 days old their saliva and blood samples were collected. The serum IgG and salivary IgA were assayed by using ELISA. The gnotobiotic rats were killed and their maxillary bone the mandibles were isolated. The anticaries effect was evaluated by Keyes caries scores. (3) Twenty-four 4-week-old BALB/c mice were randomly divided into 4 groups of 6 mice: to be injected with pGJA-P, pGLUA-P, pCI, or normal saline respectively into the quadriceps muscles of thigh, 2 weeks later a booster shot was given. Before the injection and every 2 weeks after the immunization specimens of saliva and blood were collected. The serum IgG and salivary IgA were assayed by using ELISA. RESULTS: (1) Recombinant protein could be detected in the quadriceps muscles of the rats immunized with pGJA-P, but not in the muscles of the rats immunized with pCI. (2) The levels of serum anti-PAc IgG (1:200 000) and anti-GTF IgG (1:58 000) of the rats immunized with pGJA-P were significantly higher than those of the rats immunized with pGLUA-P (1:23 000 and 1:11 000 respectively) (both P < 0.01). The levels of salivary anti-PAc IgA (1:8) and anti-GTF IgA (1:6) of the rats immunized with pGJA-P were significantly higher than those of the rats immunized with pGLUA-P (1:2 and 1:2 respectively) (both P < 0.01). The Keyes scores of the pGJA-P group were significantly lower than those of the pGLUA-P group and the control groups (all P < 0.01). The effective serum IgG and salivary IgA in the pGJA-P group and effective serum IgG in the pGLUA-P group all persisted to the end of the experiment. (3) Two weeks after the initial immunization the serum anti-PAc IgG level of the mice immunized with pGJA-P increased remarkably, 4 times that of the mice immunized with pGLUA-P, and 33 times those of the mice injected with pCI or normal saline. Two weeks after the booster immunization, the serum anti-PAc IgG level of the mice immunized with pGJA-P was 14 times that of the mice immunized with pGLUA-P, and 117 times those of the mice injected with pCI or normal saline. The serum anti-PAc IgG immunized with pGJA-P reached its peak 10 weeks after the initial immunization, 4 times that of the mice immunized with pGLUA-P, and 160 times those of the mice injected with pCI or normal saline. The serum anti-PAc IgG of the mice immunized with pGLUA-P reached its peak at 16 weeks, however, significantly lower than the peak of the mice immunized with pGJA-P (P < 0.01). The serum anti-Pac IgG levels of the mice injected with pCI or with normal saline were not significantly different (P > 0.05). Since the second week after the initial immunization, significant difference in the serum anti-PAc IgG level could be seen between the mice immunized with pGJA-P or the mice immunized with pGLUA-P, and between the mice immunized with pGJA-P and the mice immunized with pGLUA-P and those injected with pCI or normal saline (all P < 0.01). Six weeks after the initial immunization the salivary anti-PAc IgA level of the mice immunized with pGJA-P was 18 times those of the mice injected with pCI or with normal saline (both P < 0.01), 10 weeks after the salivary anti-PAc IgA level of the mice immunized with pGJA-P reached its peak, 24 times those of the mice immunized with pCI or normal saline without a significant difference between the latter 2 groups (P > 0.05). No effective salivary IgA response was seen in the mice immunized with pGLUA-P. CONCLUSION: pGJA-P can be expressed in vivo. Immunization with pGJA-P intramuscularly induces effective mucosal and systematic humoral responses. It is an effective DNA vaccine against dental caries.

Animals↗

Clinical outcomes for Early Childhood Caries (ECC): the influence of salivary mutans streptococci levels.

AIM: To assess the relationship between clinical outcomes for children treated for Early Childhood Caries (ECC) and salivary mutans streptococci (MS) levels. STUDY DESIGN AND METHODS: The study cohort consisted of 79 children (42 males, 37 females) treated for ECC, aged from 2.3 to 7.3 years at time of entry. Whole non-stimulated saliva samples were obtained from each subject prior to dental surgery and at 6 mths post dental surgery, by saturating a cotton swab in the saliva pooled in the floor of the mouth. Samples were placed into PBS on ice and processed within 2 hours. Samples were sonicated, serially diluted and plated onto MSB and SBA agar plates, then incubated 48 hours anaerobically; SBA plates were incubated an additional 24 hours aerobically. The MS level in each sample was expressed as a percentage of the total cultivable flora. The cohort was evaluated for new caries lesions at 6 months post dental surgery. Relapse was defined as the presence of new smooth surface caries lesions. STATISTICS: Comparisons between Relapse (R) and Non-Relapse (NR) groups with respect to mutans streptococci levels were performed using Wilcoxon tests. Within group comparisons were performed using Wilcoxon signed-rank tests. RESULTS: 57 children (72%) returned for the 6 months examination and 21 of these subjects (37%) relapsed. No statistically significant difference in median salivary MS levels existed between the R (0.20%) and NR (0.033%) groups at baseline (p=0.647) or at 6 months post dental surgery (R=0.03%; NR=0.01%; p=0.273). A statistically significant difference between baseline and 6 months post dental surgery was noted in the median salivary MS level within the R group (p=0.0007) and within the NR group (P<0.0001). CONCLUSIONS: The relapse rate (37%) was high and rapid for children treated for ECC. Dental surgery resulted in a statistically significant reduction in salivary MS reservoirs for children treated for ECC. However, this did not translate into acceptable clinical outcomes.

Child↗

Cariogenic virulence characteristics of mutans streptococci isolated from caries-active and caries-free adults.

The objective of the study was to compare aciduricity (ability, to live in acid), acidogenicity (ability to produce acid), and intracellular polysaccharide production of mutans streptococci (MS) strains isolated from caries-active (CA, with one or more cavitated lesions) and caries-free (CF, with no clinically observable new caries in the last five years) adults. Forty-three MS strains from 17 of 17 CA adults, and 14 strains from eight of 12 CF adults were investigated. MS isolates' growth, survival, and pH reduction in pH 3.5-7.0 broths were evaluated to compare their acidogenicity and aciduricity. Extracellular water-soluble polysaccharide (WSP) and water-insoluble polysaccharide (WISP) was extracted from MS culture in BHI broth with 5 percent sucrose and assessed by a colorimetric anthrone-sulfuric acid microassay. No significant differences in mean aciduricity were found between CA and CF MS isolates (P>0.05, t test). However, significantly more CA subjects (29 percent) were colonized by MS strains with aciduricity above the average than CF subjects (13 percent, Fisher's exact test, P<0.05). Furthermore, CA MS strains produced significantly more acid at pH<5 (Mann-Whitney, P<0.05) and significantly more CA subjects were colonized with more acidogenic MS at pH<4.5 (Fisher's exact test, P<0.01). Similarly, CA MS isolates produced significantly more WISP than CF (Mann-Whitney test, P<0.01) while no statistical difference was found in WSP between the two groups. More CA subjects were colonized by multiple strains with aciduricity, acidogenicity, and polysaccharide synthesis ability above average. The study indicated that differences in acidogenicity, aciduricity, and polysaccharide synthesis in strains of MS may partially contribute to increased caries activity.

Acids↗

Mutans streptococci: acquisition and transmission.

Dental caries is an infectious and transmissible disease. The mutans streptococci (MS) are infectious agents most strongly associated with dental caries. Earlier studies demonstrated that infants acquire MS from their mothers and only after the eruption of primary teeth. More recent studies indicate that MS can colonize the mouths of predentate infants and that horizontal as well as vertical transmission does occur. The purpose of this paper was to demonstrate that these findings will likely facilitate the development of strategies to prevent or delay infant infection by these microbes, thereby reducing the prevalence of dental caries.

Child, Preschool↗

Xylitol, sweeteners, and dental caries.

The purpose of this report was to provide an overview of xylitol and other polyol sweeteners and dental caries for clinicians and to discuss current applications for dental practice and potential community-based public health interventions. Xylitol, like other polyol sweeteners, is a naturally occurring sugar alcohol. Studies suggest polyols are noncariogenic. Furthermore, studies indicate that xylitol can decrease mutans streptococci levels in plaque and saliva and can reduce dental caries in young children, mothers, and in children via their mothers. Food products containing xylitol are now available and have the potential to be widely accessible to consumers to help control rampant decay. Determining whether products contain adequate xylitol amounts for practical use towards prevention is challenging, however, because xylitol content is not clearly labeled. Sufficient evidence exists to support the use of xylitol to reduce caries. Clinicians and dental associations should push for clear recommendations of efficacious dose and frequency of xylitol use and for clear labeling of xylitol content in products to help consumers choose appropriately.

Cariostatic Agents↗

Dental caries: an infectious and transmissible disease.

By definition, dental caries is an infectious and transmissible disease because it is caused by bacteria colonizing the tooth surfaces. Unlike most infectious diseases affecting humans, caries is the result of an imbalance of the indigenous oral biota rather than a nonindigenous, exogenous pathogen. The introduction of refined sugar into modern society's diet has tipped the balance from health to disease. New insight into the natural history of the leading cariogenic bacteria, the mutans streptococci, may contribute ways to control or prevent this infectious disease. Here, we use the host-parasite model as a platform for viewing the pathogenicity of the caries process in contrast to other infectious diseases.

Age Factors↗

Transmission of mutans streptococci.

It has been shown that early establishment of mutans streptococci in the mouth of infants increases risk of caries. Extensive studies on the timing of infection, and on sources and routes of transmission of the organism have been performed. Results of many studies suggest that the source of mutans streptococci is the mother, especially her saliva. Methods used to attempt to verify this hypothesis have developed considerably in recent years. Recent research and work in progress using methods based on DNA analysis have increased and will extend knowledge about transmission. This review summarizes the results obtained by different methods of transmission of mutans streptococci. The final goal of studies is to accumulate adequate information for prevention strategies of mutans streptococcal infection.

Child, Preschool↗

The prevention of dental caries by BLIS-mediated inhibition of mutans streptococci.

Many of the strategies that have been formulated to decrease the incidence of dental caries have focused upon attempting to reduce either the numbers or the acidogenic activities in dental plaque of the mutans streptococci. In recent years there has been a growing interest in a new method of caries control which depends upon exploiting the ability of certain bacteria to produce antibiotics called bacteriocin-like inhibitory substances (BLIS) with killing activity for mutans streptococci. The approaches under investigation include either the regular oral administration of the purified BLIS or the genetic modification of existing plaque bacteria such that they produce the antimutans BLIS in situ.

Antibiosis↗

[Experimental study on the interaction of fibronectin with oral Streptococci].

Interaction of fibronectin (Fn) with Streptococcus mutans, S. sorbrinus, and S. milleri is demonstrated by an enzyme-linked immunosorbent assay (ELISA). The results show that the three strains are able to adhere to Fn. The interaction may be strengthened while the concentration of Fn increases (q test P < 0.01). The ability of adherence among S. mutans, S. sorbrinus and S. milleri is different in Fn high concentration (q test P < 0.01). It is speculated the free Fn in saliva may serve as an agglution for elimination of the organisms from the oral cavity, or as a receptor when immobilized on the tooth surface for cariogenic streptococci to form plaque. A balance between these two functions of Fn may play a role in modulating the microbial ecological environment of the oral cavity.

Animals↗

A longitudinal study of dental caries and cariogenic microflora in a group of young adults from Göteborg.

Caries and cariogenic microorganisms were assessed in a group of young adults over a 3-year period. A 30% random sample comprising 101 individuals aged 18-19 years was re-examined under conditions consistent with the baseline survey 3 years earlier. The means for DFS prevalence and increment were 8.9 and 2, respectively. Continuing polarization of the disease was observed, with mean DFS score reaching 19.9 in the upper 15% of the frequency distribution. Highest caries activity was observed approximally where the increment of manifest and incipient lesions averaged 1.3 and 1.6 surfaces, respectively, as compared to 0.5/0.6 occlusally and 0.2/0.5 bucco-lingually. While the occlusal component continued to dominate DF score with 5.7 surfaces, the prevalence of approximal lesions increased by 48%, averaging 2.7 surfaces. Frequency distribution showed a shift to the right and increasing skewness. The proportion without manifest lesions/restorations had declined by 3%. While only 6% of the dentin lesions/restorations were found in the lowest quartile, 15% of the individuals with highest caries levels accounted for 40% of the total DFS and 58% of the D component. Among the 88 subjects who were saliva sampled, salivary mutans streptococci were detected in 89.7% and lactobacilli in 83%. Forty-one percent of the 18-19-year-olds had high numbers of mutans streptococci (> 5 x 10(5) cfu per ml) as compared to 33% at the age of 15-16-years, while high numbers of lactobacilli (> 10(5) cfu per ml) were recovered in 21.8% as compared to 14.3%. The stability within each range of microorganisms varied depending on the baseline level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[The local immunity of the oral cavity in dental caries].

Functional activity of local immunity with regard to dental caries in children is liable to appreciable individual fluctuations which depend on sex, age, and season. In children aged 4 to 5 no association between the titer of antibodies to cariogenic Streptococcus and number of carious lesions was observed, whereas in those aged 9 to 19 these parameters were in inverse relationship. In children aged 11-12 and 14-16 this association is inverse. Regression analysis of nonspecific and specific characteristics of local immunity of the oral cavity in children aged under 12 suffering from caries revealed functional insufficiency of the mechanisms regulating the local immunity, which disappears after fluoroprophylaxis. Test system for screening of mutant Streptococcus cannot be recommended for wide use to detect subjects sensitive to caries, because it has certain limitations as regards the age of examinees.

Adolescent↗

[Expression of the PAC gene of S. mutans in S. lactis].

Expression of the pac gene in S. lactis were analyzed by dot immunoblotting with rabbit anti-PAc serum. The amount of PAc produced by S. lactis HL107 (pLF107) was measured. This result indicated that a small amount of rPAc was detected in the culture supernatant and cell homogenate of S. lactis HL107 (pLF107) but not in the control strain S. lactis LM0230. The amount of rPAc in S.lacits HL107 (pLF107) was six times lower than that in S. mutans Ingbritt. Expression of cloned pac gene in S. lactis was also confirmed in this result.

Bacterial Proteins↗

Synergistic inhibitory effect of cationic peptides and antimicrobial agents on the growth of oral streptococci.

Although chlorhexidine is one of the most efficacious antimicrobial agents used for the prevention of dental caries, side effects limit its application. The effects of gaegurin 6 (GGN6), an animal-derived cationic peptide, and its derivatives PTP6 and PTP12 on the growth of oral streptococci were investigated to assess the potential of these agents for use in the prevention of dental caries. The minimal inhibitory concentrations of the peptides for inhibition of the growth of oral streptococci (Streptococcus mutans , S. sobrinus, S. sanguis and S. gordonii) ranged from 1.2 to 8.2 muM. The peptides also exhibited marked synergistic antibacterial effects with chlorhexidine or xylitol. The most effective combinations (fractional inhibitory concentration index of 0.5) were xylitol with GGN6 against S. gordonii 10558 and chlorhexidine with either GGN6 or PTP6 against S. sobrinus OMZ-175. These results indicate that cationic peptides alone or in combination with chlorhexidine or xylitol might prove effective for the inhibition of the growth of cariogenic oral streptococci in situ.

Anti-Bacterial Agents↗