Abstract
BackgroundThe ecological plaque hypothesis explains caries development as the result of the enrichment of acid tolerant bacteria in dental biofilms in response to prolonged periods of low pH. Acid production by an acid tolerant microflora causes demineralisation of tooth enamel and thus, individuals with a greater proportion of acid tolerant bacteria would be expected to be more prone to caries development. Biofilm acid tolerance could therefore be a possible biomarker for caries prediction. However, little is known about the stability of biofilm acid tolerance over time in vivo or the distribution throughout the oral cavity. Therefore the aim of this study was to assess intra-individual differences in biofilm acid-tolerance between different tooth surfaces and inter-individual variation as well as stability of acid tolerance over time.ResultsThe majority of the adolescents showed low scores for biofilm acid tolerance. In 14 of 20 individuals no differences were seen between the three tooth sites examined. In the remaining six, acid-tolerance at the premolar site differed from one of the other sites. At 51 of 60 tooth sites, acid-tolerance at baseline was unchanged after 1 month. However, acid tolerance values changed over a 1-year period in 50% of the individuals.ConclusionsBiofilm acid tolerance showed short-term stability and low variation between different sites in the same individual suggesting that the acid tolerance could be a promising biological biomarker candidate for caries prediction. Further evaluation is however needed and prospective clinical trials are called for to evaluate the diagnostic accuracy.
Highlights
The ecological plaque hypothesis explains caries development as the result of the enrichment of acid tolerant bacteria in dental biofilms in response to prolonged periods of low pH
The human oral cavity exhibits a high degree of bacterial diversity and more than 700 taxa have been identified in meta-genomic studies [2]
Biofilms on the teeth above the gingival margin are dominated by sacharolytic bacteria, which generate energy by breakdown of carbohydrates from salivary glycoproteins as well as ingested food, through the glycolytic pathway
Summary
The ecological plaque hypothesis explains caries development as the result of the enrichment of acid tolerant bacteria in dental biofilms in response to prolonged periods of low pH. Biofilm acid tolerance could be a possible biomarker for caries prediction. Little is known about the stability of biofilm acid tolerance over time in vivo or the distribution throughout the oral cavity. The aim of this study was to assess intra-individual differences in biofilm acid-tolerance between different tooth surfaces and inter-individual variation as well as stability of acid tolerance over time. Bacteria grow in complex multi-species biofilms on the hard and soft-oral tissue surfaces with saliva or gingival exudate as the major nutrient sources. Pyruvate conversion results in acidic end-products, including lactic acid, which can rapidly lower the pH in dental biofilms.
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