Physicochemical salivary properties, Lactobacillus, mutans streptococci counts and early childhood caries in preschool children of Colombia

Dental caries is a multifactorial disease, in which saliva has an important role. Saliva properties affect the growth of cariogenic microorganisms, so variations below threshold levels are considered risk factors for the development of dental caries. Salivary tests and microbiological counts of cariogenic bacteria are often used for clinical purposes in order to reveal problems that could explain caries development and have been evaluated in multiple studies, but these studies have mainly been carried out on adults. Thus, the aim of this study was to identify physicochemical salivary properties, mutans streptococci and Lactobacillus counts among preschool children, and their relationship with ECC in a cross-sectional study in Medellín, Colombia. Caries was determined using ICDAS criteria for a sample of 201 preschool children. Stimulated saliva samples were processed for bacterial detection, mean flow rate, pH and buffer capacity calculation. Risk variables for ECC were assessed individually and adjusted using a binary logistic regression model. The results showed that 71.14% of study subjects had ECC. Flow rate, final pH and Buffer capacity increased with age, but none of them were related to the presence of ECC. Although OR analysis detected correlations between ECC, gender age, dental eruption stage and Lactobacillus presence, binary logistic regression analysis only showed gender and Lactobacillus as strongly associated with ECC. It can be concluded that gender and Lactobacillus presence are key variables for the presence of ECC in these children; whilst age and dental eruption stage play a minor role. Further studies are required to clarify the role of mutans streptococci counts in this population and to establish normal salivary parameters as well as threshold levels for hyprosalivation in preschool children, as results showed differences with normal parameters used for adults.     

Correlations between the prevalence of caries and the microbiologic parameters of saliva in patients with Turner syndrome

The aim of our study was to investigate the associations between caries prevalence and microbiological composition and flow rate of saliva in patients with Turner's syndrome. The examined population consisted of 29 patients with Turner's syndrome and 30 healthy control girls. DMF-T means, stimulated salivary flow, Streptococcus mutans and Lactobacillus counts in saliva were determined. Stimulated salivary flow was significantly higher in the patients group. Caries prevalence was found significantly lower in patients with Turner's syndrome, which finding may have been caused by the significantly lower counts of salivary Streptococcus mutans and Lactobacillus. Statistically significant correlation was found between DMF-T mean values and salivary microbiological counts.     

Risk factors for dental caries in children with cerebral palsy

This study was conducted to examine the oral condition and the salivary and microbiological parameters associated with dental caries in 62 children with cerebral palsy, who came from households of low socioeconomic status (Study Group). This group had mixed (6 to 11 years old) and permanent (11 to 16 years old) dentition. Dental examinations were performed to measure dental caries, plaque index, salivary levels of mutans streptococci and lactobacilli, salivary flow rate, pH of stimulated saliva, and buffer capacity of saliva. A group of 67 non-handicapped children from similar socioeconomic backgrounds also were examined using these parameters (Control Group). Data were analyzed statistically by non-parametric tests and by correlation. The results showed that children with cerebral palsy who had permanent dentitions had a higher mean decayed, missing and filled surfaces index, as well as a higher plaque index for both sexes. Microbiological examination revealed higher levels of mutans streptococci among Study Group subjects with mixed dentition than in the Control Group. Also, lactobacillus counts were higher in the Study Group, regardless of sex or dentition. With respect to salivary flow rate, pH and buffering capacity, lower mean values were obtained for the Study Group.     

Short-term consumption of probiotic-containing cheese and its effect on dental caries risk factors

Cheese is known to contain compounds that reduce the risk of dental caries. The long-term consumption of milk containing Lactobacillus rhamnosus GG, ATCC 53103 (LGG), has been shown to reduce caries risk in children. The aim of the present study was to examine whether short-term consumption of cheese containing LGG and Lactobacillus rhamnosus LC 705 would diminish caries-associated salivary microbial counts in young adults. Altogether, 74 18-35 year-old subjects completed this double-blinded, randomised, placebo-controlled study. During the 3 week intervention, the subjects ate 5 x 15 g cheese per day. Oral examinations were made before and after the study. Stimulated salivary secretion rates, buffer capacity and counts of salivary Streptococcus mutans, yeast and lactobacilli were evaluated before and after the intervention and after a 3 week post-treatment period. The results showed no statistically significant difference between the groups in Streptococcus mutans counts after the intervention, but during the post-treatment period there was a significantly greater reduction in these counts in the intervention group compared to the control group (P=0.05). However, Streptococcus mutans counts decreased in 20% (P=0.01) and yeast counts in 27% (P=0.005) of all the subjects, regardless of the intervention group. Results from logistic regression showed a trend indicating that probiotic intervention might reduce the risk of the highest level of Streptococcus mutans (OR=0.37, 95% CI 0.08-1.75, P=0.21) and salivary yeasts (OR=0.40, 0.09-1.71, P=0.22).     

Long-term evaluation of root surface caries in periodontally treated patients

Caries development on exposed root surfaces was evaluated in 31 patients who had been subjected to surgical and/or nonsurgical periodontal treatment 8 years earlier due to advanced chronic periodontitis. Besides assessments for evaluation of the periodontal treatment, a number of examinations and tests were carried out in order to assess variables presumed to influence the root surface caries development. Both statistical and graphical analyses were carried out to test differences between groups of subjects and to evaluate the variables studied as possible risk factors for root surface caries. The variables studied were: salivary lactobacillus count, salivary Streptococcus mutans count, plaque score, salivary secretion rate, salivary buffer effect, oral sugar clearance time, dietary habits and the age of the subject. The final results support previous findings from an initial 4-year period that root surface caries occurs, though to a minor extent, in this patient category demonstrating good or excellent periodontal conditions after periodontal treatment. A positive correlation was found between the baseline and final root surface caries scores. After the second 4-year period, the salivary counts of S. mutans and lactobacilli, the plaque score and the dietary habits differed significantly between groups of subjects who had developed 0 or greater than 5 new DFS %. Root surface caries was far more prevalent when risk values of the variables studied were present than when they were absent. The important variables in this respect differed considerably between the subjects. No single variable was found to be discriminative in all subjects.     

Antimicrobial systems of human whole saliva in relation to dental caries, cariogenic bacteria, and gingival inflammation in young adults

The association of salivary antibody (total IgA, IgG, and IgM and antibodies reactive with Streptococcus mutans) and non-antibody (lysozyme, lactoferrin, salivary peroxidase, myeloperoxidase, hypothiocyanite, thiocyanate) defense factors with oral health (past and present dental caries, gingival bleeding, the number of salivary S. mutans and lactobacilli) were studied in 50 naval recruits. Dental caries was significantly associated with large amounts of S. mutans, lactobacilli, and total salivary immunoglobulins and with low salivary flow rate and buffer capacity. Salivary anti-S. mutans antibodies did not correlate with dental caries or S. mutans levels. Moreover, none of the salivary non-antibody factors alone had any strong relationship to dental caries or S. mutans levels. Gingival inflammation was associated with elevated levels of lysozyme in whole saliva. It is concluded that in adults the associations between single-point measurements of most salivary antimicrobial constituents and the factors describing oral health are weak.     

Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease

The aim of this study was to investigate the relationship among type 1 diabetes mellitus, dental caries, and salivary status in children. The study comprised 68, 10-15-yr-old diabetics, and 68, age- and gender-matched non-diabetic controls. Diabetics were categorized into well-to-moderately controlled (HbA1c < 9.0%) and poorly controlled (HbA1c >or= 9.0%) groups. Caries was recorded by assessing lesion activity at non-cavitated and cavity levels. Teeth were examined visually for the presence of dental plaque. Saliva was analyzed for unstimulated and stimulated flow rates, buffer effect, mutans streptococci, lactobacilli, and yeasts. Diabetics had fewer caries and plaque, lower salivary flow rates and buffer effect, and more frequent growth of yeasts than their non-diabetic controls. Well-to-moderately controlled diabetics had fewer decayed surfaces and lower counts of mutans streptococci and yeasts than poorly controlled diabetics, but the level of metabolic control of diabetes had no influence on salivary flow rates and buffer effect. High caries levels in diabetics were significantly associated with age, plaque score, and decreased unstimulated salivary flow rate, but were not associated with the level of metabolic control of diabetes. High caries experience in this study population could be related to plaque accumulation and/or to changes in saliva induced by diabetes mellitus.     

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 factors affecting dental erosion in children

Dental erosion is becoming a major dental problem in both children and adults. The aim of this study was to measure the salivary flow rates, buffering capacity and mutans streptococci counts in children with erosion, and compare them to age- and sex-matched caries-free and caries-active individuals to establish which factors may be important in erosion. The study was conducted as a case-control study with standard methods of salivary and mutans streptococci measurement. The results showed significant differences for mutans streptococci counts (p = 0.05), unstimulated and stimulated salivary pH and buffering capacity (p = 0.001). These results suggest that although individuals with erosion have caries experience similar to a caries-free individual, their salivary characteristics more closely match those of a caries-active subject. The tests described are simple to carry out and may be useful in explaining individual patient susceptibility.     

The value of salivary bacterial counts as a supplement to past caries experience as caries predictor in children

This study aimed to determine whether salivary mutans streptococci and lactobacilli counts could add any value to a combination of caries experience variables that was recently presented for the prediction of caries. Sixty-nine children at the age of 7.5 yr participated in this longitudinal study. Microbiological data were obtained at the ages of 7.5, 9.5 and 11.5 yr and caries data at the ages of 7.5. 9.5. 11.5, 13.5 and 15.5 yr. Spearman's correlation coefficients were computed, and forward multiple regression analyses were carried out using bacterial counts and caries experience parameters as explanatory variables and caries increment as a dependent variable. The explained variance (adjusted R2 value) was the measure used to assess the additional value of bacterial counts to the caries predictive potential of the combined parameters of the past caries experience. Correlation coefficients between bacterial counts and 4-yr caries increment were from 0.22 tip to 0.54. In all cases, the simultaneous streptococcus mutans-lactobacilli counts showed a statistically non-significant additional adjusted R2 value of <0.06. The results do not lend support to the concept that these salivary bacterial counts are useful additional caries predictors for the mixed dentition, when a combination of caries experience parameters is used.     

Salivary microflora and caries experience in 5-year-old children from two ethnic groups

The purposes of the study were threefold: to compare salivary levels of mutans streptococci and Lactobacillus in 140 5-year-old children from two ethnic groups, to correlate caries experience of each group with bacterial counts, and to determine levels of infectivity which could indicate high caries activity in young children. Pakistani-Muslim and white Caucasian children were paired, matched for age, gender and caries experience. There were no significant differences in mutans streptococci or Lactobacillus levels between the two ethnic groups. However, strong correlations were found between caries experience and levels of both mutans streptococci and Lactobacillus in each ethnic group. Furthermore, mutans streptococci and Lactobacillus levels correlated strongly with one another. For detection of high caries activity, the optimum screening levels of bacteria were > 10(5) cfu/ml for mutans streptococci (sensitivity 78% and specificity 86%) and > 10(4) cfu/ml for Lactobacillus (sensitivity 82% and specificity 89%).     

Systematic analysis of gingival s-tate and salivary variables as predictors of caries from 5 to 7 years of age

Abstract – 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.     

双歧杆菌预防龋病有效性和安全性的系统评价与Meta分析

目的 系统评价双歧杆菌预防龋病的有效性和安全性.方法 计算机检索PubMed、Embase、The Cochrane Library、Web of Science、Scopus、Clinicaltrials、CNKI、WanFang Data和VIP数据库,时限均为从建库至2020年4月,并通过手工检索进行补充.使用R...     

The effect of hyperbaric oxygenation on postradiation xerostomia and saliva in patients with head and neck tumours

The study was designed to evaluate the influence of hyperbaric oxygenation (HBO) therapy on salivary gland function and the growth of salivary Streptococcus mutans, Lactobacillus and Candida albicans in patients with head and neck tumours who had undergone radiation therapy. Sixteen patients were included, with radiation doses from 58 to 70 Gy. The first examination was performed at baseline before the first HBO therapy (33.7 ± 9 months after radiation therapy), and the second after 20 daily HBO therapies in a hyperbaric chamber at 2.5 ATA (absolute atmospheres), where patients breathed 100% oxygen for 90 min each day. Measurements of salivary flow, buffer capacity, saliva pH and colony density of S. mutans, Lactobacillus and C. albicans in stimulated saliva were conducted, and xerostomia grade was assessed. Salivary flow increased from 0.20 ± 0.1 to 0.39 ± 0.2 ml/min at the end of HBO therapy (p < 0.001). Salivary pH also increased from 6.0 ± 0.2 to 6.5 ± 0.1 (p < 0.05). The colony density decreased from the time at baseline to the end of HBO therapy for S. mutans (p < 0.001), Lactobacillus (p < 0.05) and the fungus C. albicans (p < 0.05). The xerostomia grade decreased from 2.63 ± 0.2 to 1.94 ± 0.2 after HBO (p < 0.001). There was no significant change in buffer capacity. The increased salivary secretion rate and salivary pH, and decreased S. mutans and Lactobacillus colony density that were observed after HBO therapy may reduce caries progression in those patients.     

Salivary clinical data and dental caries susceptibility: is there a relationship?

Caries onset and progression is influenced by diverse bacterial, dietary, environmental, socioeconomic and physiological risk factors. The most significant markers include caries experience, the concentrations of mutans-group streptococci and lactobacilli, as well as protective factors, such as the buffering capacity of saliva. The aim of this study was to evaluate and compare caries risk factors. The salivary parameters determined include: buffer capacity, cariogenic bacteria counts, pH, flow rate and total protein content. Individual aspects including hygiene and diet habits were also considered. Results showed that the value corresponding to the difference of stimulated saliva pH and resting saliva pH is positively correlated with DMFT index. Lactobacilli were positively correlated with mutans streptococci, as previously described for caries diagnostics. However, the results of this study were inconclusive, showing that salivary tests parameters either as single test or even in combination are incapable of predicting caries emphasising the importance of saliva composition.     

The efficacy of chlorhexidine gel in reduction of Streptococcus mutans and Lactobacillus species in patients treated with radiation therapy

Xerostomia may develop in patients with cancer who receive radiotherapy that includes the salivary glands in the field. These patients are at high risk of rampant dental caries. Streptococcus mutans and Lactobacillus species have been associated with dental caries. Quantitative counts of these organisms demonstrated high caries risk due to streptococci in 66% and due to lactobacilli in 100% of patients studied. Use of chlorhexidine rinse was shown to reduce S. mutans counts 1.1 logs and lactobacilli 1.1 logs. The use of chlorhexidine gel resulted in a reduction of S. mutans 1.2 logs and lactobacilli 2.2 logs. In the subjects using the rinse, caries risk due to streptococci was reduced to low levels in 44% and due to lactobacilli in only one subject, with reduction to moderate risk in one third and no change in risk in the remaining patients. The use of chlorhexidine gel was found to reduce the caries risk associated with streptococci to low levels in all patients, and the risk associated with lactobacilli to low and moderate risk in two thirds of patients.     

Associations between microbiological and salivary caries activity tests and caries experience in Hungarian adolescents

The aim of the study was to assess caries prevalence in connection with salivary caries-related findings in 349 14- to 16-year-old Hungarian adolescents living in two different cities. DMFT, DMFS means, stimulated salivary flow, buffer capacity, mutans streptococci, lactobacilli and candida counts in saliva were determined. The ratio of caries-free adolescents was 4.6% in the total population sample, DMFT mean values were 7.24+/-4.86, DMFS means 10.50+/-8.35. Mean secretion rate of stimulated saliva was 0. 84+/-0.50; a low buffer capacity was found in 6.3% of the examined children. The ratio of carriers of mutans streptococci, lactobacilli and yeasts in saliva was 89.7, 73.9 and 47.7%, respectively. DMFT and DMFS values as well as mutans streptococci and candida counts were lower in the capital than in the other city. Statistically significant correlations were found between DMFT, DMFS mean values, and salivary microbiological counts.     

Individual risk assessment of caries

The estimation of individual caries risk factors and the related preventive treatment in the dental practice are discussed. Salivary counts of mutans streptococci and lactobacilli reflect the bacteriological attack (mutans streptococci) and sugar intake (lactobacilli). Caries resistance can be estimated by measurement of the salivary secretion rate and buffer capacity. Treatment of high caries risk patients should be directed against etiological factors. Salivary flow rates and buffer capacity can be stimulated by daily (sugar-free) gum-chewing. For the use of fluoridated toothpaste and sugar intake the dentist is dependent upon the cooperation of the patient. The bacteriological factor in the caries process can be suppressed by application of chlorhexidine varnish.     

Dental caries increments and related factors in children with type 1 diabetes mellitus

The aim of this study was to analyse possible associations between caries increments and selected caries determinants in children with type 1 diabetes mellitus and their age- and sex-matched non-diabetic controls, over 2 years. A total of 63 (10-15 years old) diabetic and non-diabetic pairs were examined for dental caries, oral hygiene and salivary factors. Salivary flow rates, buffer effect, concentrations of mutans streptococci, lactobacilli, yeasts, total IgA and IgG, protein, albumin, amylase and glucose were analysed. Means of 2-year decayed/missing/filled surface (DMFS) increments were similar in diabetics and their controls. Over the study period, both unstimulated and stimulated salivary flow rates remained significantly lower in diabetic children compared to controls. No differences were observed in the counts of lactobacilli, mutans streptococci or yeast growth during follow-up, whereas salivary IgA, protein and glucose concentrations were higher in diabetics than in controls throughout the 2-year period. Multivariable linear regression analysis showed that children with higher 2-year DMFS increments were older at baseline and had higher salivary glucose concentrations than children with lower 2-year DMFS increments. Likewise, higher 2-year DMFS increments in diabetics versus controls were associated with greater increments in salivary glucose concentrations in diabetics. Higher increments in active caries lesions in diabetics versus controls were associated with greater increments of dental plaque and greater increments of salivary albumin. Our results suggest that, in addition to dental plaque as a common caries risk factor, diabetes-induced changes in salivary glucose and albumin concentrations are indicative of caries development among diabetics.     

Chlorhexidine rinse in prevention of dental caries in patients following radiation therapy

Patients who receive cancer radiotherapy, which compromises salivary gland function, may develop xerostomia. These patients are at increased risk to develop rampant dental caries. Streptococcus mutans and species of lactobacillus have been associated with dental caries. Quantitative counts of these organisms demonstrated high caries risk in 85% of patients studied. The use of chlorhexidine rinse to reduce the counts of S. mutans and lactobacillus was studied. A modest reduction in S. mutans was seen, but little effect was demonstrated on lactobacillus counts. Caries activity was shown to be related to lactobacillus count.