High Mutans Streptococci Counts Research Articles

Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment.

This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth. The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal-Wallis/Mann-Whitney U tests for clinical analysis and microbiological evaluations (p < 0.05). The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts. A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations. Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment. da Silva ME, de Sena MD, Colombo NH, et al. Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment. Int J Clin Pediatr Dent 2023;16(S-1):S27-S32.

Relationship between the IgA antibody response against Streptococcus mutans GbpB and severity of dental caries in childhood

ObjectiveExplore the associations between the severity of dental caries in childhood, mutans streptococci (MS) levels and IgA antibody response against Streptococcus mutans GbpB. Moreover, other caries-related etiological factors were also investigated. Design36–60 month-old children were grouped into Caries-Free (CF, n=19), Early Childhood Caries (ECC, n=17) and Severe Early Childhood Caries (S-ECC, n=21). Data from socio-economic-cultural status, oral hygiene habits and dietary patterns were obtained from a questionnaire and a food-frequency diary filled out by parents. Saliva was collected from children for microbiological analysis and detection of salivary IgA antibody reactive with S. mutans GbpB in western blot. ResultsS-ECC children had reduced family income compared to those with ECC and CF. There was difference between CF and caries groups (ECC and S-ECC) in MS counts. Positive correlations between salivary IgA antibody response against GbpB and MS counts were found when the entire population was evaluated. When children with high MS counts were compared, S-ECC group showed significantly lower IgA antibody levels to GbpB compared to CF group. This finding was not observed for the ECC group. ConclusionsThis study suggests that children with S-ECC have reduced salivary IgA immune responses to S. mutans GbpB, potentially compromising their ability to modify MS infection and its cariogenic potential. Furthermore, a reduced family income and high levels of MS were also associated with S-ECC.

The effect of a chlorhexidine-fluoride varnish on mutans streptococci counts and laser fluorescence readings in occlusal fissures of permanent teeth: A split-mouth study.

To evaluate the effect of a new chlorhexidine-fluoride varnish on mutans streptococci (MS) counts and laser fluorescence (LF) readings in fissures of permanent molars. The study group consisted of 57 healthy schoolchildren (7 to 14 yrs) that volunteered after informed consent. A double-blind split-mouth design was employed and 87 pairs of non-cavitated permanent molars were randomly assigned to treatments with either chlorhexidine-fluoride varnish (CHX-F) or chlorhexidine-thymol varnish (CHX-T, Cervitec Plus) as active control. The varnishes were topically applied at baseline and every sixth week throughout the 24-week study period. Endpoints were MS counts (CRT test) and occlusal LF readings (DIAGNOdent pen) registered regularly during follow-up. At baseline, > 50% of the occlusal fissures harbored high MS counts (≥ 105 CFU), but a significant decrease (P < .05) was found after treatment with both varnishes. After 24 weeks, less than 5% exhibited high counts. There were no significant differences between the varnishes at any time point. The mean LF values were similar in both treatment groups at baseline, but a significant reduction (P < .05) was scored in the CHX-F group after 12 and 24 weeks. A similar reduction was found also in the CHX-T group after 24 weeks. No adverse events were reported. There were no significant differences between the CHX-F and CHX-T varnishes in terms of MS suppression after four applications over 24 weeks. Both varnishes also reduced the LF readings significantly compared with baseline, but further long-term studies are needed to confirm a caries-preventive effect.

BMI, eating habits and sleep in relation to salivary counts of mutans streptococci in children - the IDEFICS Sweden study.

The objective of the present study was to investigate the association between salivary counts of mutans streptococci (MS) and children's weight status, while considering associated covariates. MS ferments carbohydrates from the diet and contributes to caries by lowering the pH in dental plaque. In adults, high counts of MS in saliva have been associated with overweight, but this has not been shown in children. Cross-sectional study investigating salivary counts of MS, BMI Z-score, waist circumference, meal frequency, sugar propensity and sleep duration, in children. West Sweden. Children (n 271) aged 4-11 years. Medium-high counts of MS were positively associated with higher BMI Z-score (OR=1·6; 95% CI 1·1, 2·3). Positive associations were also found between medium-high counts of MS and more frequent meals per day (OR=1·5; 95% CI 1·1, 2·2), greater percentage of sugar-rich foods consumed (OR=1·1; 95% CI 1·0, 1·3) and female sex (OR=2·4; 95% CI 1·1, 5·4). A negative association was found between medium-high counts of MS and longer sleep duration (OR=0·5; 95% CI 0·3, 1·0). BMI Z-score was associated with counts of MS. Promoting adequate sleep duration and limiting the intake frequency of sugar-rich foods and beverages could provide multiple benefits in public health interventions aimed at reducing dental caries and childhood overweight.

Lactobacillus reuteri Influences Regrowth of Mutans Streptococci after Full-Mouth Disinfection: A Double-Blind, Randomised Controlled Trial

This study assessed whether the persistence of Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 in saliva could delay the regrowth of mutans streptococci (MS) after a full-mouth disinfection with chlorhexidine (CHX). A randomised, double-blind, placebo-controlled study with a 6-week intervention period and 3- and 6-month follow-up was performed. 62 healthy subjects with moderate to high counts of MS were randomly assigned to a test group (n = 32) or a placebo group (n = 30). Before onset of the intervention, subjects received two sessions of professional cleaning, flossing, and application of CHX varnish and rinsed their mouth with a CHX solution between the sessions (2 days). Thereafter, the test group used probiotic lozenges (2/day) containing L. reuteri (DSM 17938 and ATCC PTA 5289; 1 × 10⁸ CFU of each strain), and the placebo group used identical lozenges lacking the lactobacilli. Saliva samples were collected and cultured onto selective media, and isolates of L. reuteri as well as DNA directly extracted from saliva were tested by polymerase chain reaction (PCR) with specific primers. Presence of salivary MS was analysed with a chair-side test. L. reuteri was frequently detected by culture during the intervention period but in only 3 test group subjects at follow-ups. Regrowth of MS statistically significantly differed depending on the presence or absence of L. reuteri DSM 17938 detected by PCR. We conclude that cultivable L. reuteri strains may only sporadically be confirmed after termination of the intervention, but subjects with PCR-detected L. reuteri demonstrated slower regrowth of MS.

Correlating dental caries with oral bacteria and the buffering capacity of saliva in children in Madinah, Saudi Arabia

Introduction:Caries is associated with high counts of mutans streptococci (MS), lactobacillus (LB), and a low saliva buffering capacity (BC). No study using odds ratios (OR) has correlated caries and these factors and no similar study has been done in Saudi Arabia before. Objectives: To determine: The prevalence of caries, the number of colony forming units (CFUs) of MS and LB, the saliva buffering capacity (BC) and the relationship between these factors.Materials and Methods:This was an analytical cross sectional study on children from Madinah. Caries was recorded using dmft/DMFT (decayed, missing, filled teeth). The scores for MS and LB and the BC of saliva was calculated using the Caries Risk Test (CRT)®.Results:A total of 316 students were examined; two-thirds (62%) were female and 25% were caries free. Saliva was collected from 235 participants and the majority had high MS and LB scores (66 and 71%, respectively) while 25% had a low saliva BC. The odds for those who had high LB and MS CFUs, were 9 and 4 times more at risk to developing dental caries and those with a low BC had significantly more caries (P = 0.03). The likelihood for those having severe caries and high counts of LB and MS was 25 (P < 0.01) and 6 (P = 0.042) times greater, respectively, compared to those with no or mild caries. Those with multiple risk factors were more likely to have caries compared to those with single or no risk factors present.Conclusions:The prevalence of caries was relatively high and many respondents had greater than 105 CFUs/ml of MS and LB. Almost all with a low BC had severe caries. There was a strong correlation between high MS, high LB, and low BC and the high prevalence of caries; hence the combination of these factors could be confidently used to predict caries in this population.

Bifidobacteriumanimalis subsp. lactis BB-12 Administration in Early Childhood: A Randomized Clinical Trial of Effects on Oral Colonization by Mutans Streptococci and the Probiotic

A randomized clinical trial studied the effects of early ad-ministration of Bifidobacterium animalis subsp. lactis BB-12 (BB-12) on oral colonization of (1) mutans streptococci (MS), and (2) BB-12. In this double-blind, placebo-controlled study, infants (n = 106) received probiotic bacteria (BB-12 group), xylitol (X group), or sorbitol (S group). Test tablets were administered twice a day (from the age of 1-2 months) with a novel slow-release pacifier or a spoon (daily dose of BB-12 10¹⁰ CFU, polyol 200-600 mg). Samples were collected from mucosa/teeth at the age of 8 months and 2 years for BB- 12 determination (qPCR) and plate culturing of MS (MSB, TYCSB), lactobacilli (Rogosa) and yeasts (Sabouraud). The MS levels of the mothers were determined (Dentocult SM Strip Mutans). The baseline characteristics of the three groups were similar. Mean duration of tablet delivery was 14.9 ± 6.7 months. In all groups, >90% of the mothers showed high MS counts (log CFU ≧5). MS colonization percentages of the children at the age of 2 years were rather low (BB-12 group: 6%; X group: 31%; S group: 10%; p < 0.05). The levels of lactobacilli and yeasts did not differ between the groups. BB-12 cell counts barely exceeding the detection limit were found in three of the oral samples of the 8-month-old children; however, the 2-year samples did not contain BB-12. The early administration of BB-12 did not result in permanent oral colonization of this probiotic or significantly affect MS colonization in the children.

Early childhood caries in children aged 6-19 months.

To investigate the relationship between socioeconomic factors, behaviors and the severity of early childhood caries (ECC) in 6-19 month-old Thai children. The severity of ECC was estimated using the proportion of ECC teeth to erupted teeth. This was termed the 'Intensity of ECC' (I-ECC) index. Cross-sectional questionnaire survey, dental examinations, and mutans streptococci counts were obtained from children and mothers/caregivers who participated in the ECC prevention program. The 520 children from rural areas were categorized into four age groups by the mean number of erupted teeth. In the 15-19-month-old children, the prevalence of ECC was 82.8% (cavitated caries, 40.8%; noncavitated caries, 42.0%) with a mean ECC teeth score of 4.18 +/- 3.19. The mean I-ECC severity score was 0.45 +/- 0.30 in these toddlers. Children from low-income families, those with low education, and mothers/caregivers with decayed teeth had higher I-ECC scores (P < 0.05). Children who were breast fed or had high counts of mutans streptococci also had higher I-ECC scores (P < 0.05). The logistic regression model revealed that only children's mutans streptococci level was a statistically significant predictor of ECC, with an odds ratio = 4.5 (95% CI = 1.8, 11.7). ECC is not only a public health problem but also a social problem in Thailand, because it relates to family income and education level. The community development approach to assisting disadvantaged Thai children should be combined with an effective preventive program at a very young age. Future longitudinal research should be performed to improve the I-ECC for measuring the severity of ECC.

Oral status of 35 subjects with eating disorders--a 1-year study.

The aim was to record changes over time in the oral status of subjects with diagnosed eating disorders. The outpatient psychiatrist had referred to the hospital dental clinic 35 women (19–47 yr, median 27 yr) with eating disorders, diagnosed according to DSM III‐R criteria. At the baseline examination, dental, medical and dietary histories were taken, and intra‐oral clinical and radiographic examinations were supplemented by intra‐oral photographs, study casts and salivary analysis. The subjects were re‐examined 1 yr later. Together, the investigators assessed progression of tooth wear blindly by comparing coded study casts from the baseline and 12‐month examinations. Progression of erosive tooth wear was recorded in almost half of the subjects. Several subjects had low unstimulated salivary flow rates (&lt;0.1 ml/min) and very high counts of mutans streptococci and lactobacilli, both at baseline and 1 yr later. The flow rates for paraffin‐stimulated saliva at baseline were significantly lower for subjects with progression of erosive tooth wear than for those without. Because of the increased susceptibility to both caries and erosion, patients with eating disorders should be encouraged to have regular dental check‐ups. Test of salivary flow may serve as an indicator of patients' risk of progression of erosive tooth wear.

Factors associated with caries incidence in an elderly population.

The purpose of this paper was to identify baseline factors associated with future caries development in older adults (age 60+) during a 3-year study period. Poisson regression analysis was used to determine the association between potential risk factors and disease incidence. The significant factors associated with high coronal caries incidence rates were high baseline root DMFS (P<0.001), high counts of mutans streptococci and lactobacilli (P=0.036), male gender (P=0.007), and Asian ethnicity (P=0.002). These factors had small to moderate effects on incidence rates, with relative risk values of approximately 1.2 to 2. The significant factors associated with higher disease incidence on root surfaces were baseline coronal DMFS (marginally significant, P=0.078), high bacterial counts (P=0.002), and Asian ethnicity (P=0.009). The predictive value of the models was low for both coronal and root caries. This result may be because this population had a higher than usual caries incidence rate, making discrimination among these caries-active individuals difficult. The current study affirmed the value of baseline DMFS and salivary variables to modeling caries incidence and introduced ethnicity as a variable useful for the study of dental caries in older adults.

Colonization by mutans streptococci in the mouths of 3- and 4-year-old Chinese children with or without enamel hypoplasia

This case-control study compared the prevalence and concentration of mutans streptococci (MS) in saliva between children with and without enamel hypoplasia (EHP). A total of 486 3- or 4-year-old Chinese children were initially screened for EHP, then distributed into two groups: 234 children diagnosed as having EHP were assigned to the case group; 252 who were free of EHP were included in the control group. The concentration of MS in saliva was assayed for each child. Nutritional status was deduced from body height and weight. Birth weight, prematurity, and nursing history were also determined. MS were found in 94.7% of the study population. The differences in MS concentrations were not associated with low birth weight, prematurity, length of breast feeding, or body height and weight. A statistically significant association existed between the presence of EHP and high counts of MS ( p < 0.001). High MS counts were correlated with severity of enamel defects ( p < 0.001). When the caries status of the children was controlled as the confounding factor in statistical analyses, the association between EHP and MS decreased but still remained significant ( p = 0.025). This study shows that high MS counts are correlated with EHP, suggesting that irregularities in enamel surfaces could be a contributing factor that fosters the increased colonization of MS in the mouths of children.

Mutans streptococci and lactobacilli in the elderly

The prevalence of salivary mutans streptococci and lactobacilli, salivary flow rate, and the type of dentition were studied in connection with a medical survey of 76-, 81-, and 86-yr-old inhabitants of Helsinki living at home. High bacterial counts were associated with low salivary flow rates. High counts of mutans streptococci (> 10(6) CFU/ml) were found in 68% of wearers of full dentures, as compared with 53% of subjects having natural teeth. High counts of lactobacilli (< 10(6) CFU/ml) were found in 44% of subjects having removable partial dentures and in 39% of subjects having natural teeth. The bacterial counts correlated neither with medicines taken daily nor with diseases among this population.

Caries and saliva in 12–18‐year‐old diabetics and controls

Eighty-five 12-18-yr-old adolescents suffering from insulin-dependent diabetes mellitus (IDDM) and their healthy age- and sex-matched controls were investigated with respect to dental caries, salivary flow rate, pH and buffering capacity of saliva, counts for lactobacilli and mutans streptococci, and salivary glucose content. The diabetics had their disease well controlled according to the HbA1 levels. The results showed no statistically significant difference between diabetics and controls in DMF and DMFS indexes and the number of initial caries lesions. Mean number of initial caries lesions was 3.2 in diabetics, 2.3 in controls. Mean stimulated salivary flow rate was 1.2 ml/min in the patients, 1.4 ml/min in the controls. The pH and buffering capacity values were 7.3 and 4.8 in the patients, 7.4 and 5.1 in the controls, respectively. High counts of mutans streptococci (> 10(6) CFU/ml) and lactobacilli (> 10(5) CFU/ml) were observed more often, but not significantly so, among the patients than in the controls. The mean concentration of glucose in saliva was 10.3 micrograms/ml in the patients, 9.7 1 microgram/ml in the controls. Thus, if the patients' IDDM is well controlled, their salivary and caries data does not differ from that of healthy controls.

Effect of Extraction of Partly Erupted Third Molars on Salivary Microbial Counts in Conscripts

Viable counts of mutans streptococci, lactobacilli and yeasts in saliva were followed for 5 months after extraction of partly erupted third molars in 49 conscripts aged 19.9 +/- 0.8 years. For controls, 27 conscripts aged 19.7 +/- 1.2 years were studied who did not have indications for third molar extractions. The microbiological analyses were made from paraffin-wax-stimulated saliva using dip-slide techniques. The results showed a statistically significant reduction of the high counts of mutans streptococci (greater than or equal to 10(6) CFU/ml saliva) and lactobacilli (greater than or equal to 10(5) CFU/ml saliva), both 2 and 5 months after extraction, when compared with the baseline values and with the controls. The extraction of partly erupted third molars did not appear to affect salivary yeast counts. We suggest that partly erupted wisdom teeth act as reservoirs for mutans streptococci and lactobacilli, in particular, and that their state of eruption must be taken into account when interpreting salivary microbiological counts.