Caries status and microbial conditions in children in 1973 and 1984

Abstract — In 1973 all 9–12-yr-old children in a county in Sweden were examined with regard to caries prevalence, salivary Streptococcus mutans and lactobacilli. Eleven years later the same parameters were analyzed in 250 randomly selected children of the same age and from the same county. Both the number ofcariogenic microorganisms and the caries prevalence were significant-ly lower in 1984 than in 1973 (P<0.001). The lower number of S. mutans and lactobacilli could be due to several EBctors and is probably one of the reasons for the low caries prevalence in the children in the present study.     

Mutans streptococci, lactobacilli and caries prevalence in 11-and 12-year-old Icelandic children

Since the caries prevalence has not declined in Iceland as it has in other European countries, it was of interest to study the presence of cariogenic bacteria in Icelandic children. The prevalence of salivary mutans streptococci and lactobacilli was examined in 217 11- and 12-yr-old Icelandic children and was related to their caries prevalence. In 2% of the children mutans streptococci were not found whereas 31% and 35% of the 11-yr-olds and 12-yr-olds respectively carried more than 10(6) CFU per ml saliva. Lactobacilli were not detected in 8% of the children whereas 28% of the 11-yr-olds and 23% of the 12-yr-olds had more than 10(5) CFU per ml saliva. The mean caries prevalence (DFS), initial caries included, for 11-yr-olds was 21.6 and for 12-yr-olds 28.8. Both mutans streptococci and lactobacilli were significantly correlated to each other as well as to caries prevalence. An increased number of these microorganisms, especially the mutans streptococci, were associated with an increased DFS. Children with high salivary counts of mutans streptococci and lactobacilli showed four times higher DFS than children with low numbers. The magnitude of salivary cariogenic bacteria as well as caries prevalence was found to resemble the situation in Sweden 10 yr ago. S. mutans (serotype c/e/f) was carried by all mutans streptococci positive children. S. sobrinus (serotype d/g) was found in 60 children (30.2%). Children with both S. mutans and S. sobrinus had significantly higher salivary counts of mutans streptococci and lactobacilli as well as caries prevalence than children with only S. mutans.     

Mutans streptococci and lactobacilli in saliva from children with insulin-dependent diabetes mellitus

The quantitative distribution of mutans streptococci and lactobacilli in saliva of insulin-dependent diabetic children was compared with a group of healthy children and related to the metabolic control of the disease. The study group, consisting of 94 boys and girls (age 4-19) with type 1 diabetes was matched by sex and age with a non-diabetic control group. Stimulated whole saliva was collected and flow rate, buffer capacity and the levels of mutans streptococci and lactobacilli were analysed in all children. In the diabetic group, total salivary proteins and glucose content of saliva were determined. Data on caries experience were recorded from the dental cards of all children. There were no difference in the distribution or number of mutans streptococci between the groups, but significantly (p less than 0.05) lower levels of lactobacilli were found among the diabetic children. The number of lactobacilli was positively correlated (p less than 0.05) to glucose concentration in saliva. There was no difference in the prevalence of caries between the groups. The present findings suggest that the dietary treatment of young insulin dependent diabetics gives rise to a reduced number of lactobacilli in saliva but does not affect the mutans streptococci.     

Streptococcus mutans, lactobacilli and dental health in 13–14-year-old Swedish children

Abstract The dental health and the prevalence of Streptococcus mutans and lactobacilli were examined in 101 13–14-year-old children. The average number of decayed (incipient caries) and filled surfaces (DFS) was 10.1 and 12.8, respectively. S. mutans was not detected in 11% of the children while 21% had 10⁶ or more S. mutans per ml saliva. Lactobacilli were not found in 21% of the children whereas 11% had 10⁵ or more lactobacilli per ml saliva. Statistically significant correlations were found between S. mutans and lactobacilli, S. mutans and DFS, lactobacilli and DPS and S. mutans plus lactobacilli and DFS. Increasing numbers of S. mutans and lactobacilli, alone and in combination, were associated with an increased caries frequency.     

Impact of oral hygiene and use of fluorides on caries increment in children during one year

The aim of this study was to assess the modifying effect of oral hygiene, and the use of fluorides on caries increment in children when frequency of meals, intake of sugars and prevalence of lactobacilli and S. mutans in the saliva were known. In 8- and 13-yr-olds it was possible to show that children with a low caries increment (0-2 surfaces) had lower mean values for frequency of meals, daily sucrose consumption and prevalence of lactobacilli and S. mutans in the saliva than children with a high caries increment (greater than or equal to 3 surfaces). There were higher mean values in the low caries-increment groups for toothbrushing frequency, use of fluoridated toothpaste and NaF-mouthrinse. Gingival bleeding index (GBI %) was used as an objective measure of oral hygiene and revealed statistically significant differences between the two groups in both age groups (P less than 0.05, P less than 0.01) with the highest scores recorded in the high caries-increment groups. Using as discriminating variables number of meals/day, daily consumption of sucrose and other sugars and number of lactobacilli and S. mutans in the saliva, 77% of the 8-yr-olds and 70% of the 13-yr-olds were correctly classified with regard to net caries increment. If GBJ %, tooth-brushing frequency, use of fluoridated toothpaste and NaF-mouthrinse were included in the analysis another 4% of the 8-yr-olds and 11% of the 13-yr-olds could be correctly classified.     

Microbial and salivary conditions in 9- to 12-year-old children

abstract – The prevalence of S. mutans and lactobacilli, the salivary secretion rate, and salivary pH and buffer capacity were examined in 655 children 9–12 years old. Some of these factors were correlated with the frequency of caries. Positive correlations were ob served between for example S. mutans and lactobacilli, between S. mutans and incipient smooth surface caries, and between lactobacilli and open carious lesion. A high proportion of the children showed large numbers of S. mutans and lactobacilli     

Mutans streptococci and lactobacilli in breast-fed children with rampant caries.

This study aimed to investigate the prevalence of selected components of the oral microflora in breast-fed children who developed rampant caries (resembling nursing caries) under hitherto unexplained circumstances. Dental plaque and saliva samples were collected from breast-fed children, aged between 1 and 2.5 years, with and without rampant caries. Mutans streptococci and lactobacilli were isolated from dental plaque of all children with rampant caries and from most caries-free children. None of the colonies of mutans streptococci resembled those of Streptococcus sobrinus. The mean counts of the mutans streptococci and lactobacilli were 100-fold higher in plaque samples from children with rampant caries as compared with caries-free children. No difference could be found between the numbers of mutans streptococci in plaque overlaying cavities and that from adjacent sound enamel. In contrast, the counts of lactobacilli in plaque were approximately 100-fold higher from cavities than from sound surfaces. The levels of mutans streptococci in saliva were directly related to the presence of rampant caries. The results show that caries-free and caries-active breast-fed children, aged 1 to 2.5 years, harbour mutans streptococci and lactobacilli on their teeth. Rampant caries in these children can occur in the absence of nursing bottles or any other feeding abuse during weaning and in the presence of an aciduric plaque microflora, as has been reported for children with nursing bottle caries.     

Microbial and salivary conditions in 9- to 12-year-old children.

The prevalence of S. mutans and lactobacilli, the salivary secretion rate, and salivary pH and buffer capacity were examined in 655 children 9-12 years old. Some of these factors were correlated with the frequency of caries. Positive correlations were observed between for example S. mutans and lactobacilli, between S. mutans and incipient smooth surface caries, and between lactobacilli and open carious lesion. A high proportion of the children showed large numbers of S. mutans and lactobacilli.     

Relationships between socioeconomic backgrounds, caries associated microflora and caries experience in 12-year-olds in Bosnia and Herzegovina in 2004

AIM: To present the prevalence of dental caries in Bosnia and Herzegovina (BH), to estimate the levels of salivary mutans streptococci and lactobacilli and compare them with caries prevalence in 12-years-old children from different socioeconomic backgrounds. STUDY DESIGN AND METHODS: A survey was carried out in 8 cantons of the Federation of BH (FBH) and in Republic Srpska (RS) in 2004. The final sample included 560 12-year-olds. The clinical examinations focused on dental status, expressed as DMFT index, and they were carried out by one examiner, following WHO standard methodologies. Additionally, the study involved 109 12-years old children from Sarajevo, divided in three groups, based on their socioeconomic background. For measuring lactobacillus and mutans streptococci (MS) count in saliva Dentocult LB and Dentocult SM-Strip Mutans were used. Levels of MS and lactobacilli were expressed as a score between 0 and 3, indicating very low to very high levels of SM and lactobacilli. RESULTS: The average DMFT of the 12-year-olds was 4.16+/-2.92. On average, 91% of the 12-year-olds were affected with dental caries. The SiC Index was 7.41+/-3.31. Investigating the relationship between caries associated microflora and caries experience in children of different socioeconomic status showed the following: significant difference in caries prevalence was found in children with different living conditions, where children with high socioeconomic status had better oral health compared to the other two groups. For mutans streptococci, 25.7% of the children had mutans class 0, 24.8% class 1, 34.9% class 2 and 14.6% class 3. The mean DMFT for mutans class 0 was 3.50, for class 1 was 4.30, for class 2 was 5.62 and for class 3 was 6.0. For lactobacilli, 38.5% of the children had lactobacilli class 0, 25.7% class 1, 23.9% class 2 and 11.9% class 3. The mean DMFT for lactobacilli class 0 was 4.3, for class 1 was 4.9, for class 2 was 4.8 and for class 3 was 6.0. No significant differences in the level of mutans streptococci and lactobacilli were found between the groups. CONCLUSION: There is moderate caries prevalence among BH 12-year-olds (DMFT 4.16+/-2.92). Caries experience varies between children with different living condition but no relation between levels of salivary mutans streptococci and lactobacilli and socioeconomic status of children could be found.     

Effect of caries-preventive measures in children with high numbers of S. mutans and lactobacilli

abstract — On the basis of the number of Streptococcus mutans and lactobacilli, 645 children 9–12 years old were divided into five groups. The children with the highest number of S. mutans and lactobacilli were considered to be at a high caries risk and were divided into three groups with 49 children in each. One group received preventive measures from a specially trained nurse twice a month, one group was treated once a month and the third group served as a control. The other 498 children with lower numbers of S. mutans and lactobacilli were considered to be at a lower caries risk and were divided into two groups. One group was treated once a month while the other was a control. The children with originally high numbers of S. mutans and lactobacilli developed significantly more new carious lesions after 1 and 2 years (2.5 and 4.3) than the children with low counts in the control groups (1.9 and 2.8). All the children in the test groups which had received the preventive program developed significantly less caries than the corresponding control group. In the test risk group treated twice a month the caries activity was extremely low during the 1st year with an average of 0.34 new carious lesions. After 2 years the average was 0.92. The microbial conditions as well as the saliva secretion rate, buffer capacity and saliva pH did not seem to be influenced by the preventive program.     

Microbial conditions and caries increment 2 years after discontinuation of controlled antimicrobial measures in Swedish teenagers

The purpose of the present study was to examine the long-term effect of a special caries preventive program in teenagers. Over a 3-yr period directed and controlled antimicrobial treatment using Streptococcus mutans as an indicator organism resulted in a remarkable caries reduction especially in children with greater than 10(6) S. mutans per ml of saliva at the start of the study. Two years after discontinuation of the special preventive program 83 out of 101 subjects, 18-19 yr old, were reexamined. All the children had followed the same basic preventive program in the Dental Health Service. The number of S. mutans and lactobacilli per ml of saliva within and between control and test groups was with few exceptions practically the same as 5 yr earlier. During the posttreatment period the caries activity was similar in the control and test groups and lower than during the experimental years especially in the control group. Subjects with initial S. mutans level of greater than 10(6) CFU per ml of saliva continued to show incremental caries scores higher than those subjects with lower S. mutans levels.     

Mutans streptococci, lactobacilli and caries experience in 12-year-old Icelandic urban children, 1984 and 1991

Abstract In order to evaluate changes in salivary counts of cariogenic bacteria and relate these to trends in caries experience, stimulated saliva was collected from a 20% random sample of 12-yr-old residents of Reykjavik. Iceland (252 children) in 1991 under conditions consistent with those of a survey conducted in 1984. The mean and median counts of salivary mutans streptococci and lactobacilli remained similar in the two studies. However, the frequency distribution at lower levels of mutans streptococci differed significantly between 1991 and 1984, e.g. in the present study 25.8% of the children had < 10⁵ compared with 13.8% in the study 1984. The mean caries prevalence in the permanent dentition (DFS_tot) was 11.0, which is significantly lower than in 1984 (mean DFS_tot 28.8). A significant difference in caries prevalence was found at various levels of salivary mutans streptococci. Strep. mutans (serotype c/e/f) was carried by all mutans streptococci-positive children, save one child, who carried only Strep. sobrinus. The proportion of 12-yr-olds who carried Strep, sobrinus had decreased significantly to 15.7% from 34.0% in 1984. Significantly more children with Strep. sobrinus showed high levels of total mutans streptococci than children with only Strep. mutans. As the case was in 1984 significantly more Strep. sobrinus carriers had a high level of salivary lactobacilli as well as higher caries prevalence than the children who did not carry this species.     

Association of the microbial flora of dental plaque and saliva with human root-surface caries

Dental plaque was obtained from one or two sound root surfaces of subjects with different degrees of root-surface caries experience. From subjects with root-surface caries, plaque samples were also obtained from either one incipient or one more advanced lesion. Proportions of the total flora were determined for total streptococci and different streptococcal species, total and different Actinomyces species, and lactobacilli. A sample of saliva was obtained from about one-third of the subjects for determination of the concentrations of mutans streptococci and lactobacilli. The main observations were: (1) Subjects without root-surface caries or restorations (group I), as compared with subjects with root-surface caries with or without restorations (group II), were characterized by having a lower prevalence and proportion of mutans streptococci and a higher prevalence and proportion of A. naeslundii in plaque on sound root surfaces; (2) subjects in group I also tended to have a lower salivary concentration of mutans streptococci and lactobacilli than subjects in group II; (3) dental plaque on sound surfaces in group II subjects contained a lower proportion of mutans streptococci than plaque associated with incipient or advanced lesions; and (4) the prevalence and proportion of lactobacilli in plaque associated with sound as well as carious root surfaces were very low. The data reinforce findings from other studies and indicate that, as for coronal caries, the plaque and saliva populations of mutans streptococci specifically are correlated positively with the presence of root-surface caries.     

Longitudinal study of the presence of mutans streptococci and lactobacilli in relation to dental caries development in 3-24 month old Thai children

OBJECTIVE: To study the acquisition of mutans streptococci (MS) and lactobacilli in relation to dental caries development in 3-24 month old Thai children. METHODS: Salivary samples were collected from 169 children using sterile wooden tongue depressors at the ages of 3, 9, 12, 18 and 24 months. The blades were pressed onto selective media for MS or lactobacilli. After incubation, the colony forming units of MS/lactobacilli were counted. Dental status was recorded from 9 months old using modified WHO criteria. RESULTS: The number of children with caries and number and severity of decayed teeth significantly increased with age. The presence of MS/lactobacilli was detectable at an early age and the cumulative prevalence of MS/lactobacilli increased with age. Children who were colonised early by MS or lactobacilli showed a higher number of decayed teeth than of those who were colonised later. The children with no MS/lactobacilli had significantly fewer decayed teeth and there was a significant correlation between MS/lactobacilli level and tooth decay. CONCLUSIONS: This longitudinal study shows early colonisation of the mouths of Thai children by MS/lactobacilli and where there are persistently high levels of the bacterias increased risk of development of dental caries.     

Maternal caries incidence and salivary close-contacts with children affect antibody levels to Streptococcus mutans in children

Serum and salivary immunoglobulins and antibodies reactive with Streptococcus mutans were determined in 67 5-8-year-old children. The children of mothers whose caries incidence rates exceeded the median value had significantly more serum IgG antibodies to S. mutans than those with a lower maternal caries activity (p less than 0.05). The children (n = 14) who had been exposed to frequent maternal salivary close-contacts in their first year had significantly higher (p less than 0.05) serum total specific IgG antibodies but significantly lower (p less than 0.01) high-avidity IgG antibodies to S. mutans than the other children (n = 53) with less frequent close-contacts. The maternal caries incidence rates were significantly positively associated with children's dfs/DFS-indices (r = 0.41; p less than 0.001). However, the high maternal caries incidence did not increase the risk of caries in those children whose mothers' saliva contained high amounts of lactobacilli during the first nursing year, when compared with matched children with a low maternal level of lactobacilli. This was possibly due to the fact that the former children had significantly (p less than 0.05) more anti-S. mutans IgG antibodies in their sera than the latter.     

Mutans streptococci, lactobacilli and caries prevalence in 15 to 16-year olds in G?teborg. Part II.

During the fall of 1987 one hundred and fifty-five 15 to 16-year-olds were examined with regard to caries prevalence, saliva secretion rate and salivary numbers of mutans streptococci and lactobacilli. In 15% of the subjects no mutans streptococci were detected, while 17.7% carried > 10(6) colony forming units (cfu) per ml saliva. The median value was 1.8 x 10(5) cfu per ml saliva. No lactobacilli were detected in 19% of the subjects and 14.3% had > 10(5) cfu per ml saliva. The mean caries prevalence was 21.0, of these 14.1 were incipient lesions. Increased numbers of mutans streptococci and lactobacilli were associated with increasing caries prevalence. Subjects with high numbers of both microorganisms showed about 4 times higher mean caries prevalence than those with low numbers. Streptococcus sobrinus carriers (15%) had both higher mean caries prevalence and a higher proportion of subjects with > 10(6) cfu mutans streptococci per ml saliva than was found in the whole group.     

Dental caries and caries-associated microorganisms in Uruguayan preschool children

The prevalence of dental caries was studied in 3-5-year-old Uruguayan children (n = 76) living in 2 areas with different socioeconomic and cultural conditions. More children from the low socioeconomic area of Las Acacias had caries (68%) than children from the middle- to high-class neighborhood of Pocitos (19%). They also had poorer oral hygiene and a significantly higher caries prevalence (P < 0.05) than those from Pocitos. The occurrence of mutans streptococci and lactobacilli was determined in whole unstimulated saliva and compared with that in debris collected with a loop from the dorsum of the tongue. Mutans streptococci were detected in 42% of the children with significant correlations between the salivary levels of the microorganism and caries experience. Lactobacilli were recovered less frequently (18%). The detection of mutans streptococci in the tongue-loop samples was significantly correlated with that in whole saliva.     

Caries-related microbiological findings in a group of teenagers and their parents

The levels of salivary Streptococcus mutans and lactobacilli and caries experience were studied in 113 teenagers and 163 adults. The study population consisted of 82 mother-child and 73 father-child pairs. The number of decayed, missing, and filled tooth surfaces (DMFS) was eightfold higher in adults than in teenagers (56.4 +/- 22.8 vs. 7.3 +/- 6.7). The percentage distribution of the level of salivary S. mutans and lactobacilli was approximately the same in both groups. The mean number of DMFS increased with increasing levels of salivary S. mutans and lactobacilli, the correlation being highly significant both in teenagers and adults. There was a significant correlation of the DMFS indices in the mother-child pairs (r = 0.364), but the correlation was not significant in the father-child pairs (r = 0.138). The salivary level of S. mutans was higher in the children of mothers with high DMFS values compared to the children of mothers with low DMFS values.     

Caries prevalence and salivary mutans streptococci in 0–2-year-old children of Japan

The prevalence of caries and the number and species distribution of salivary mutans streptococci in 356 children (aged 0-2 yr old) in Japan were examined twice at an interval of 1 yr. No mutans streptococci were isolated from the predentate children. The detection rate of mutans streptococci and the prevalence of caries increased with age. Mutans streptococci were isolated from 39.9% of the subjects. The majority of isolates were identified as Streptococcus mutans. The concentration of mutans streptococci correlated with the number of erupted teeth (r = 0.339). In addition, the concentration of mutans streptococci was more closely correlated to the caries prevalence of the next year (r = 0.465) than that of the year when the salivary concentration of mutans streptococci was first evaluated (r = 0.368). The children who had no caries but harbored mutans streptococci in the first year showed significantly higher caries prevalence in the next year than did the children with neither caries nor mutans streptococci. These results indicate that the establishment of mutans streptococci is associated with caries initiation in early childhood.     

Two-year longitudinal observations of salivary status and dental caries in children with insulin-dependent diabetes mellitus.

Salivary status and caries incidence were studied in 28 young, Type 1 diabetics from the onset of the disease and during a two-year period. Flow rate, buffer capacity, glucose content, total protein concentration and levels of mutans streptococci and lactobacilli were determined in stimulated whole saliva every third month. Dental caries was recorded at onset and then once a year. Forty-six per cent of the children developed caries during the observation period. Caries incidence was significantly higher (P less than 0.05) during the first year of diabetes, compared with the second. Caries-active children displayed significantly higher HbA1c levels (P less than 0.001), compared with caries-inactive diabetics. The number of salivary lactobacilli dropped significantly (P less than 0.05) during the first six months of the disease, while mutans streptococci levels remained unchanged during the study period. Salivary glucose concentration showed a considerable individual variation, but tended to be lower during the second year. The results suggest a possible relationship between Type 1 diabetes treatment and caries.