Salivary Streptococcus mutans, Lactobacilli levels and buffer capacity in children with esophageal burns

Children with esophageal burns due to toxic ingestion are medically compromised in many ways. They have problems like strictures in esophagus, dysphagia, gastroesophageal reflux and necessity to be fed with a special soft diet. Taking these distinctive features into consideration, we aimed to study these children with special focus on the dental caries risk. The experimental group consisted of 33 children between 2 and 14 years old (mean age 6.42 +/- 0.56) who had received stricture treatment in the Pediatric Surgery Department of our university. The control group consisted of 20 healthy children aged between 3 and 14 (mean age 7.25 +/- 0.7) who applied to the Pedodontics department for dental treatment. While mean dfs (+/- SE) was 11.13 +/- 2.30 and mean DMFs (+/- SE) was 9.79 +/- 4.76 in the experimental group, mean dfs (+/- SE) was found as 11.53 +/- 2.16 and mean DMFS (+/- SE) was 1.90 +/- 0.56 in control group. For the determination of Streptococcus mutans (SM), Lactobacilli (LB) and Buffer capacity (BC), salivary tests of Dentocult SM (Vivacult SM Vivadent-Liechtenstein), Dentocult LB (Vivacult LB-Vivadent-Liechtenstein) and Dentobuff (Vivacult BC-Vivadent-Liechtenstein) were applied to both groups. Our findings were evaluated statistically and compared by the Mann Whitney Confidence Test. The amount of Streptococcus mutans, Lactobacilli and the level of buffering capacity in the children with esophageal burns showed a high caries risk. Positive correlations were found between SM and LB, SM and dfs, LB and dfs levels and DMFs and duration of stricture treatment (p < 0.05). However, negative correlations were found between BC and DMFs, DMFs and tooth brushing habit, dental visit and DMFs (p < 0.05). The mean DMFs, LB and SM levels were lower and BC levels were higher in the control group. Although a significant difference was found between DMFs scores (p < 0.05), no significant difference was found between LB, BC, SM and dfs levels (p > 0.05). It could be concluded that children with esophageal burns have high dental caries risk and for this reason parental counseling about oral hygiene, diet, dental plaque controlling and preventive dental regimens have an importance in these medically compromised children.     

Salivary mutans streptococci and dental caries patterns in pre-school children

Abstract Recent studies have suggested that the identification of caries as discrete patterns may be valuable in describing and predicting caries experience on an individual basis. The purpose of this study was to assess the association between levels of salivary mutans streptococci and the prevalence, incidence and distribution of caries patterns in the primary dentition. A cohort of pre-school children (n=146, mean age 3.8 yr) were examined for dental caries and sampled for salivary mutans streptococci (SMS) at baseline and once annually for 2 yr. Children's tooth surfaces were categorized into four patterns: pit/fissure, maxillary anterior, posterior proximal, and buccal/lingual smooth surface. Salivary mutans streptococci were enumerated using a tongue blade technique, and were categorized as low (0 CPU), moderate (1–50 CPU) and high (>50 CPU). At year 2, children with high baseline SMS had the 1) highest prevalence of caries (87%) and the highest dmfs (9.15); 2) highest prevalence of each pattern, and 3) greatest number of patterns. Among children with the pit/fissure pattern, those with high baseline SMS had the greatest pit/fissure dmfs after 2 yr. Results show that baseline SMS levels were associated with both cross-sectional and longitudinal caries experience, numbers of caries patterns, and the prevalence and severity of those patterns.     

Salivary antimicrobial proteins and mutans streptococci in tonsillectomized children.

Whole saliva from 53 children who had been tonsillectomized when they were younger than 4 years old was analyzed for selected antimicrobial proteins and oral mutans streptococci 3-4 years after the operation. The results were compared with those from age- and gender-matched control children with no history of tonsillectomy. The salivary analyses comprised both immune (total IgA, IgG and IgM) and selected nonimmune (lactoferrin, myeloperoxidase, salivary peroxidase) antimicrobial proteins. Specific IgA and IgG antibodies against viral antigens (adeno-, cytomegalo-, respiratory syncytial- and Epstein-Barr-viruses) and against Streptococcus mutans cells were quantitated in both groups. The tonsillectomized children had statistically significantly higher concentrations of all immunoglobulin isotypes (P 0.001) as well as of lactoferrin (P less than 0.005), and myeloperoxidase (P less than 0.001) in saliva. However, no differences were found in the numbers of cariogenic mutans streptococci or in the total oral aerobic flora. In line with the streptococcal counts, no differences existed in anti-S. mutans IgA or IgG titers between the groups. Most antibodies against viruses, especially of IgG isotype, were significantly (P less than 0.001) higher in saliva of tonsillectomized children than in that of the controls. The results suggest that, within a long run, the humoral immune status of human saliva is not weakened by tonsillectomy. Also, mainly serum-derived antimicrobial proteins (myeloperoxidase, lactoferrin, IgG) exist in high concentrations in whole saliva after tonsillectomy.     

Salivary mutans streptococci and caries development in the primary and mixed dentitions of children

OBJECTIVES: For more than 25 years, both cross-sectional and longitudinal studies of dental caries have focused on the role of salivary mutans streptococci (SMS) as a predictor of caries risk. This study examined the relationship between SMS and longitudinal caries development in the primary and mixed dentitions. METHODS: Eighty-five children, initial mean age 3.8 years, were examined for dental caries at baseline and once annually for 6 years. Children's SMS were sampled with a tongue blade, which was impressed onto plates containing a medium selective for SMS. After incubation, colony forming units of SMS were determined semi-quantitatively and categorized as low, moderate or high. RESULTS: Children classified as high caries risk at baseline had significantly greater (P<0.05) dmfs scores for all teeth, and in the primary molars, than children classified as moderate or low caries risk at every age but 9 (P<0.10). Children classified as high risk at age 3 had the greatest DMFS increment through age 8. Based on annual examinations, there was a trend towards increasing mean dmfs/DMFS scores among children classified as high risk in every year. CONCLUSIONS: The current study is among the first to report on the ability of annual measurements of SMS to identify long-term caries risk in both the primary and the mixed dentitions. Despite limitations in predicting caries risk using microbiological methods, this longitudinal study supports the overall benefits of this type of testing.     

Salivary Streptococcus mutans and Lactobacillus sp levels in cardiac children.

This study assesses salivary conditions of 20 children with cardiac disease comparing with a control group of 15 healthy children. The results showed that there was no difference between the groups on salivary flow, buffer capacity and the level of Streptococcus mutans (Sm). The test group i.e., children with cardiac disease, showed a lower level of Lactobacillus sp. The association between the usage of antibiotics and the risk of developing caries, measuring the level of Streptococcus mutans and Lactobacillus sp., showed that children taking antibiotics frequently had a significant lower level of Lactobacillus sp (p<0.05) than healthy children. This association was not found on relation to the levels of Streptococcus mutans.     

Detection of mutans streptococci in plaque samples from Mongolian preschool and school children

Mutans streptococci, in particular Streptococcus mutans and Streptococcus sobrinus, are generally considered to be the principal microbial pathogen of dental caries. The objective of the study was to isolate S. mutans and S. sobrinus, identify them by PCR, and to compare their presence with the caries status and caries risk in Mongolian preschool and school children. Forty one preschool children aged 3–5 years and 40 school children aged 12–15 years were enrolled in this study. As assessed using Cariostat test, 75.6% of preschool children had high caries risk and 37.5% of school children had high caries risk. In preschool children, the prevalence of S. mutans and S. sobrinus were 100% and 36.6%, respectively; 63.4% were positive for S. mutans alone and 36.6% were positive for both S. mutans and S. sobrinus. In school children, the prevalence of S. mutans and S. sobrinus were 100% and 25.0%, respectively; 75.0% carried S. mutans alone and 25.0% had both S. mutans and S. sobrinus. The percentage of children positive for both S. mutans and S. sobrinus in the high caries risk group were significantly higher than those in the low risk group of either preschool (42.0% vs. 10.0%, P< 0.001) or school children (46.6% vs. 12.0%, P<0.001). Moreover, the caries status of children positive for both S. mutans and S. sobrinus were significantly higher than those positive for S. mutans alone (P< 0.01 for preschool children, and P< 0.05 for school children).     

Pre- and post-treatment levels of salivary mutans streptococci and lactobacilli in pre-school children

Summary. Objectives . To examine the effect of operative and restorative treatment of dental caries on the levels of caries associated microorganisms in saliva and to relate alterations to the type and extent of treatment.
Design . Longitudinal.
Setting . Paediatric Dentistry Department at a central hospital in Sweden.
Subjects and methods . One hundred and eight pre-school children with severe dental caries scheduled for treatment under general anaesthesia. Chair-side tests were used to estimate the levels of salivary mutans streptococci, lactobacilli and buffer capacity before the surgery and at recall appointments 1 and 6 months after treatment. Caries were assessed according to WHO guidelines and the number of extracted teeth and filled surfaces during surgery were recorded.
Results . The results demonstrate that the post-treatment levels of mutans streptococci and lactobacilli were significantly reduced ( P < 0·001) compared to pretreatment levels. Lactobacilli levels were more dramatically reduced than mutans streptococci. The reduction of mutans streptococci was positively correlated to the number of extracted teeth ( P < 0·01), but not to the number of restored or ground surfaces. Lactobacilli reduction was not significantly related to the type of treatment.
Conclusion . The findings suggest that extensive operative and restorative dental care effectively reduces the levels of caries associated with microorganisms during a period of at least 6 months.     

Salivary mutans streptococci and caries prevalence in 8-year-old Swedish schoolchildren

The aim of this study was to obtain cross-sectional information about the quantitative distribution of salivary mutants streptococci assessed with a clinically applicable microbiological method and the relation to dental caries in young schoolchildren. A total of 355 8-year-old children were examined for the presence and number of mutants streptococci in saliva by a specially prepared strip, the "Strip-mutans" method, cultivated in a selective broth. The strips were first visually examined and grouped by aid of a templet provided by the manufacturer and thereafter transferred to a laboratory for enumeration of colony forming units (CFU) with aid of a stereomicroscope. Caries scores were obtained from the dental records. Mutans streptococci were identified in 70% of all children. 46% were free from the bacterium or harboured low levels (0-10 CFU) while high levels (greater than or equal to 500 CFU) were found only in 6% of the material. Strong positive correlations (p less than 0.001) were found between different levels of mutans streptococci infection and the caries experience in both the primary (dmfs) and the permanent (DMFS) dentition. A statistically significant correlation between the direct examination and the microscopic enumeration was disclosed (r = 0.84). The bacterial culturing technique used in this study proved to be practical and reliable and thus useful in clinical routines of pediatric dentistry.     

Caries risk in children: determined by levels of mutans streptococci and Lactobaccilus

Lactobacullus sp. and S. mutans are microorganisms with cariogenic capacity, however, their presence do not determine the presence of dental caries. We evaluated the relationship between the presence of Lactobacillus sp. and S. mutans and dental caries in a schoolchildren population. The relation PI-DMFT have a value of significance p = 0.001489. In dental caries risk evaluation, the S. mutans and Lactobacillus sp. detection in saliva is a good predictor and contributing to the caries development.     

母亲唾液变形链球菌水平与幼儿变形链球菌检出关系的研究

目的：研究母亲唾液中变形链球菌水平与幼儿变形链球菌检出的关系。方法：选取北京市海淀区124对1～2岁幼儿和母亲,检测母亲刺激性唾液中变形链球菌水平及幼儿菌斑中变形链球菌检出情况,问卷获取幼儿看护信息。结果：在50对主要看护母亲和幼儿中,幼儿变形链球菌检出阳性组和阴性组的母亲唾液中变形链球菌水平分布的差异有统计学意义;母亲唾液变形链球菌水平较高组的幼儿变形链球菌检出率明显高于较低组的幼儿变形链球菌检出率,差异有统计学意义。而在74对非主要看护母亲和幼儿中,以上组间差异均无统计学意义。结论：主要看护母亲是幼儿变形链球菌的主要传播源,而非主要看护母亲可能不是幼儿变形链球菌的主要传播源。     

Salivary levels of mutans streptococci and lactobacilli in dentate 80- and 85-year-old Swedish men and women

The number of Streptococcus mutans, Streptococcus sobrinus, and lactobacilli in whole stimulated saliva was examined in 130 dentate 80- and 85-yr-old persons. 88.5% were positive for mutans streptococci and 29% carried greater than 10(6) cfu per ml saliva. S. mutans was most frequently isolated and was found in 114 persons (88%) alone or in combination with S. sobrinus. S. sobrinus was detected in 33 persons (25%), who also showed significantly higher salivary numbers of both mutans streptococci and lactobacilli than persons from whom S. sobrinus was not isolated. The S. sobrinus carriers also had significantly lower stimulated saliva secretion rates than the non-carriers. 95% of the subjects had detectable levels of lactobacilli in saliva with 35% having greater than 10(5) cfu per ml saliva. When the subjects were divided into classes according to the number of intermaxillary contacts, i.e. the Eichner classification, the distribution of subjects with high and low salivary counts of cariogenic bacteria varied. Thus fewer subjects belonging to Eichner class A showed higher salivary numbers of mutans streptococci (14% had greater than 10(6) cfu/ml) as well as lactobacilli (21% had greater than 10(5) cfu/ml) than, for example, subjects belonging to Eichner class B (26% had greater than 10(6) cfu/ml of mutans streptococci, 35% had greater than 10(5) cfu/ml of lactobacilli). Subjects who carried a removable denture(s) had significantly higher salivary numbers of both mutans streptococci and lactobacilli than subjects without removable dentures.     

Prevalence of mutans streptococci in one-year-old children

Colonization with mutans streptococci was studied in 1095 1-year-old children living in suburban Stockholm. During a scheduled vaccination appointment at a child health centre, a bacterial sample was obtained from the child's tongue and a structured questionnaire was completed by the accompanying parent. Six percent of the subjects were colonized with mutans streptococci. The variables most strongly correlated with presence of mutans streptococci were: non-Swedish background, consumption of sugar-containing beverages at night and total consumption of sugar-containing beverages. The results indicate that, by the age of 1 year, maternally influenced behaviour patterns such as dietary habits that may predispose to early colonization of mutans streptococci are already established. Such early colonization with mutans streptococci may predict high caries risk in the primary dentition.     

Salivary levels of mutans streptococci, Lactobacillus, Candida, and Veillonella species in a group of Scottish adolescents

Salivary levels of mutans streptococci, Lactobacillus, Candida, and Veillonella species were investigated on three occasions at annual intervals in a group of 372 Scottish adolescents. Counts of the micro-organisms studied were logarithmically distributed, with Candida spp. being isolated from approximately half the subjects. Counts of lactobacilli, mutans streptococci, and candida were significantly intercorrelated, while veillonella were associated consistently with mutans streptococci alone. Levels of each of the four micro-organisms were significantly correlated over the three examinations, with levels of the Candida spp. being the most stable over the period studied.     

Salivary levels of mutans streptococci, lactobacilli, yeasts, and root caries prevalence in non-institutionalized elderly dental patients

Root caries prevalence was recorded for a consecutive sample of dental patients (n = 146), aged over 55 yr and with at least 12 natural teeth. The mean root DFS score of the males (n = 49) was 6.34 +/- 4.55 and for the females (n = 97) 3.76 +/- 3.31 (P less than 0.001). The salivary levels of mutans streptococci, lactobacilli, and yeasts were determined in addition to salivary flow rate and buffering capacity. Subjects with greater than 1 root DFS had significantly higher salivary levels of mutans streptococci, lactobacilli, and yeasts. They also had fewer teeth and more exposed root surfaces. In step-wise multivariate analyses the factors significantly related to the root DFS score were the number of exposed root surfaces, number of teeth, sex and salivary yeast levels (R2 = 0.41). In the multivariate analyses salivary levels of mutans streptococci were not significantly related to any clinical measurement of root caries experience due to the greater strength of association between the root DFS score and salivary levels of yeasts. Subjects prescribed medicines with a reported xerostomic effect had significantly fewer active root lesions than those not prescribed such medicines and salivary levels of all microorganisms studied were significantly elevated in subjects prescribed medications containing sucrose.     

Salivary mutans streptococci counts as indicators in caries risk assessment in 6-7-year-old Chinese children

OBJECTIVES: This study aimed to determine whether salivary mutans streptococci (MS) counts in Chinese children had any value in the prediction of new caries in the permanent dentition in the age interval of 6.5-8.5 years. METHODS: Four hundred and thirty-three 6-7-year-old children participated in this 2-year longitudinal study. Salivary MS counts were obtained at baseline with the spatula method. Dentin and enamel caries was recorded at baseline and at the follow-up, 2 years later. Spearman's correlation coefficients were computed. Past caries experience variables at baseline were entered into a multiple regression model with caries increment of the permanent dentition as dependent variable. MS counts were subsequently entered into the model to assess the additional caries predictive value. RESULTS: Spearman's correlation coefficient for MS counts and caries experience of the primary dentition at baseline was 0.48 and for MS counts and caries increment in the permanent dentition 0.12. In the multiple regression model caries increment of the permanent dentition had an adjusted R2 of 0.17 when the past caries experience variables were entered. Adding MS counts in the regression model did not change the R2 value. CONCLUSIONS: Salivary MS counts did not add any caries predictive value when past caries experience variables were used as caries predictors in this Chinese child population.     

Salivary lactobacilli explain dental caries better than salivary mutans streptococci in 4–5-year-old children

The present comparative study was undertaken to determine which of the bacteria, lactobacilli (Ibc) and mutans streptococci (ms), in saliva better explains the variation of caries in 2728 South African 4–5-yr-old children. Caries was diagnosed according to WHO criteria. For Ibc, the Dentocult system was used. The number of ms in stimulated saliva was counted on MSB agar plates. For correction of confounding factors, data on the frequency of intake of sweets were derived from extensive interviews. Oral hygiene was determined according to the simplified debris index of G reene & V ermillion. Simple correlation analyses between dmfs and bacterial counts were done for the total material and for three caries intervals by calculating Spearman's and Pearson's coefficients of correlation. Multivariate regression analyses were done on all intervals to correct for the confounding effects of regular intake of sweets, presence of salivary ms or Ibc, and oral hygiene. Of the children, 68% had detectable Ibc in the saliva, and 74% had ms. Except for children with more than 6 dmfs, the explanatory values, i.e., percentage of variation in dmfs explained, were higher for Ibc than for ms. Before correction, the values for the total material were 15 vs 6%; for children with caries, 7 vs 5%; for those with 1–6 dmfs, 5 vs 0.4%; and for those with more than 6 dmfs, 0.3 vs 2%. All γ -values were reduced after correction, indicating that the confounders explain some of the correlation between dmfs and bacterial count. As was the case before correction, the percentage of variation in dmfs explained by Ibc after correction was higher than that for ms, except for children with more than 6 dmfs. The results suggest that Ibc explain the variation in caries among preschool children better than ms, but the question of whether Ibc is a belter predictor remains.     

Factors associated with mutans streptococci among young WIC‐enrolled children

Objectives: The objective of this study is to assess relationships between the presence or absence of mutans streptococci (MS) and other covariates in children aged 12‐49 months. Methods: Data were analyzed using baseline information from 411 children enrolled in the Special Supplemental Food Program for Women, Infants and Children (WIC) who participated in a psychoeducational study in Iowa. Children were assessed for MS using a semiquantitative method (RODAC plates). Dental examinations using d₁d₂.₃ criteria and presence of visible plaque on incisors and molars were completed. Mothers completed a series of detailed questionnaires regarding their child's oral health, their socioeconomic status, their child's dietary/oral hygiene habits, and beverage consumption, among other behaviors. Bivariate relationships with the presence of MS were assessed and followed by multivariable modeling using logistic regression (alpha = 0.05). Results: MS was present in 144 children (35 percent). Bivariate relationships with MS presence were identified for multiple covariates that included demographic characteristics, type of beverage consumption, dental caries, and plaque measures. Multivariate logistic regression modeling suggested that MS presence in children was positively associated with nonwhite race of the child, number of teeth present, presence of cavitated lesions, proportion of teeth with plaque, and lower levels of maternal education. Conclusions: The presence of MS was associated with greater caries and plaque scores and with low maternal education and nonwhite racial background.     

Antibody responses to mutans streptococci in children.

Because mutans streptococci (Streptococcus mutans, S. sobrinus) are considered the main causative bacteria in human dental caries, immune responses to these bacteria have aroused much research interest over the last two decades. Studies in man have focused mainly on salivary and serum antibodies developing naturally in response to oral colonization by mutans streptococci, or in relation to the development of dental caries. Although both salivary (IgA) and serum-derived (IgG) antibodies have been shown in many studies to protect against the adherence of and to interfere with the metabolism of mutans streptococci, no conclusive evidence relating to their clinical significance is available. In young children, serum IgG antibodies to S. mutans seem more important than salivary IgA antibodies in relation to protection against dental caries. In studies in animals and, recently, in man, monoclonal IgG antibodies to S. mutans protein antigen I/II ("adhesin") have provided effective protection against mutans streptococci. Whether they could also prevent dental caries in man is not yet known.     

Association of mutans streptococci between caregivers and their children

The purposes of this literature review were to: (1) review the sources of mutans streptococci (MS) colonization in children and the effect of MS levels of primary caregivers on children's MS colonization; and (2) evaluate studies examining interventions to reduce transmission of MS from caregivers to their children. Forty-six studies were reviewed. Strong evidence demonstrated that mothers are a primary source of MS colonization of their children. A few investigations showed other potential sources of children's MS colonization, notably fathers. The role of other factors influencing transmission, such as socioeconomic status (SES) and specific cultural or behavioral practices, are unclear. There were at least 12 reports of microbiological interventions to reduce transmission of MS from caregivers to their children. Even though most studies found a reduction of MS in the children and 2 showed significant caries reduction, these studies generally lock consistent findings regarding caries reduction, hove a small sample size and inadequate control groups, and lock blindness of investigators and subjects. The efficacy of microbiological approaches on the caregivers to reduce caries risk in children still needs to be established through more rigorously designed clinical trials.     

Colony forming unit levels of salivary Lactobacilli and Streptococcus mutans in orthodontic patients

The purpose of this study was to compare the levels of Lactobacilli (LB) and Streptococcus mutans (SM) colony forming units (CFU) in the saliva of subjects before and after orthodontic appliance placement. This was a controlled, prospective two-group, two-measurement, clinical trial performed on 64 study patients, 12-15 years old. Subjects in the experimental group were sampled for LB and SM in stimulated saliva collected on the same day but prior to band and bracket placement. The subjects in the control group were sampled on their first screening appointment two months prior to band and bracket placement. The second samples of LB and SM were taken from the experimental and control groups after two months. Saliva was transferred to a selective agar carrier and incubated for 48 hours at 37 degrees C / 99 degrees F. LB and SM colonies forming units were compared with standard densities. The experimental group wearing orthodontic appliances had significantly higher mean LB CFU counts than the control group at the 2 month follow-up (3.25 vs. 2.57, p = 0.0036). The two groups, however, did not show any difference in mean SM CFU counts at the 2 month follow-up (3.0 vs. 3.1, p = 0.66). The results of this study showed that a higher number of CFUs of LB were associated with the group wearing orthodontic appliances after two months and may play a role in the increased levels of plaque seen in many orthodontic patients.