Salivary Counts Of Lactobacilli Research Articles

Analysis of salivary level Lactobacillus spp. and associated factors as determinants of dental caries amongst primary school children in Harar town, eastern Ethiopia

BackgroundLactobacillus spp. play a major role in the development of dental caries. Although effective methods are known for the prevention and management of dental caries, its prevalence of dental caries is increasing amongst school-age children in Ethiopia. Hence, this study is aimed to determine the association of salivary Lactobacillus spp. level and oral health factors as determinants of dental caries amongst primary school children in Harar town, Eastern Ethiopia.MethodsA cross-sectional study was conducted amongst primary school children (n = 407) using a questionnaire survey, clinical DMFT (decayed, missing, filled tooth number) examination and enumeration of salivary level Lactobacillus spp. Data were analyzed by SPSS (Statistical Package for Social Science software- version 25.0). The odds ratio was used to determine the predictors of the outcome. The data were expressed as mean ± SD. Statistical significance was defined as a p-value of less than 0.05.ResultsThe prevalence of dental caries was found to be 36.9% amongst primary school children. The mean DMFT value of the participants was 0.95 ± 1.57. The dental decay component was the primary observation that accounted for 84.6% of the DMFT. Almost, 67% of the saliva culture revealed a significant amount of Lactobacillus spp. count. The mean bacterial count was found to be 14.92 × 105 ± 22.92 × 105. Among various parameters analysed for association with dental caries, a number of them show positive associtation, incluing reduction in academic scores in the prevous academic year (p = 0.034), grade levels of school children 1–4 (p = 0.041), sweet food consumption habit (p = 0.003), absence of daily teeth cleaning habit (p = 0.002), absence of toothpaste use (p = 0.001), dental ache history (p = < 0.001), significant microbial load of salivary Lactobacillus spp. (p = < 0.001), acidic (p = 0.028) and basic salivary pH (p = 0.025).ConclusionA significant salivary Lactobacillus count associated with lower grade level, sweet diet, and poor oral hygiene were found to be the determinant factors for dental caries. Thus, dissemination of oral health information is obligatory to prevent dental caries amongst primary school children in the study area.

Effect of probiotic delivery vehicles for probiotic Lactobacillus rhamnosus SD11 in caries prevention: A clinical study

This study aimed to compare the effect of two delivery vehicles for probiotic Lactobacillus rhamnosus SD11 in the form of fermented milk and milk powder for prevention of dental caries. In total, 201 children were randomly assigned to receive milk powder or fermented milk, and either the probiotic or control groups. Salivary counts of Streptococcus mutans and lactobacilli were examined at the baseline, 3, 6, and 9 months using the real-time PCR. The oral examination was recorded at the baseline and 9 months. Results demonstrated that a reduction in S. mutans was observed in both probiotic groups compared to their controls (p < .001). The increment of newly developed caries lesions was significantly lower in the probiotic groups than in controls. In conclusion, the dairy products (milk powder and fermented milk) containing L. rhamnosus SD11 provide a similar effect on prevention of caries risk regarding reducing cariogenic S. mutans. Practical applications Our previous study revealed Lactobacillus rhamnosus SD11 in fermented milk could reduce cariogenic bacteria. It was hypothesized that different vehicles for probiotic delivery of even the same probiotic strain may give different results in caries prevention. Results showed that either milk powder or fermented milk containing probiotic could significantly reduce both salivary cariogenic Streptococcus mutans and newly developed caries lesions. It indicates that the dairy products, either milk powder or fermented milk, containing L. rhamnosus SD11 provide a similar effect on prevention of the caries risk. The advantage of milk powder over fermented milk includes longer shelf-life, easier storage, and easier handling and transportation.

Acid production in dental plaque after exposure to probiotic bacteria

BackgroundThe increasing interest in probiotic lactobacilli in health maintenance has raised the question of potential risks. One possible side effect could be an increased acidogenicity in dental plaque. The aim of this study was to investigate the effect of probiotic lactobacilli on plaque lactic acid (LA) production in vitro and in vivo.MethodsIn the first part (A), suspensions of two lactobacilli strains (L. reuteri DSM 17938, L. plantarum 299v) were added to suspensions of supragingival dental plaque collected from healthy young adults (n=25). LA production after fermentation with either xylitol or fructose was analyzed. In the second part (B), subjects (n=18) were given lozenges with probiotic lactobacilli (L. reuteri DSM 17938 and ATCC PTA 5289) or placebo for two weeks in a double-blinded, randomized cross-over trial. The concentration of LA in supragingival plaque samples was determined at baseline and after 2 weeks. Salivary counts of mutans streptococci (MS) and lactobacilli were estimated with chair-side methods.ResultsPlaque suspensions with L. reuteri DSM 17938 produced significantly less LA compared with L. plantarum 299v or controls (p<0.05). Fructose gave higher LA concentrations than xylitol. In part B, there were no significant differences in LA production between baseline and follow up in any of the groups and no differences between test and placebo were displayed. The salivary MS counts were not significantly altered during the intervention but the lactobacilli counts increased significantly in the test group (p<0.05).ConclusionLactic acid production in suspensions of plaque and probiotic lactobacilli was strain-dependant and the present study provides no evidence of an increase in plaque acidity by the supply of selected probiotic lactobacilli when challenged by fructose or xylitol. The study protocol was approved by The Danish National Committee on Biomedical Research Ethics (protocol no H-2-2010-112).Trial registrationNCT01700712

There are no Clearly Superior Methods for Diagnosing, Predicting, and Noninvasively Treating Dental Caries

To be included in the systematic review, all articles were required to meet predetermined criteria: the results of the studies should be relevant to the questions posed by the project, ie, have appropriate outcome measures and an appropriate follow-up period and study design. With respect to diagnosis, the efficacy of the various methods was compared with reference methods that included studies of extracted teeth. For prediction, the material comprised mainly prospective studies, where the reliability of risk assessment could be evaluated. With respect to treatment of early caries lesions, it was a requirement for inclusion that the study had a control group. For caries detection of accessible surfaces, visual-tactile testing was used. Radiographic diagnosis was used for approximal surfaces. For caries risk prediction, modeling was used to determine the influence of specific variables (eg, sugar intake). For noninvasive treatment assessment, size of lesion growth or shrinkage after treatment was used. Caries detection: Visual-tactile detection for accessible surfaces carried the best, but far from optimal, accuracy. Although specificity tends to be high with this method, sensitivity is low. Caries risk prediction: Streptococcus mutans count, salivary Lactobacillus count, salivary buffering capacity, visible plaque levels, and sugar intake have low accuracy. The best, but still far from optimal, predictor was past caries history. Noninvasive methods of caries treatment: Too few studies exist for meaningful analysis. (1) Past caries is the best predictor of future caries. (2) A combination of visual-tactile and radiographic examination is better than either method alone. (3) There is insufficient evidence to support noninvasive treatment of early caries. STUDY OBJECTIVE AND METHODS: To perform a systematic review of published literature to (1) determine the evidence for the effectiveness of different methods (visual-tactile versus radiographic) for detecting caries; (2) identify the most prescient predictors of dental caries; and (3) evaluate the evidence supporting the use of noninvasive methods for the treatment of caries, particularly early caries. With regard to the questions posed by the study team: (1) Past caries is the best predictor of future caries; (2) a combination of visual- tactile and radiographic examination is better than either method alone; and (3) there is insufficient evidence to support noninvasive treatment of early caries.

Salivary Characteristics in a Sample of Preschool Children with Severe Early Childhood Caries (S-ECC)

The aim of this study is to investigate the salivary counts of mutans streptococci and lactobacilli, as well as measure the saliva buffering capacity and salivary flow rate in a sample of preschool children with severe early childhood caries in Jeddah, Saudi Arabia. The study was designed as a cross-sectional investigation; sixty children diagnosed to have severe early childhood caries were selected and another thirty caries free children were selected as control. Children were selected according to certain criteria; healthy normal, diagnosed as severe early childhood caries and age range 36-71 months. A clinical examination was done to measure decayed, missing and filled index, salivary tests to measure bacterial counts, buffering capacity and salivary flow rate. There was a highly significant difference in streptococcus count (p = 0.02), lactobacillus count (p = 0.00), between both groups, but there was no significant difference in the saliva buffering capacity and salivary flow rate. Based on the sample of patient studied, it was concluded that Streptococcus mutans and lactobacilli counts are major risk factors. Furthermore, there was no statistically significant difference in the saliva buffering capacity and salivary flow rate between the two groups.

Probiotic Treatment Increases Salivary Counts of Lactobacilli: A Double-Blind, Randomized, Controlled Study

Background/Aims: Lactobacilli are used in the prevention and treatment of several diseases, but they are also known to play a role in the pathogenesis of dental caries. The aim of our study was to evaluate whether the oral administration of lactobacilli could change the salivary counts of these bacteria compared with placebo. Moreover, lactobacilli were administered in liquid and in capsule form to determine the role of direct contact with the oral cavity. Methods: Thirty-five healthy volunteers were randomized into three groups to receive lactobacilli and/or placebo for 45 days: group A (n = 14) received probiotics in capsules and placebo in liquid form; group B (n = 16) took liquid probiotics and placebo in capsules, and group C (n = 5) used placebo in both liquid and capsule form. Streptococcus mutans populations served as control. The salivary counts of lactobacilli and S. mutans were measured semi-quantitatively using the CRT^® bacteria kit. Results: Compared with placebo, the oral administration of probiotics, both in capsules and in liquid form, significantly increases salivary counts of lactobacilli (p = 0.005 and p = 0.02, respectively). S. mutans populations were not significantly modified. Conclusions: The increased salivary counts of lactobacilli may indicate the need to closely monitor the dental health of patients undergoing long-term probiotics treatment, even when this treatment is administrated in a form that avoids direct contact with the oral cavity.

Intake of sweet foods and counts of cariogenic microorganisms in relation to body mass index and psychometric variables in women.

As a part of the SPAWN (Stockholm Pregnancy and Women's Nutrition) study, the intake of sweet foods (habitual and pre-menstrual intakes) and the number of cariogenic microorganisms in saliva was analysed in relation to body mass index (BMI) and psychometric variables. A cross-sectional study. Three hundred and sixty-two women with a median BMI of 24.2 kg/m(2) (range 17.5-47.8) and 45 y of age (range 34-64). A questionnaire of sweet food intake, salivary counts of mutans streptococci and lactobacilli and a self-rating scale on psychometric variables (CPRS-S-A). The number of mutans streptococci correlated with BMI (P<0.05), indirectly indicating a higher intake of sweet foods in obese women. The reported energy intake of sweet foods (more specifically the intake of chocolate), correlated with CPRS scores (P<0.01), indicating that women with more severe psychiatric symptomatology have higher intakes of sweet foods. This study suggests that women with higher CPRS score have higher energy intakes of sweet foods, indicating a possible link between mood regulation and the intake of sweet food. Karolinska Institute Research Funds.

Effect of a school-based preventive program with salivary lactobacillus counts as sugar-motivating tool on caries increment in adolescents

The caries preventive outcome of a school-based program with salivary lactobacillus counts as sugarmotivating tool was evaluated in six cohorts of totally 936 adolescents in a comprehensive school in Sweden. Students from a neighboring district with similar socioeconomic structure but with no corresponding dental health-promoting activities were selected as reference. The program started in the beginning of the 7th grade (13 years) and was terminated at the end of the 9th grade (16 years). Salivary lactobacilli were evaluated semi-annually with a dip-slide method and used for individual counseling. Dental caries was scored from the dental records and bitewing radiographs of each 4th participant at baseline and at 16 and 19 years of age. The number of salivary lactobacilli decreased significantly (P < 0.05) in all cohorts but one during the program. There was no significant difference in the increment of caries (DFS) between the participants from the study and reference schools, either at the end of the program or at 19 years of age. The increment of proximal enamel caries was slightly lower in the study group compared with the reference group (P < 0.05) at the final registration. Considering the time and efforts spent, the results did not seem to justify a school-based intervention with lactobacillus counts as a sugar-motivating tool in an adolescent low-caries population.

Five-Year Incidence of Caries, Salivary and Microbial Conditions in 60-, 70- and 80-Year-Old Swedish Individuals

The 5-year incidence of dental caries in a random sample of 60-, 70- and 80-year-old inhabitants of Göteborg was related to salivary and microbial conditions. Of the 208 persons examined at baseline, 148 (71%) participated in the follow-up examination; 69, 51 and 28, respectively, in the different age groups. The study revealed that 27% of the participants had not developed any carious lesions during the 5-year period and that the incidence of coronal and root caries increased with age. In the 60-year-olds, 2.5% of the susceptible coronal and root surfaces, respectively, had decayed, while the corresponding figures for the 80-year-olds were 8.8% for coronal surfaces and 9.8% for root surfaces. In all, 18% had an unstimulated saliva secretion rate of below 0.1 ml/min and 14% had a stimulated secretion rate of < 0.7 ml/min, with a mean rate which decreased with increasing age from 2.0 to 1.6 and 1.3 ml/min (p = 0.02). The overall salivary counts of lactobacilli and mutans streptococci, particularly the subspecies of Streptococcus sobrinus, had increased during the period. In the respective age groups of 60, 70 and 80 years, 15, 39 and 39% had a mutans streptococci count of ≥ 10⁶ CFU/ml in saliva and the corresponding figures for ≥ 10⁵ lactobacilli counts were 22, 31 and 43%. In the stepwise regression analysis, it was found that age, salivary levels of mutans streptococci and lactobacilli and number of teeth were the best predictors of the incidence of root caries. In conclusion, these observations indicate that there is an increased risk of dental caries with age owing to unfavourable microbial and salivary conditions.

Root Caries and Some Related Factors in 88-Year-Old Carriers and Non-Carriers of Streptococcus sobrinus in Saliva

The prevalence of caries on exposed root surfaces in 88-year-old subjects with and without salivary levels of Streptococcus sobrinus was studied. Ninety-two individuals were examined with regard to root caries lesions and fillings. The root caries index (RCI) was calculated and related to salivary flow rate and buffer capacity, plaque score and salivary counts of Streptococcus mutans, S. sobrinus and lactobacilli. In 89 subjects with exposed root surfaces, all but 2 harbored mutans streptococci; 51 subjects carried S. mutans only, 35 both S. sobrinus and S. mutans, and 1 S. sobrinus only. The RCI was significantly higher in persons with than those without S. sobrinus (p < 0.05). Subjects with both S. sobrinus and S. mutans had higher counts of total mutans streptococci and lactobacilli than subjects with only S. mutans (p < 0.05). The RCI was significantly correlated to S. sobrinus and S. mutans (p < 0.05). The positive correlation between the RCI and S. sobrinus was still significant when the other tested variables were kept constant, whereas the correlation between the RCI and S. mutans was weaker when S. sobrinus and lactobacilli were kept constant. The D-component of the RCI (DSr%) was significantly correlated to S. sobrinus, S. mutans and lactobacilli, whereas the F-component of the RCI showed no significant correlation to any of the tested variables. A stepwise multiple correlation showed that the variance of DSr% was best explained in the S. sobrinus carriers by S. sobrinus and the salivary buffer effect, and in the non-carriers by S. mutans.

Longitudinal study of caries, cariogenic bacteria and diet in children just before and after starting school

Fifty 5-yr-old preschool children living in Akranes, a small community in West Iceland known to have a high caries prevalence, were investigated with respect to caries, salivary counts of mutans streptococci and lactobacilli, and consumption of cariogenic foods. Fifteen months later, after being in school for half a year, 43 of the 50 children were reexamined and investigated as before. Mean dmfs scores rose from 7.1 to 9.0, but the scores including initial caries rose from 9.7 to 15.3. Mutans streptococci were carried by 84% of children on both occasions with a mean count 2.1 and 3.6 x 10(5) cfu/ml. Lactobacillus carriage increased from 29 to 38% and the mean count from 5.1 to 13 x 10(3) cfu/ml at 6 yr. The frequency of consumption of sugar-containing foods increased from 4.2 to 5.2 intakes per day and between-meal snacks rose from 3.0 to 3.7 per day. Children classified as "misusing" sugar were 59% at 5 yr and 83% at 6 yr. The mean caries score at 6 yr for children "misusing" sugar was 10.7 but only 2.0 for those not misusing sugar. Thus the deterioration in dental health appears, in these children, to be associated with the increased consumption of sweets and other cariogenic between-meal snacks after starting school.

Effect of a long-term change from a mixed to a lactovegetarian diet on human saliva

The effects of this long-term dietary change on secretion rate, buffer capacity, concentration of sodium and potassium and amylase activity of stimulated parotid and whole saliva was studied in 20 healthy, normal-weight, non-smoking omnivores. Salivary counts of mutans streptococci and lactobacilli were also made. Dietary surveys were carried out and saliva samples collected before (baseline) and 3, 6 and 12 months after the dietary change as well as 3 yr after the end of the lactovegetarian diet period. The dietary data showed an increase in the consumption of fruits, vegetables and dairy products and a decrease in meat, fish, eggs, sweets and biscuits. These changes led to an increased intake of carbohydrates, fibre and water. After 12 months on the vegetarian diet, the secretion rate, buffer capacity and sodium concentration of whole saliva and the secretion rate of parotid saliva had increased significantly. At the 3-yr follow-up, the buffer capacity and sodium concentration were still elevated, while the secretion rate had almost returned to the baseline values. The potassium content of whole saliva showed a tendency to increase during the vegetarian diet period, but had decreased again at the 3-yr follow-up.

Influence of salivary levels of mutans streptococci on colonization of crown margins: A longitudinal study

Initial colonization of mutans streptococci in 36 crown margins of 21 patients was studied. Before cementation, salivary concentrations of mutans streptococci and Lactobacillus sp, microorganisms associated with dental caries, were determined. Within 1 week 25% of the selected crown margins in subjects with low salivary levels of mutans streptococci and 89% in subjects with high salivary levels were colonized. High salivary counts of lactobacilli seemed to reflect conditions that enhanced the risk of colonization of mutans streptococci. The results suggest that, before cementation of fixed prosthodontics, measures should be taken to control the salivary concentrations of these organisms to reduce the susceptibility to recurrent caries.

Root caries susceptibility in periodontally treated patients

The aim of the investigation was to study the individual susceptibility to root caries in periodontally treated patients in a long-term follow-up of 12 years. Age, plaque score, salivary counts of lactobacilli and mutans streptococci, salivary secretion rate and buffer effect, oral sugar clearance time and dietary habit index were tested as possible predictors for root caries incidence. During the whole observation period of 12 years, new root caries lesions were recorded in 24 of a total of 27 patients. In 8 of these, the root caries incidence was between 1 and 5, in 7 between 6 and 9 and in 9, 12 or more new DFS. However, the annual mean number of new DFS was rather low. 13 patients with > 5 new DFS% during the 3rd 4-year period (years 9-12) differed significantly from 14 patients with < or = 5 new DFS% in salivary mutans streptococcus counts (p < 0.01), plaque scores (p < 0.001) and new DFS% during the 2nd 4-year period (years 5-8) (p < 0.001). Simultaneously, risk values among the variables tested at the 8-year examination were about 3 x more prevalent in patients that developed > 5 new DFS% in years 9-12 than in those with < or = 5 new DFS%. During the whole 12-year observation period, smokers had significantly more root caries than non-smokers (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Sweets and other sugary products tend to be the primary etiologic factors in dental caries.

The aim of this study was to analyze the relationships between caries incidence and each of seven caries-related factors in a group of 15- to 18-yr-olds as well as in single and combined subgroups representing favorable or less favorable fractions of six of the factors. Sixty-nine 18-yr-olds were interviewed about consumption of sweets and other sugar-containing products during the past 3 yr and examined for oral hygiene, salivary counts of mutants streptococci and lactobacilli, salivary flow rate and oral sugar clearance time at the ages of 15 and 18. Simple linear correlations and a stepwise multiple regression analysis were used to compare ranks and explanatory values. The highest correlations were obtained for intake of sweets and intake of other sugary products, with r values increasing from 0.25 and 0.16, respectively, in the total material to 0.70 and 0.67 in less favorable fractions of oral hygiene, salivary flow rate and other sugary products in the former case, sweets in the latter. The stepwise multiple regression analysis revealed that sweets and other sugary products contributed 12 percentage points to the total explanatory value, which was as low as 19%.

Variation of posterior approximal caries incidence with consumption of sweets with regard to other caries-related factors in 15-18-year-olds.

The aim of this study was to analyze the relationships between caries incidence and a number of caries-related factors in 15-18-yr-olds, in order to estimate the explanatory value of consumption of sweets under different conditions. Sixty-nine 18-yr-olds were interviewed about consumption of sweets and other sugar-containing products during the past 3 yr. Data on oral hygiene, salivary counts of mutans streptococci and lactobacilli, salivary flow rate and oral sugar clearance time were collected when the individuals were 15 and 18 yr old. Caries incidence for the 3-yr period was expressed as a percentage of the number of caries-free approximal surfaces of premolars and molars at the age of 15. Simple linear correlations between caries incidence and the different variables showed that lactobacilli count ranked first (r = 0.26), sweets second (r = 0.25), and mutans streptococci count third (r = 0.24). The r value for caries incidence and consumption of sweets increased in subgroups with combinations of poor oral hygiene, a high intake of other sugary products and a low salivary flow rate (r = 0.67-0.70). In conclusion, consumption of sweets should still be considered an important caries-related factor and particularly harmful when oral hygiene is poor and consumption of other sugary products is high.

Oral sugar clearance and root caries prevalence in rheumatic patients with dry mouth symptoms.

The relationship between root caries, oral sugar clearance, salivary flow rate, and salivary counts of mutans streptococci, lactobacilli and candida has been studied in a group of 22 rheumatic patients (age range 40-72 years). The study group comprised all subjects volunteering for a clinical trial on relief of dry mouth symptoms. The median salivary flow was 0.09 ml/min at rest and 0.9 ml/min during chewing stimulation. The median sugar clearance time was about 5 min in the sublingual area and 16 min in the lower buccal vestibule. For subjects with 0-2 root caries lesions the clearance time at both sites was shorter than for subjects with 3 or more lesions (p < 0.05). A long oral clearance time was significantly correlated with age, root caries (DS and DFS), low resting salivary flow, and high salivary counts of mutans streptococci. It is concluded that root caries in rheumatic patients with low salivary flow is significantly related to oral sugar clearance time.

Effects of a chlorhexidine‐fluoride‐strontium rinsing program on caries, gingivitis and some salivary bacteria among Finnish school children

In order to find out if it is possible to prevent caries and gingivitis by periodical use of chlorhexidine-fluoride mouthrinses with or without strontium, and to find out what effects they have on salivary mutans streptococci and lactobacilli counts, a total of 243 schoolchildren aged 11 yr with high DMFS scores were randomly divided into four groups. One group (C) served as a basic control. Subjects in the second group (CXF) rinsed their mouths twice a day every third week with a rinsing solution containing 0.05% chlorhexidine gluconate and 0.04% NaF. In the third group (CXFS) the rinsing solution contained 500 ppm Sr during the first and second year and 15 ppm during the last 6 months, in addition to chlorhexidine and fluoride. In the fourth group (CX) the solution contained only 0.05% chlorhexidine gluconate. All the rinsing solutions had pH 5.8 buffered with succinic acid-NaOH buffer. After 2 yr and 9 months, the mean DMFS (SD) increments in the C, CXF, CXFS, and CX groups were 3.8 (5.7), 2.5 (3.2), 3.5 (4.8), and 3.4 (5.5), respectively. The percentage of subjects with bleeding gingival units had decreased from initial to final values as follows: C, 81-38; CXF, 88-42; CXFS, 89-56; CX, 89-37. The number of lactobacilli and mutans streptococci in saliva remained virtually unchanged throughout the study. For caries increment and gingival bleeding, the differences between groups were not statistically significant. The chlorhexidine-fluoride combination tended to prevent caries, but the effect on gingival bleeding and salivary counts of mutans streptococci and lactobacilli was negligible.

Systematic analysis of gingival state and salivary variables as predictors of caries from 5 to 7 years of age.

The aim was to assess the caries predictive ability of gingival state, salivary counts of lactobacilli and S. mutans, salivary secretion rate and buffer capacity of the saliva from the ages of 5 to 7 yr. The material comprised 105 children who were examined once a year. All available screening levels were systematically tested for the single variables as well as for combinations of two or three variables. The screening levels were set where the highest possible sensitivity and specificity were reached simultaneously. The predictive values for positive and negative tests were then calculated. The S. mutans count turned out to have the best combination of sensitivity (0.41) and specificity (0.83). The single variables gingival state and S. mutans had constant screening levels, while the values for lactobacilli and buffer capacity varied. The saliva secretion rate could not be measured at 5 yr of age. Systematic analyses of predictive ability of combinations of two or three variables were then performed and did not result in any clinically significant improvements of the predictive ability. The observed low predictive ability might be explained by the fact that 1) many children changed their habits during the period of investigation and 2) they were examined and treated once a year according to their individual needs, which meant variations in conservative as well as in preventive treatment.

Salivary parameters and efficiency of dietary instructions to reduce sugar intake among 7-8-year-old schoolchildren.

The efficiency of dietary instructions was tested in a group of 7-8-year-old schoolchildren. The instructions were given in the presence of the child's mother either verbally (control group n = 14) or both verbally and written (test group n = 12). For this purpose the salivary status of the first grade pupils (n = 79) of a primary school in Turku was screened. Salivary flow, buffer capacity, sucrase activity, lactobacillus, yeast and S. mutans counts were determined. Children whose salivary lactobacillus count was over 10(4) CFU/ml (n = 32) were selected for the present study. The efficiency of the dietary instructions was measured as a reduction of salivary lactobacilli. There were no differences in the number of children with reduced LB counts or in the caries increment of 1 yr between the test and the control groups. However, children who succeeded in reducing the number of salivary lactobacilli (42%) within 4 wk revealed a significantly (P less than 0.05) lower caries increment after 1 yr than the rest of the subjects. We concluded that children whose lactobacillus counts were reduced by the dietary instructions developed significantly less caries than children whose lactobacillus counts remained high after the instruction. No additional effect on lactobacillus counts and caries increment could be demonstrated by supplementing the verbal dietary counseling with written instructions.