Measurement of salivary IgA antibody (PAc-peptide antibody, PPA) to amino acid residues 361-386 of Streptococcus mutans PAc, which possess a multiple binding motif to various HLA-DR molecules and a B-cell epitope that recognises the inhibiting antibody to S. mutans, is an indicator for the population numbers of mutans streptococci (MS) in human saliva. The purpose of this study was to clarify the role of PPA in infection control of MS after professional oral hygiene care. Thirty-nine dependently living institutionalised elderly subjects (75.9 +/- 7.5 years; 10 males, 29 females) participated in the study. The measurements of PPA, MS, total streptococci (TS) and lactobacilli (LB) were performed by ELISA and culture techniques from saliva, plaque and tongue samples from the elderly. After treatment using professional oral care, the numbers of MS decreased significantly at 6 months in saliva and tongue samples from the group not having PPA in comparison with the primary data; whereas in the PPA-detected group, a significant decrease in MS number was shown immediately following professional care at 1-12 months in all samples. There was little difference in the numbers of LB at any of the time points. The numbers of TS decreased rapidly in PPA-not detected group in comparison with the PPA-detected group. PPA may be more effective for controlling MS number in the oral cavity after professional treatment. The measurement of PPA may be used for preventive instruction to dental caries at the chair side in the clinical setting.