Salivary Streptococcus Mutans Count Research Articles

Effect of Probiotic Yogurt on Salivary Streptococcus mutans Count in Patients Undergoing Fixed Orthodontic Treatment: A Systematic Review and Meta-analysis

Effect of Probiotic Yogurt on Salivary Streptococcus mutans Count in Patients Undergoing Fixed Orthodontic Treatment: A Systematic Review and Meta-analysis

Comparative evaluation of Cranberry extract mouth rinse, Ozonized water and 0.2% Chlorhexidine on salivary Streptococcus mutans and Lactobacilli count: An in-vivo study

Background: Cariogenic bacteria has always been considered as the highest risk factor for dental caries. The eradication of microorganisms from the oral health environment is important and hence may remedies have been suggested for its removal for a better oral health.
 Objectives: To assess the minimal inhibitory concentration (MIC) of Cranberry extract and to determine the efficacy and compare the effect of the three products on salivary Streptococcus Mutans count and lactobacilli count.Materials and Methodology: A randomized control, double blind, parallel-group clinical trial was conducted on 75 subjects of age group of 15 years who were divided into three study groups ,Cranberry , Ozonized water and Chlorhexidine mouthwash. Microbial analysis was done by colony counter unit at baseline, 8thday and 15th day of using the mouthwashes. The inter-group variations was analyzed by using One way ANOVA followed by Tukey’s post hoc and Repeated measures for intra-group variations at different time intervals.
 Results: Streptococcus mutans and Lactobacilli colony count showed a statistically highly significant difference in reduction of colony count between the three groups (p=0.001) at 8th and 15th day of using the mouthwashes. Ozonized water showed better reduction when compared with Cranberry mouth wash in reduction of Streptococcus mutans count. Cranberry mouth wash had shown a better reduction when compared with Ozonized water in reduction of Lactobacilli colony count.Conclusion: The test mouthwash was effective in reducing the microbial count, similar to Chlorhexidine mouth wash. Recent advances may allow the dental community to be exposed to much better oral health care.
 key words : cranberry, ozone water, streptococcus mutans, lacto bacilli, oral hygiene

Evaluation of the Effect of Tea Tree Oil Mouthwash on Streptococcus Mutans as Compared with Chlorohexidine in A Group of Egyptian Children

Purpose: The objective of this study is to evaluate the effect of Tea tree oil mouthwash on salivary Streptococcus mutans count in a group of children compared to chlorhexidine. Materials and methods: 24 children from both sexes participated in the study. Their ages ranged from 8 to12 years. Participants were divided into 2 groups (1&2), each group included 12 children. Group 1: every child was given a bottle of prepared tea tree oil mouthwash (0.2%) for rinsing. Group 2: every child was given a bottle of chlorhexidine mouthwash (0.12 %) for rinsing. Unstimulated saliva samples were collected and microbiological analysis was done. Results: There was a significant reduction in the mean number of Streptococcus mutans colonies in both tea tree oil and chlorohexidine groups. Conclusion: Tea tree oil mouthwash has significant antimicrobial activity and could be utilized as a natural substitute to chlorhexidine

Comparative Evaluation of the Efficacy of Chlorhexidine, Fluoride and the Combined Use of Chlorhexidine and Fluoride Varnishes on Salivary Streptococcus mutans Count in Children with Mixed Dentition: An In Vivo Study.

AimTo study the effect of combination of chlorhexidine and Fluoride on the growth and colonization of cariogenic bacteria (Streptococcus mutans) in children with mixed dentition.Materials and methodsSixty children of age 6–14 years with mixed dentition and S. mutans count > 1 × 105 CFU/mL of saliva were divided: group I–chlorhexidine varnish; group II–Fluoride varnish; group III–Combination of chlorhexidine and Fluoride varnish. chlorhexidine and Fluoride varnishes were applied to teeth once every week for four consecutive weeks in respective groups. Salivary S. mutans count was estimated and evaluated at baseline, 1, 3, and 6 months.ResultsNo significant difference was seen in group I and II at the end of 1, 3, and 6 months (p > 0.001) but the reduction in S. mutans count was statistically more significant in group III after a period of 6 months (p < 0.001). Maximum reduction in count was noted in group III at all intervals of varnish application.ConclusionThe concomitant use of chlorhexidine and fluoride varnish would prove to be more effective than individual components over a longer period of time and especially in high caries risk children.How to cite this articleMore VP, Hugar SM, Sogi S, et al. Comparative Evaluation of the Efficacy of Chlorhexidine, Fluoride and the Combined Use of Chlorhexidine and Fluoride Varnishes on Salivary Streptococcus mutans Count in Children with Mixed Dentition: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(3):267-272.

A Prospective Longitudinal Study of Early Childhood Caries Onset in Initially Caries-Free Children.

Early childhood caries (ECC) is a complex oral disease that is prevalent in US children. The purpose of this 2-y prospective cohort study was to examine baseline and time-dependent risk factors for ECC onset in initially caries-free preschool children. A cohort of 189 initially caries-free children aged 1 to 3 y was recruited. At each 6-mo study visit, children were examined using the ICDAS index; salivary samples were collected to assess mutans streptococci (MS), lactobacilli, Candida species, salivary cortisol (prior and after a stressor), and salivary IgA. Diet and oral health behavior were assessed from parent report. Child and family stress exposure was assessed from measures of psychological symptoms, stressful life event exposure, family organization and violence exposure, and social support. Sociodemographic factors were also considered. A Kaplan-Meier estimator of survival function of time to ECC and a Cox proportional hazards model were used to identify predictors of ECC onset. Onset of ECC was associated with high salivary MS levels at baseline (log-rank test, P < 0.0001). Cox proportional hazards regression showed that the risk of dental caries significantly increased with salivary MS in log scale over the 6-mo period (hazard ratio, 1.08; P = 0.01). Other risk factors in the model did not reach statistical significance. Our results provide prospective evidence that an increase in salivary MS predicts ECC onset in young, initially caries-free children, confirming that a high salivary MS count likely plays a causal role in ECC onset, independent of covariates. These results suggest that we must focus on reducing salivary MS counts in young children and preventing or delaying MS colonization in infants and young children determined to be at risk for ECC.

Antibacterial effect of an herbal toothpaste containing Bamboo salt: a randomized double-blinded controlled clinical trial

BackgroundThe inclusion of herbal antibacterial agents in the composition of toothpastes is becoming increasingly popular, due to lower side effects. The present study intended to investigate the antibacterial efficacy of a herbal toothpaste containing Bamboo salt on cariogenic oral bacteria.MethodsThe present double-blinded parallel randomized controlled clinical trial was conducted on 60 dental students (age range: 18–30). Following the baseline saliva sampling, the participants were randomly assigned into the case and control groups, to use the Bamboo salt herbal toothpaste and conventional non-herbal toothpaste, respectively. They were instructed to brush their teeth twice a day using the Bass technique. Saliva sampling was repeated after four weeks. The salivary counts of Streptococcus mutans and Lactobacillus at baseline and 4-week follow-up were determined and presented as the logarithm of colony-forming units per milliliter (log CFU/mL).ResultsA significant decrease in salivary Streptococcus mutans and Lactobacillus was observed using both toothpastes (*P < 0.001). The difference between the antibacterial efficacy of two toothpaste types on Streptococcus mutans and Lactobacillus was not statistically significant (P = 0.530, and P = 0.137, respectively).ConclusionDue to the comparable efficacy of the investigated herbal toothpaste with conventional toothpaste, it potentially qualifies as a complementary agent for self-care oral hygiene procedures.Trial registration: This trial was registered in the “Iranian Registry of Clinical Trials” (IRCT20210414050964N1) on 21/06/2021.

Effect of Immunoglobulin Y Tablets on Streptococcus Mutans Counts in Adolescents: An in vivo Study

Objectives: Streptococcus mutans has been most intimately associated with the initiation and development of carious lesion. Nowadays, the treatment strategies are aimed at either elimination of this bacterium or suppression of its virulence. The search for more efficient and economical techniques, has led to growing interest for the use of egg yolk antibodies (Immunoglobulin Y). This study was conducted to evaluate the microbiological effect of Ig Y tablets on salivary Streptococcus mutans count in adolescents.&#x0D; Methods: In this randomized controlled clinical trial, 50 adolescents (12–18 years old) were divided into two groups. Group I adolescents were instructed to use fluoridated toothpaste and Group II were instructed to administer S. Mutans specific Immunoglobulin Y chewable tablets for a period of 15 days along with the fluoridated toothpaste.&#x0D; Results: The findings of this research demonstrated that the tablets containing specific egg yolk antibodies (IgY) against glucosyltransferase of S. mutans exerted a suppressive effect on S. mutans colonization of the oral cavity in healthy adolescents.&#x0D; Conclusion: These findings indicate that using IgY in the form of tablets is a novel approach and has the advantage of releasing antibodies slowly into the oral cavity. It is thus effective in decreasing the colonization of the S. mutans, and lowering the induction of dental caries.

Comparative evaluation of the antimicrobial effects of probiotic milk and probiotic powder on the salivary Streptococcus mutans counts and the plaque scores in children aged 3-6 years: A randomized controlled trial.

Probiotics have been shown to have a positive influence on systemic and oral health. The prevention of dental caries and gingival diseases through the consumption of probiotics has been studied extensively. The aim of this research was to determine the effects of a short-term intake of probiotic milk and powder on the salivary levels of Streptococcus mutans (S. mutans) and the plaque scores in children. In this short-term study, 34 healthy 3-6-year-old children were randomly assigned to group A (control), group B (enKor‑D) or group C (Yakult). The probiotics were taken for 7 days. To screen for the amount of S. mutans measured in colony-forming units per milliliter of saliva (CFU/mL), unstimulated saliva samples were collected and cultured on Mitis Salivarius Agar plates before and after the intervention. The plaque scores were also recorded at preand post-intervention visits. A statistically significant reduction of salivary S. mutans was recorded after the consumption of probiotic milk (Yakult®) and powder (enKor®-D) (p < 0.05), with the decrease being greater for the enKor‑D group. However, only the consumption of Yakult decreased the plaque scores significantly (p < 0.05). A short-term use of Yakult and enKor‑D can have a cariostatic effect by lowering oral microbial load in children with certain risk profiles. Further research is required to confirm this probiotic effect over a long-term period. Prior to prescribing or promoting Yakult or enKor‑D as an adjunct caries prevention therapy for children, a thorough risk evaluation may be needed.

A Comparative Evaluation of Xylitol Chewing Gum and a Combination of IgY + Xylitol Chewable Tablet on Salivary Streptococcus mutans Count in Children: A Double-blind Randomized Controlled Trial.

AimThe study was designed for evaluation and comparison of the efficacy of Xylitol chewing gum and a combination of IgY + Xylitol chewable tablet (Nodecay TM) against the “salivary Streptococcus mutans ” count in children.Materials and methodsAbout 120 children belonging to 6-12 years age-group were enrolled into this “double-blind randomized control clinical trial” according to the selection criteria. They were randomly assigned to three groups of 40 each: Group I-Xylitol chewing gum, Group II-IgY + Xylitol Chewable tablet (Nodecay TM), and Group III-Control. Children in all the groups had to chew the gum/tablet twice daily for 5 minutes during the 15-day period. The salivary samples at baseline, 15 days, 1, 2, and 3 months were inoculated on mitis salivarius bacitracin agar with potassium tellurite medium and the number of colony-forming units (CFUs) of Streptococcus mutans were determined. The data obtained was subjected to statistical analysis.ResultThere was a “significant” difference in the number of “S. mutans CFUs” amongst the three groups at 15 days, 1st month, 2nd month, 3rd month with highest levels of S. mutans CFUs in Group III-Control and least in Group II-IgY + Xylitol (NodecayTM).ConclusionThe combination of IgY + Xylitol (NodecayTM) when administered for 15 days had significant efficacy against “S. mutans” when compared to Xylitol and control group.Clinical significancePassive immunization with immunoglobulin Y is known not only to decrease the S. mutans count but also confers extended immunity by preventing recolonization of the tooth surface by persistence of the antibodies in saliva.How to cite this articleJain RL, Tandon S, Rai TS, et al. A Comparative Evaluation of Xylitol Chewing Gum and a Combination of IgY + Xylitol Chewable Tablet on Salivary Streptococcus mutans Count in Children: A Double-blind Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(S-2):S212-S220.

Prebiotics-A Primeval Measure to Combat Dental Caries: A Short-term Clinical Study.

BackgroundPrevention of dental caries is paramount in reducing the global burden of the disease. The consumption of probiotics as a prophylactic and therapeutic agent for dental caries, has certain limitations. Prebiotics are nondigestible food ingredients, that enhance the growth and activity of probiotic microorganism, thereby help in the establishment of a healthy oral environment.AimThe aim of this study was to evaluate and compare the effect of prebiotics, probiotics, and synbiotics on the salivary Streptococcus mutans (S. mutans) counts and salivary IgA concentrations.MethodologyChildren of age-group 6–9 years with DMFT score of 5 and above were divided into three groups of 10 each: Group 1 (prebiotics), Group 2 (probiotics), and Group 3 (synbiotics). The functional food therapy was done for a period of 1 month twice daily. The S. mutans count and IgA concentrations were assessed pre- and postintervention. The obtained results were subjected to statistical analysis.ResultsA statistically significant reduction of S. mutans was seen in all three groups after 1 month. However, no statistically significant difference was noted between the groups.ConclusionPrebitoics can serve as an unfortified and natural means of combating dental caries.How to cite this articleKonde S, Ravindran S, Agarwal M, et al. Prebiotics—A Primeval Measure to Combat Dental Caries: A Short-term Clinical Study. Int J Clin Pediatr Dent 2022;15(S-2):S234–S238.

Association between Oral Probiotic Streptococcus Supplements and Salivary Streptococcus Mutans Count in Human Study: A Systematic Review

Introduction: Probiotics in caries prevention is a subject of growing interest due to their specific activities and inhibitory effects on the cariogenic organisms. Though numerous reviews have evaluated the effect of probiotics in caries prevention, very few have focussed on the probiotic streptococcus strains, none of them have emphasised on the effect of probiotic Streptococcus strains on the salivary Streptococcus mutans count. Aim: To evaluate the current literature on the association between oral probiotic Streptococcus supplements on the Streptococcus mutans level. Materials and Methods: A focused PICO question was formulated. Comprehensive literature searches were independently performed by two reviewers in various electronic databases. Randomised control trials in humans in which oral probiotic Streptococcus supplements were used to alter the salivary Streptococcus mutans count were included. Risk of bias and data extraction of the included articles was performed. Results: Five studies were included in the qualitative synthesis. The quality of the included studies was quite low as only one among the five studies had moderate risk of bias while all others had a high risk of bias. Conclusion: Within the limitations of the available data, it can be concluded that probiotic Streptococcus supplements have a positive effect on reducing the Streptococcus mutans levels as long as they are being used.

EVALUATING SALIVARY Streptococcus mutans COUNT IN PREGNANCY AND THE POSTPARTUM PERIOD

Introduction: It has been well established that pregnancy is associated with the development of some oral lesions and worsening of existing ones with adverse effects on pregnancy and pregnancy outcome. The heightened risk for dental conditions among pregnant women is related to the intraoral changes during pregnancy as well as delays in the treatment for their oral diseases.&#x0D; Objective: The purpose of this study was to evaluate the salivary S. mutans count in pregnant and non-pregnant women.&#x0D; Methods: The 50 pregnant women were examined for salivary streptococcus mutans counts throughout the first, second, and third trimesters of pregnancy as well as in the weeks after delivery.The associated salivary parameters evaluated were salivary flow rate, salivary pH, total salivary calcium content and DMFT.&#x0D; Conclusion: This research lends credence to the idea that dental caries risk and pregnancy progress are related. The results suggest that, in order to stop the development of caries in pregnant women, actions must be taken to enhance their dental health.

Comparison of Antibacterial Effect of Probiotic Yogurt and Xylitol-Containing Chewing Gum in Geriatric Patients: A Randomized Controlled Clinical Trial.

ObjectivesTo evaluate the effect of probiotic bacteria in yogurt on Streptococcus mutans (MS) count, plaque adherence and salivary pH compared to xylitol-containing chewing gum in geriatric patients.Materials and methodsTotal number of 96 high caries risk geriatric patients were randomized into two equal groups (n=48). Group 1 (intervention group) received probiotic yogurt (Activia, Danone) once per day, and group 2 (control group) received xylitol chewing gum (Trident original) three times per day. The primary outcome was salivary Streptococcus mutans count and secondary outcomes were interdental plaque Streptococcus mutans count, salivary pH and bacterial adherence.ResultsFor Streptococcus mutans count in saliva and plaque, a statistically significant reduction in the level of MS over all the examined follow up periods of the study in probiotic yogurt group as well as xylitol gum group was found. An intergroup comparison for salivary MS count showed statistically significant difference between the two materials in a two week and a three month period of time and there was no statistically significant difference between both materials at one month time period. Salivary pH results showed statistically significant increase in pH in both groups along the follow-up periods. Bacterial adherence results showed statistically significant reduction in both groups.ConclusionsProbiotic yogurt is an effective antibacterial agent against salivary and plaque bacteria in geriatric patients.

Efficacy of 4% tulsi leaf extract, fluoridated and placebo dentifrices against salivary Streptococcus mutans count among 14–15 years school children in Davangere City, Karnataka – A concurrent parallel trial

Efficacy of 4% tulsi leaf extract, fluoridated and placebo dentifrices against salivary Streptococcus mutans count among 14–15 years school children in Davangere City, Karnataka – A concurrent parallel trial

A comparative evaluation of herbal and nonherbal mouthrinses on salivary pH levels and salivary Streptococcus mutans count in 6–12-year-old children: A randomized controlled trial

Background: Dental caries is a disease of complex etiology, in which microorganisms play an important role. Salivary pH and Streptococcus mutans count influence the initiation and progression of dental caries. Objectives: This study aimed to assess the efficacy of the combined herbal and nonherbal rinse on salivary pH and salivary S. mutans count and comparing it with herbal and nonherbal mouthrinse in 6–12-year-old high caries-risk children. Methodology: Ninety high caries-risk children of age 6–12 years were selected and allocated randomly into three groups (herbal, nonherbal, combination mouthrinses = 30 each). Children were instructed to rinse their mouth twice daily with their assigned mouthrinses for 7 days. Salivary samples were collected at baseline, 1 h post rinsing, and at the end of 7th day of mouthrinsing for determining the salivary pH and S. mutans count. ANOVA and post hoc tests were applied. Statistical significance was considered at P

A comparative evaluation of probiotic formulations in prevention of dental caries: A clinical study.

Caries is a multifactorial disease, microbes being an important etiological factor. "Probiotics" are nonpathogenic microbes which can stimulate health-promoting flora and suppress pathogens. It's the era of prevention, clinical approach toward prevention by altering bacterial ecology is the need of the hour. The aim of the study was to evaluate anticariogenic effect of probiotic curd (Amul's Probiotic Dahi) containing Lactobacillus acidophilus (La5) and Bifidobacterium lactis (Bb12) in 6-12 years of age group. This was a prospective, randomized, nonblinded study conducted on school children aged between 6 and 12 years having Decayed, Missing, and Filled Teeth and/or deft ≥2. Selected subjects were divided into two groups of 31 each, study group received probiotic curd ("Amul's Probiotic Dahi") two times a day in a quantity of 100 g, respectively, for 21 days and control group did not receive any intervention. Salivary Streptococcus mutans count and salivary pH estimation were done at the baseline, after 7 days and at the end after 24 days, for comparison. No statistical difference was seen in salivary S. mutans count between both groups, after intervention of 7 days. However, there was significant difference in salivary S. mutans count at the end of 24 days. There was no statistical difference in salivary pH between both groups. The present study concludes that probiotics substitute decreases salivary S. mutans count after continuous consumption for 3 weeks and there is no short-term effect on salivary pH.

A Comparative Study on the Effect of Spilanthes acmella and Chlorhexidine (0.2%) Mouth Rinses on Salivary Streptococcus mutans Count in Children

In the wake of an increased interest in finding natural alternatives for chemical medicinal products, this study assesses and compares the effects and acceptance of Spilanthes acmella, a widely used plant in various traditional systems of medicine, with Chlorhexidine (0.2%) mouth rinse on the dental caries causing pathogen Streptococcus mutans colonizing the oral cavity of children. The study included 40 healthy children in the age group of 8-12 years based on inclusion and extrusion criteria. In the beginning of the study, non-stimulated whole salivary samples were tested for the baseline count of colony forming units (CFU) of Streptococcus mutans using Mitis Salivarius Agar supplemented with potassium tellurite. The same process was repeated 24 hours after 15 days of regular use of mouth rinses twice daily. Results showed that there was statistically highly significant decrease in CFU in the post rinse phase in both the groups. S. acmella showed greater acceptance by study subjects when compared with the Chlorhexidine mouth rinse. It can be concluded based on the results of this study that S. acmella has beneficial effects against S. mutans and can be a potential option for preventive measures against dental caries, although more studies are needed for its validation.

Antibacterial effect of amorphous calcium phosphate-casein phosphopeptide varnish against Streptococcus mutans: An exploratory in vivo randomized controlled trial

Background: Nowadays, amorphous calcium phosphate-casein phosphopeptide and tricalcium phosphate are being incorporated into fluoride varnishes to enhance remineralization potential which might interfere with antibacterial effect of fluoride in varnishes. Aim of study was to evaluate and compare the antimicrobial property of sodium fluoride varnish reinforced with amorphous calcium phosphate-casein phosphopeptide and tricalcium phosphate against streptococcus mutans.Methods: In the clinical setting, trial was conducted involving 18, 14-15 year old school children, randomly allocated into three interventional groups, Group A (5% Sodium fluoride varnish, Fluoritop-SR varnish), Group B (5% Sodium fluoride - Tricalcium phosphate varnish, Clinpro White varnish) and Group C (5% Sodium fluoride- amorphous calcium phosphate-casein phosphopeptide varnish, MI Varnish) to receive the varnish application. Saliva samples were collected at the end of one hour after varnish application for S Mutans count estimation. Student’s paired ‘t’ test and One way-ANOVA tests were used for statistical analyses.Results: Significant reductions in salivary streptococcus mutans count at one hour was achieved with application of B & C varnishes compared to varnish A. Conclusion: amorphous calcium phosphate-casein phosphopeptide and tricalcium phosphate varnish groups exhibited better antimicrobial property against streptococcus mutans compared to Sodium fluoride varnish at one-hour post intervention.

Evaluation of the Antimicrobial Effect of Thyme Extract on Streptococcus Mutans

Purpose: This study was conducted to evaluate the effect of Thyme extract mouth rinse against Chlorhexidine mouthwash on salivary Streptococcus mutans count in a group of Egyptian children. Materials and Methods: A total of 70 Egyptian children were included in this study. Children ages ranged from 5 to 10 years old in a good physical condition. Children were randomly distributed into two groups A & B each of 35 children. In children of group A (using Thyme extract) each participant was instructed to rinse with 10ml of thyme extract for one minute. In group B (control group using Chlorhexidine mouthwash 0.2%) each participant was instructed to rinse with 10ml of CHX for one minute. Results: There was a significant reduction in Streptococcus mutans count in both groups. Conclusion: Thyme extract mouthwash was successful as an antimicrobial agent. It significantly reduced the total bacterial count in the saliva of children when compared to a potent antiseptic like Chlorhexidine.

Comparative evaluation of Stevia and Xylitol chewing gum on salivary Streptococcus mutans count - A pilot study.

BackgroundStevia is a natural sweetener which is used as sugar substitute. It has been suggested that stevia may be anticariogenic. However, there is limited research in this regard. Hence, the present study was designed to assess reduction in S. mutans in stevia and xylitol chewing gums. The aim of this study is to evaluate the effectiveness of stevia and xylitol chewing gums on salivary Streptococcus mutans count. Material and MethodsA randomized triple blinded clinical study with a crossover design included twenty healthy children aged 8-13 years with decayed, missing, and filled teeth (dmft)/DMFT index score ≥ 3. Before the test, unstimulated saliva was collected. Children divided into Group I and II were given Stevia and Xylitol chewing gums respectively. Saliva samples were then collected at 15 min (just after spitting) and after 1 h. The amount of S. mutans in saliva was evaluated using a selective media (TYCSB). The data were subjected to statistical analysis using statistical software IBM SPSS statistics 20.0 (IBM Corporation, Armonk, NY, USA) ResultsReduction in S. mutans was seen from baseline to 1 hour in both groups in trial and crossover design though intergroup comparison was not statistically significant. There was reduction seen from baseline to 15 minutes and 15 minutes to 1 hour in xylitol and stevia group both in trial and crossover design which was statistically significant. ConclusionsStevia containing chewing gum is equally effective to Xylitol chewing gum in reducing salivary S. mutans counts. Key words:Stevia, Xylitol , S. mutans.