Role In Caries Research Articles

Mechanical and chemical plaque control in the simultaneous management of gingivitis and caries: a systematic review.

To report the evidence on the effect of mechanical and/or chemical plaque control in the simultaneous management of gingivitis and caries. A protocol was designed to identify randomized (RCTs) and controlled (CCTs) clinical trials, cohort studies and prospective case series (PCS), with at least 6months of follow-up, reporting on plaque, gingivitis and caries. Relevant information was extracted from full papers, including quality and risk of bias. Meta-analyses were performed whenever possible. After the screening of 1,373 titles, 15 RCTs, 10 CCTs and 2 PCS were included. Low to moderate evidence support that combined professional and self-performed mechanical plaque control significantly reduces standardized plaque index [n=4; weighted mean difference (WMD)=1.294; 95% CI (0.445; 2.144); p=0.003] and gingivitis scores [n=4; WMD=1.728; 95% CI (0.631; 2.825); p=0.002]. The addition of fluoride to mechanical plaque control is relevant for caries management [n=5; WMD=1.159; 95% CI (0.145; 2.172); p=0.025] while chlorhexidine rinses are relevant for gingivitis. Mechanical plaque control procedures are effective in reducing plaque and gingivitis. The addition of fluoride to mechanical plaque control is significant for caries management. Chlorhexidine rinse has a positive effect on gingivitis and inconclusive role in caries.

First Detection and Characterization of Streptococcus dentapri from Caries Active Subject.

Mutans streptococci (MS) are a group of oral bacteria generally regarded as the principal agents in the pathogenesis of dental caries. The study aimed was characterize S. dentapri based on phylogenetic analysis and phenotypic methods from Caries Active Subject. While sequencing MS species which were isolated from 65 caries active subjects, one strain of S. dentapri was detected. Dental plaque samples were processed and cultured on mitis salivarius bacitracin agar. S. dentapri was characterized using phylogenetic analysis, colony morphology characterization and biotyping. Among the study population, one strain designated as H14 was identified as S. dentapri by 16S rDNA sequencing. Morphologically, S. dentapri could not differentiate from other species of MS. S. dentapri H14 demonstrated biotype II biochemical characteristics of MS. The phylogenetic analysis showed S. dentapri is closely related to S. macacae. The study concludes that S. dentapri can inhabit the human oral cavity and therefore further investigations are warranted to determine its role in caries.

Oral Bacterial Acid-Base Metabolism in Caries Screening: A Proof-Of-Concept Study.

The objective of this cross-sectional study was to clinically validate an array of biochemical tests for oral acid/alkali generation as caries screening instruments. 185 adult subjects (mean 33.6±10.6 years) were examined clinically for dental caries using the ICDAS criteria. Bitewing radiographs were used to confirm interproximal surfaces of posterior teeth. For the purposes of this study, subjects were classified as "caries-active" if they had at least one untreated caries lesion with ICDAS 4 or higher. Pooled supragingival plaque and unstimulated saliva samples were collected and assayed for pH changes from sucrose and urea metabolism using colorimetric tests. The validity of each test to discriminate between "caries-inactive" and "caries-active" subjects was assessed and compared to a commercial bacteriological caries-screening test using roc regression and logistic regression models. The AUCs of the plaque-urea (PU: 0.59 (0.51, 0.67)), plaque-urea-glucose (PUG: 0.59 (0.51, 0.67)) and saliva-urea-glucose (SUG: 0.59 (0.51, 0.67)) tests did not differ significantly from the bacteriological tests (CRT-mutans: 0.62 (0.54, 0.70); CRT-lactobacillus: 0.63 (0.56, 0.71) (P>0.05), but the plaque-glucose (SG), saliva-glucose (SG), saliva-urea (SU) and saliva-plaque-glucose (SPG) tests had significantly smaller AUCs (P<0.05). The AUCs for the PU, PUG, SUG, and the CRT-mutans tests were higher in subjects who had no existing dental restorations (PU: 0.90 (0.77, 1.04); PUG: 0.90 (0.79, 1.01); SUG: 0.89 (0.69, 1.08); CRT-mutans: 0.90 (0.73, 1.08)). The incorporation of the biochemical tests into a multidimensional bacteriological/psychosocial caries screening model significantly increased its diagnostic values (Se+Sp: 160.6, AUC: 0.846). In conclusion, as a proof of concept, the results of this study indicate that measuring the ability of dental plaque and saliva to metabolize urea together with the ability to generate acid from sugars may have a promising role in caries screening either independently, or as part of a multidimensional biological test.

Dermatoglyphics: A Plausible Role in Dental Caries and Malocclusion?

Background: Palmistry in scientific terms is called as dermatoglyphics (derma means skin and glyphic means carvings). Dermatoglyphics as an independent field of study, even though it has a body of theory, methods, and applications; in many respects, it has been used as an adjunct to other disciplines, serving as a vehicle to resolve broader biomedical problems. Many studies have shown that hereditary factors play contributory role in the development of caries risk and malocclusion. This study was done to check whether dermatoglyphics plays a role in malocclusion and dental caries. Aim: To assess whether dermatoglyphics could help predict genetic susceptibility of children to dental caries and malocclusion. Materials and Methods: A total of 300 children aged 6-12 years were screened for dermatoglyphics, dental caries using decayed, missing, and filled teeth and discrete Fourier transform index and malocclusion using Angle's classification. Statistical Analysis Used: To show significant difference between the expected frequencies and the observed frequencies in one or more categories, a Chi-square test was applied. The observed difference was statistically significant and P = 0.03 (<0.05). Results: There was an increased frequency of loop in right hand digit 3 and 5 (middle and little finger) in caries positive participants. Eighty-one percent of loop pattern was observed in digit 5 (little finger) of right hand in Class II malocclusion. Conclusion: Specific fingerprint patterns may be used as a potential noninvasive anatomical tool for mass screening of dental caries and malocclusion and for guiding future research.

Oral Hygiene Practices in Dental Students

ABSTRACT Objective This study aims to determine oral health practices among under graduate dental students from Pravara Rural Dental college Loni. Methods A self administered questionnaire was distributed among dental students randomly. The questionnaire was developed to assess the self reported perception of oral hygiene practices. Results The response rate was 85%. 15% of the students did not answer the questionnaire completely so were not included in the study. (n=252) 67.46% students reported brushing twice daily while only 5.55% were brushing thrice daily, 26.98% of them were brushing once in a day. 96.03% the students reported using toothpaste, 79.75% of them were using fluoridated toothpaste this indicates that many of them were well aware of fact that fluorides have significant role in dental caries and show potential therapeutic, adjunctive and preventive use in the treatment of periodontal diseases. 73.41% of students reported rinsing their mouth with water, only 23.80% were using mouthwashes. All of them were using one or more oral cleaning aids i.e. dental floss, interdental brush and tongue cleaner.seventy nine percent students were reported using tongue cleaners. Conclusion The results indicate that more emphasis should be given on Oral health care of Undergraduate dental students and further research is needed to examine oral cavity clinically and objectively by standard procedures available. Students should be motivated to keep their mouth free of dental diseases by practicing proper oral hygine aids and guidelines.

Correlation of plaque nitric oxide levels with plaque Streptococcus mutans, plaque pH and decayed, missing and filled teeth index of children of different age groups.

Dental plaque is considered one of the most important etiological factors for dental caries. Nitrate and Nitrite levels in saliva are considered protective against oral and gastrointestinal disease. Plaque nitric oxide (NO) levels and its role in dental caries has not be explored in the literature. Determine the correlation of the plaque nitric oxide (NO) with dental caries in vivo. 75 healthy children between ages of 3-15 years were selected. The age, state of dentition and the level of caries in all individuals were determined by the same examiner, using DMFT/deft index. The plaque samples collected were subjected to nitric oxide estimation, streptococcus mutans count and pH for correlation. SPSS computer based software was used for descriptive data analysis. ANOVA one way analysis and Karl pearson's correlation was carried out. Statistically significant relationship was observed between plaque nitric oxide and dental caries in all age groups. Similarly, significant correlation of nitric oxide was found in relation to plaque streptococcus mutans and plaque pH. Thus concluded, plaque nitric oxide can be considered as a risk assessment tool for prediction of dental caries.

Mode of Delivery and Its Influence on the Acquisition of Streptococcus mutans in Infants

IntroductionDental caries pose distinct challenges when it comes to determining their microbial etymology. Streptococcus mutans play an important role in dental caries. The aim of the present study was to compare oral microbiota in infants delivered by these different routes. A study was conducted on 40 infants. Swab sample collection was done for the detection of S. mutans. Our study indicated no differences in oral microbiota in infants due to mode of delivery.AimTo assess whether infants born through cesarean section delivery or infants born through normal delivery influence the initial acquisition of S. mutans in infants.Settings and designThe study was carried out on the premises of Bharati Hospital, Pune, wherein 40 infants (3-36 months) were enrolled for the study. Two groups were designed.Group I: Infants born with cesarean section deliveryGroup II: Infants born with normal section deliveryMaterials and methodsBacterial swab sampling was done in the participants for the detection of S. mutans. Colony-forming units on each plate were determined for the estimation of S. mutans level in oral cavity.Statistical analysis usedBar diagram analysis and chi-square test were performed to derive p-value.ResultsThe p value derived at the end of the study was 0.52. Hence, analysis of data demonstrates no significant influence of cesarean section delivery and normal delivery on oral microbiota development in infants.ConclusionInitial acquisition of oral S. mutans in infants is not dependent on the mode of delivery.Key MessagesInitial acquisition of S. mutans, Mode of delivery.How to cite this articleUbeja RG, Bhat C. Mode of Delivery and Its Influence on the Acquisition of Streptococcus mutans in Infants. Int J Clin Pediatr Dent 2016;9(4):326-329.

Quantification and Correlation of Oral Candida with Caries Index Among Different Age Groups of School Children: A Case-Control Study.

Background:Dental caries is the most common infectious disease affecting humans and is the predominant cause of tooth loss in children. Although Candida's role in dental caries has been studied extensively, limited homogenous studies have been conducted and none have been found, that associate Candida with dental caries, while correlating it to different age groups.Aim:The study aimed to quantify oral Candida in school children and correlate candidal carriage to the caries index and further analyze an age association.Subjects and Methods:Decayed-Filled teeth/Decayed-Missing-Filled Teeth (dft/DMFT) index scores of 150 subjects were evaluated, and concentrated oral rinse samples were collected from each participant for mycologic investigation. Based on the age and caries activity, the participants were categorized into three groups consisting of 50 each such as Group-I (caries active participants of 6–12 years age), Group-II (caries active participants in 13–18 years age), and Group-III (caries-free participants in 6–18 years age); CHROMagar™ was used as a primary culture medium for candidal growth. The data was statistically analyzed using Unpaired t-test, Chi-square test and Spearman's rank order.Results:The results demonstrated that as age increases, the dft/DMFT scores as well as the candidal growth decreased. In addition, the oral candidal carriage levels were found to be low in caries-free group (Group-III) when compared to the study groups.Conclusion:The presence of Candida was directly related to the caries status and inversely proportional to the age.

Dental Chatter: Bacterial Cross‐Talk in the Biofilm of the Oral Cavity

AbstractDental biofilms are composed of hundreds of bacterial species. These biofilms are diverse biological structures due to the heterogeneity of the many different types of supports in the oral cavity. The bacteria immobilized in these biofilms are exposed to rapid environmental changes such as pH, temperature, nutrition and anti‐plaque agents. One mode in which these bacteria adapt in the dental biofilm is by quorum sensing. This cell‐cell communication regulates diverse sets of adhesion modes, physiological changes, virulence properties, allowing the bacteria to persist in the dental biofilm under rapid environmental changes. In this review, we will concentrate mostly on the cariogenic bacterium Streptococcus mutans as one of the pivotal microorganisms in the supra‐gingival biofilm that plays a major role in dental caries.

Beyond Mucosal Infection: a Role for C. albicans-Streptococcal Interactions in the Pathogenesis of Dental Caries

The human body is home to countless microorganisms that can modulate the transition between health and disease. When conditions in the host favor the growth of pathogens, the populations can shift toward their dominance and/or cause disbyosis. In the mouth, commensal organisms are typically most abundant, but when oral hygiene is neglected and sugar is frequently consumed and/or there is a disruption in saliva production/flow, organisms associated with dental caries disease eg, Streptococcus mutans (S. mutans) become more prevalent. These organisms interact with dietary sugars and host saliva to form complex 3-dimensional biofilms on pellicle-coated teeth. The production of exopolysaccharides (eg, via S. mutans-sucrose interactions) modulates the assembly of the biofilm matrix, while acid production (eg, by acidogenic flora) and low pH within the biofilm facilitate the demineralization of the adjacent tooth enamel. During the assembly of cariogenic biofilms, S. mutans likely interacts and competes with other oral microbial species in the mouth. Although it is widely recognized that bacterial-fungal interactions commonly occur on mucosal surfaces, their possible role in dental caries has received limited attention. This review provides evidence that interactions between S. mutans and Candida albicans (C. albicans) may be involved in the pathogenesis of early childhood caries.

Comparison of the source of introduction to cariogenic food substance and caries prevalence in children.

Dental caries being a multi-factorial disease depends on lot of factors. Since awareness and exposure seems to have increased, in the present scenario it is difficult to assume that one particular source would increase the occurrence of dental caries. Children are exposed to different media sources and spend most of their free time watching them. They are attracted by messages of advertisers' and susceptible to stylish advertisements of foods often harmful to oral and general health. To compare the effects of three different sources of introduction to cariogenic food substance among school children and their role in caries prevalence. A total of 300 school children were selected for the study and a questionnaire was prepared keeping in mind the various sources introducing cariogenic foods to children namely television advertisement, magazines/news paper, posters/banners. Following which oral examination will be done to determine the number of carious lesions in the subjects. The data will be acquired, computed and statistically analysed to compare the correlation between these sources and caries prevalence. Children who watched television advertisements and asked for food items and soft drinks were found to have more caries and DMFT/dmft index. A total ban on advertisements would not be practically possible. A more realistic approach would be to limit the number of advertisements that feature potentially cariogenic and unhealthy food products, and also ensure that they ideally carry statutory warnings.

Lessons Learned from Clinical Studies: Roles of Mutans Streptococci in the Pathogenesis of Dental Caries

Dental caries is a major health problem worldwide. This disease results from improper interactions between oral microorganisms and host that stimulate the establishment of cariogenic biofilms on tooth surfaces, whose high and sustained acidogenicity promotes demineralization of tooth tissues. These interactions are modulated by environmental factors, among which diet has significant impact, especially regarding its carbohydrate content. Although microorganisms are recognized as having a central role in dental caries, current approaches for intervening in the establishment of cariogenic biofilms are limited. In this review, we focus on clinical studies supporting the role of mutans streptococci (MS) as promoters of cariogenic microbiota. Functions of MS in this process are analyzed under the current knowledge about the genetic and phenotypic diversity of Streptococcus mutans, the most well-known MS species. Effects of host immune responses on the establishment and pathogenesis of S. mutans are also discussed, further encouraging studies testing anti-MS therapies.

Role of sortase in Streptococcus mutans under the effect of nicotine

Streptococcus mutans is a common Gram-positive bacterium and plays a significant role in dental caries. Tobacco and/or nicotine have documented effects on S. mutans growth and colonization. Sortase A is used by many Gram-positive bacteria, including S. mutans, to facilitate the insertion of certain cell surface proteins, containing an LPXTGX motif such as antigen I/II. This study examined the effect of nicotine on the function of sortase A to control the physiology and growth of S. mutans using wild-type S. mutans NG8, and its isogenic sortase-defective and -complemented strains. Briefly, the strains were treated with increasing amounts of nicotine in planktonic growth, biofilm metabolism, and sucrose-induced and saliva-induced antigen I/II-dependent biofilm formation assays. The strains exhibited no significant differences with different concentrations of nicotine in planktonic growth assays. However, they had significantly increased (P≤0.05) biofilm metabolic activity (2- to 3-fold increase) as the concentration of nicotine increased. Furthermore, the sortase-defective strain was more sensitive metabolically to nicotine than the wild-type or sortase-complemented strains. All strains had significantly increased sucrose-induced biofilm formation (2- to 3-fold increase) as a result of increasing concentrations of nicotine. However, the sortase-defective strain was not able to make as much sucrose- and saliva-induced biofilm as the wild-type NG8 did with increasing nicotine concentrations. These results indicated that nicotine increased metabolic activity and sucrose-induced biofilm formation. The saliva-induced biofilm formation assay and qPCR data suggested that antigen I/II was upregulated with nicotine but biofilm was not able to be formed as much as wild-type NG8 without functional sortase A.

Genetic variation in MMP20 contributes to higher caries experience

Matrix metalloproteinases play an important role during the initial process of enamel development and therefore may play a role in caries. ObjectivesTo evaluate the association between MMP20 and caries experience in Brazilian children. MethodsEligible unrelated children with or without caries were evaluated using a cohort design. Demographic data and oral health habits were obtained though a questionnaire. Caries data was collected by clinical examination. Genotyping of the selected polymorphism was carried out by real-time PCR from genomic DNA. Allele and genotype frequencies were compared between groups with distinct caries experience and oral health habits. ResultsOf 388 subjects, 161 were caries free children. There were no differences between caries levels and genotype distribution in the total cohort. When ethnic background was considered, differences in genotype distribution were observed in caries free children vs. children with caries in Caucasians (p=0.03). Differences could also be seen when poor oral hygiene was used to stratify the analysis (p=0.02). Regression analysis, adjusted for genotype and ethnicity, confirmed that ingestion of sweets between meals increases the risk of presenting carious lesions (p=0.00001; OR=2.33; 95%CI 1.53–3.54). ConclusionVariation in MMP20 may be associated with caries experience mainly in Caucasian subjects with poor oral health habits.

Mode of Delivery and Other Maternal Factors Influence the Acquisition of Streptococcus mutans in Infants

S. mutans plays a key role in dental caries. The extent to which perinatal events influence the acquisition of S. mutans is unclear. We hypothesized that several maternal factors, including the mode of delivery, influence the initial acquisition of S. mutans in infants. A prospective cohort study was conducted in 156 mother-infant pairs. The study found that maternal gestational age (p = 0.04), S. mutans level (p = 0.02), caries score (p = 0.02), sexually transmitted disease (STD) infection experience (p = 0.01), and family income (p = 0.03) had significant effects on the acquisition of S. mutans. Among infants who became infected, those delivered by Caesarean section acquired S. mutans 11.7 mos earlier than did vaginally delivered infants (p = 0.038). C-section infants harbored a single genotype of S. mutans that was identical to that of their mothers (100% fidelity). Analysis of the data demonstrated the possible perinatal influences on infants' acquisition of a member of the cariogenic microbiota, and its potential effect on caries outcome.

Identification of oral mitis group streptococci by arbitrarily primed polymerase chain reaction.

"Mitis group" streptococci are commensal but may play some role in dental caries, septicemia or endocarditis. Rapid genotypic identification would aid studies of dental plaque ecology, or diagnostic use. AP-PCR with 58 unpaired arbitrary primers was used to characterize 7 Streptococcus gordonii, 11 Streptococcus sanguis, 2 Streptococcus crista, 5 Streptococcus parasanguis, 18 Streptococcus oralis, and 36 Streptococcus mitis (22 biovar 1 and 14 biovar 2). S. parasanguis 16S rRNA variable region primer RR2 produced species-specific bands with all S. gordonii and S. sanguis. Human V beta 1 T-cell receptor primer 434 yielded concordant genotypic identification of all phenotypically defined S. crista and S. parasanguis, 83% of S. oralis, and 74% of S. mitis biovar 1. Amplicon patterns for S. mitis biovar 2 were heterogeneous. Findings suggest that primers RR2 and 434 in succession will allow rapid identification of genotypic groups corresponding closely to mitis group species established by phenotype.

Identification of human antigenic epitopes in an alanine-rich repeating region using sera from hu-PBL-SCID mice immunized with a surface protein antigen of Streptococcus mutans.

A 190-kDa surface protein antigen (PAc) of Streptococcus mutans is considered to play an important role in dental caries. To identify antigenic epitopes of the PAc in humans, we immunized severe combined immunodeficient (SCID) mice with recombinant PAc that was transplanted with human peripheral blood mononuclear cells (PBMC). The reactivities of the sera from the immunized hu-PBL-SCID mice to the recombinant PAc and 24 19-mer synthetic peptides covering the alanine-rich repeating region (A-region) presented in the PAc molecule were then examined. The results showed that the immunized mice produced a significant recombinant PAc-specific human antibody, and among 24 19-mer peptides, 6 19-mer peptides showed a strong reaction with the antibodies. In addition, 4 19-mer peptides containing human antigenic epitope in a donor were identified with enzyme-linked immunosorbent assay (ELISA) inhibition assays using the recombinant PAc protein. In this study, the SCID mouse was useful in identifying human antigenic epitopes.

The Importance of Regular Dental Treatment in Patients With Cyclic Neutropenia. Follow‐up of 2 Cases

Data on two patients with cyclic neutropenia are presented. They demonstrate that regular tooth care and professional dental treatment can prevent progressive periodontal breakdown but that neglecting oral hygiene soon leads to periodontal pathology. Regular, monthly professional removal of dental plaque and calculus, and rinsing with 0.2% chlorhexidine gluconate during neutropenia help maintain periodontal attachment level. The caries susceptibility and the apical periodontitis in the intact anterior tooth of the female patient indicate the possibility of cyclic neutropenia playing a role in caries and pulpal pathology.

Nature and Role of Loosely Bound Fluoride in Dental Caries

This paper discusses loosely bound fluoride and its role in dental caries and prevention. Loosely bound fluoride (abbr. by Fa) is fluoride adsorbed onto enamel mineral crystallites. Several recent studies indicate that a high total level of fluoride in enamel does not guarantee protection against caries. This leads to the conclusion that a major part of fluoride present in the solid enamel is not active in prevention. The adsorption of Fa to the mineral under acidic conditions is described. Most likely there is a dynamic equilibrium between fluoride in solution and adsorbed Fa at the crystal surface interface. When the crystallite is completely covered by adsorbed Fa, there is a maximum inhibition of dissolution. The rate of dissolution of mineral depends on pH, the actual concentrations of calcium and phosphate in the liquid in contact with the crystallites, and on the fraction of the surface covered by adsorbed fluoride. The fluoride, Fs, localized in the inner part of the crystallites is relatively unimportant. "CaF2-like" material can be formed on and in enamel depending on conditions. The in vivo-formed globular "CaF2-like" material is not pure CaF2 and releases F- ions when dissolving; these ions will also be partly adsorbed as Fa in and on enamel. Presently, the amount and importance of Fa originating from in vivo-formed "CaF2-like" material are not known. The level of fluoride, Fa, necessary for strong inhibition of enamel demineralization in vitro is estimated to correspond to a fluoride concentration, FL, in the liquid phase of 1 ppm or 50 mumol/L fluoride ions.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental caries in Japanese remains (author's transl)

The incidence of dental diseases would be expected to rise as frequency of tooth to denture base discrepancy becomes higher, because the discrepancy seems to have pathogenetic influence on malocclusion, dental caries, and other related disorders. By studying incidence and seriousness of dental diseases in each historic age, therefore, it may be possible to obtain pathogenetic information on dental caries, to estimate the degree and extent of reduction of human dentition, and even to discuss evolution and civilization.From this point of view, we have already reported on dental caries and some other diseases in Japanese remains from the Kamakura era, and conclusively pointed out that the degree of the discrepancy was not so dominant in that era as in the modern age, but it seemed firmly to exsist, with pathogenetic influence on dental caries. In the present paper, incidence and specificity of dental caries, and occlusal and proximal attritions observed in Japanese remains from the later Jomon period are reported. We also discuss the degree and extent of the discrepancy, its pathogenetic role in dental caries, and the food and eating behavior in comparison with those in the Kamakura and modern ages.The materials used were 89 maxillae and 102 mandibles with permanent or mixed dentition, selected from 327 Japanese skulls mostly from the later Jomon period, stored in the University Museum, The University of Tokyo.The frequency of dental caries in the Jomon period was almost the same as in the Kamakura era, but much lower than in the modern age. However, its seriousness was much worse than in the Kamakura era, and almost the same as in the modern age, as indicated from the fact that the carious teeth are distributed more frequently in C3 and C4 than in C1 and C2.The pathogenetic pattern of dental caries in the Jomon period is different from that in the Kamakura era and in the modern age in the following points. 1. The distribution of carious teeth is biased towards the posterior teeth, but not so dominantly as in the Kamakura era. 2. Carious teeth are distributed even in the anterior region. 3. The rate of carious teeth for the third molar does not exceed that for the first molar in both maxilla and mandible. From these facts, the dental caries in the later Jomon period seems to be of environmental pollution type, while it is of the discrepancy type in the Kamakura era and of a combination type in the modern age.