Oral health in 4-year-old Swedish children

ABSTRACT The present study was carried out to investigate the oral status of a group of 4-year-old children who had already been investigated as 3-year-olds 1 year previously. The children were examined for caries, gingivitis, extrinsic stains, supragingival calculus, signs of traumatic injury, occlusion, interdental spacing, and lactobacilli and C. albicans in plaque samples. The parents were interviewed regarding toothbrushing habits, fluoride prophylaxis, and oral habits in the children. The investigation was performed in association with a general physical examination of the children. Caries was demonstrated in 67 % of the children. The mean Gingival Index was 0.52. Lactobacilli in plaque were detected in 34 % of the children and C. albicans in 18 %. The children in whom lactobacilli were demonstrated had significantly more decayed surfaces than the other children. Various sucking habits were noted in 42 % and nocturnal grinding of the teeth in 28%. Most of the parents had received dental advice at the Child Health Centers, and 41 % had given their children fluoride tablets regularly for at least 2 years.     

Clonal identity of Candida albicans in the oral cavity and the gastrointestinal tract of pre‐school children

The clonal relationship between oral and fecal Candida albicans isolated from children of pre‐school age was examined using RAPD analysis. Significantly higher levels of C. albicans were found in saliva, dental plaque, carious specimens and stools of 56 patients with severe caries as compared to 52 healthy control subjects. The highest prevalence was found in carious specimens and a strong correlation was observed between its presence in saliva, dental plaque, carious specimen and feces. RAPD analysis of isolates from 23 patients with simultaneous oral and fecal C. albicans revealed clonal counterparts present in both oral and stool samples in 15 cases; five patients harbored closely related strains; and three patients harbored unrelated strains. Our results demonstrate a strong correlation between oral and gastrointestinal C. albicans colonization. We assume that carious teeth may constitute an ecologic niche for C. albicans potentially responsible for recurrent oral and non‐oral candidiasis.     

Outcome of an oral health outreach programme for preschool children in a low socioeconomic multicultural area

Background. Despite a significant reduction in the prevalence of dental caries, childhood tooth decay is still a public health problem in both developed and developing countries. Objective. The aim of this study was to evaluate the caries preventive effect of an oral health programme for preschool children living in a low socioeconomic multicultural area in the city of Malmö, Sweden. Methods. Eight hundred and four 2‐year‐old children were enrolled and recalled every third month between ages 2 and 3 and semi‐annually between ages 3 and 5 years. From an outreach facility, parents were instructed on oral health with a focus on toothbrushing and diet, and provided fluoride tablets free of charge. Participants completed a clinical examination and a structured interview at age of 5 years, at which point 651 children (81%) remained in the programme. The results of the intervention group were compared with a non‐intervention reference group consisting of 201 5‐year‐old children from the same district. Results. In the intervention group, 96% attended four or more of their scheduled appointments, and mean caries prevalence was significantly lower than in the reference group (5.4 deft vs. 6.9 deft; P < 0.001). The prevented defs fraction was 27%. Parents’ daily assistance with toothbrushing and administering fluoride tablets was significantly better in the intervention group than in the reference group (P < 0.05). Conclusion. This study demonstrated that the early start of oral health programme had a significant beneficial effect on caries prevalence after 3 years.     

Urease activity in dental plaque and saliva of children during a three-year study period and its relationship with other caries risk factors

Bacterial urease activity in dental plaque and in saliva generates ammonia, which can increase the plaque pH and can protect acid-sensitive oral bacteria. Recent cross-sectional studies suggest that reduced ability to generate ammonia from urea in dental plaque can be an important caries risk factor. In spite of this proposed important clinical role, there is currently no information available regarding important clinical aspects of oral ureolysis in children.

Objective

The objective of this study was to evaluate the distribution and pattern of urease activity in the dental plaque and in the saliva of children during a three-year period, and to examine the relationship of urease with some important caries risk factors.

Methods

A longitudinal study was conducted with repeated measures over a three-year period on a panel of 80 children, aged 3–6 years at recruitment. The dynamics of change in urease activity were described and associated with clinical, biological, and behavioural caries risk factors.

Results

Urease activity in plaque showed a trend to remain stable during the study period and was negatively associated with sugar consumption (P < 0.05). Urease activity in unstimulated saliva increased with age, and it was positively associated with the levels of mutans streptococci in saliva and with the educational level of the parents (P < 0.05).

Conclusions

The results of this study reveal interesting and complex interactions between oral urease activity and some important caries risk factors. Urease activity in saliva could be an indicator of mutans infection in children.     

Evaluation of the relationship between caries indices and salivary secretory IgA, salivary pH, buffering capacity and flow rate in children with Down's syndrome

The aim of this study was to compare the caries prevalence and salivary secretory IgA (sIgA), salivary pH, buffering capacity and flow rate between Down's syndrome (DS) and control subjects. Seventy-three institutionalised children with DS and 70 normal children aged 7-12 years old were included in this study. Tooth-brushing habits and daily dietary sugar exposures of the children, family income and education levels of the parents were recorded. DMFS and dfs scores were assessed according to the World Health Organisation's criteria and stimulated whole saliva samples were collected. Salivary sIgA levels were determined by radial immunodiffusion technique, the average salivary flow rate was measured from the total volume, and salivary pH and buffering capacity were determined using a pH micro-electrode. All data were analysed using SPSS version 11.0. The DMFS and dfs scores were significantly lower in the DS group than the control group (P < 0.05). Otherwise, the difference in plaque scores between the DS and control groups was not statistically significant (P > 0.05). There were no significant differences in tooth-brushing habits and daily dietary sugar exposures of the children, family income and education levels of the parents between the two groups (P > 0.05). Salivary sIgA levels were significantly higher in the DS group (P < 0.05). Salivary pH, buffering capacity and flow rate were quite similar in both the DS and control groups (P > 0.05). In conclusion, the patients with DS had a significantly lower prevalence of caries and significantly higher levels of salivary sIgA in this study. This finding tends to support the hypothesis that higher levels of salivary sIgA may protect against dental caries.     

学龄前儿童乳牙龋相关因素的分析

目的 评价学龄前儿童的唾液变形链球菌、唾液流速和缓冲力、口腔卫生状况、饮食和口腔卫生习惯、母亲文化程度和职业等因素在乳牙龋发生中的意义.方法 采用病例对照研究方法,对1018名4岁和5岁儿童进行龋齿检查,其中dmft≥6的204人构成高龋组,dmft=0的237人为无龋组.测定两组儿童唾液变形链球菌水平、唾液流速和缓冲力、软垢指数,并由儿童母亲回答统一问卷.结果 共有417名儿童纳入结果的统计中.Logistic回归分析结果显示,唾液变形链球菌(OR=3.019)、软垢指数(OR=2.263)、每天吃甜食次数(OR=1.729)、每天喝甜饮料次数(OR=1.496)、奶瓶内容物含糖(OR=2.255)等因素有意义.结论 唾液变形链球菌水平高、口腔卫生差、高频率摄入甜食、奶瓶喂养时内容物含糖是乳牙龋的重要危险因素.     

双歧杆菌在儿童口腔中的分离及其分子生物学鉴定

目的：通过分离鉴定不同患龋情况儿童口腔中双歧杆菌的存在情况,奠定研究口腔双歧杆菌与儿童龋病发生关系的基础。方法：选取18例3-6岁高龋患儿为实验组,15例3-6岁无龋健康儿童为对照组,采集两组儿童龈上混合菌斑和口内非刺激性唾液,采用双歧杆菌特异性选择培养基对其进行专性厌氧分离培养;采用双歧杆菌特异性引物对培养后形成的单菌落进行分子生物学鉴定。结果：双歧杆菌特异性选择培养基上形成典型菌落,部分菌落通过革兰氏染色后光镜观察可见典型的Y或V状分又,也有棍棒状和匙状;实验组双歧杆菌检出率为83．3％,对照组检出率为0,两组双歧杆菌检出率的差异有统计学意义（P〈0．05）;实验组检出双歧杆菌的样本中通过随机挑取单菌落行PER扩增后测序,其结果为：实验组菌斑60个菌落中齿双歧杆菌占83.3％、殊形双歧杆菌占10％、栖牙双歧杆菌占6．7％;唾液样本60个菌落中齿双歧杆菌占90．0％、殊形双歧杆菌占6．7％、栖牙双歧杆菌占3-3％。结论：高龋儿童双歧杆菌的检出率均高于无龋儿童;口腔双歧杆菌中含有的菌种主要为齿双歧杆菌、殊形双歧杆菌、栖牙双歧杆菌;齿双歧杆菌在口腔双歧杆菌中所占比例最大,是高龋儿童口腔中的活跃菌种。     

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.     

Dental caries in children with asthma undergoing treatment with short-acting beta2-agonists

AIM: This study sought to evaluate possible higher risk for dental caries among asthmatic children undergoing treatment with short-acting beta2-agonists. METHODS: Dental clinical assessments, saliva analysis and a questionnaire survey were carried out on 60 children aged 6-12, of whom 30 were asthmatic subjects undergoing treatment with short-acting beta2-agonists and 30 were used as controls. The obtained data for DMFT/dmft scores, Silness-L?e plaque index, buffer capacity and bacteria counts for Streptococcus mutans and Lactobacillus in the saliva, oral hygiene and dietary habits were compared using Student t-test and Pearson chi-square test. RESULTS: We registered a higher DMFT score among asthmatics of 1.2-/+1.8 (SD) and 0.3-/+0.8 among non-asthmatic patients (p<0.05), while comparison of dmft scores between the examined groups showed not significant (Student t-test). Saliva analysis revealed lower buffer capacity in 43.3% of the asthmatic children, followed by higher cariogenic bacteria counts in their saliva (p<0.05 Student t-test). These results show the lower plaque index in the asthmatic group (1.6+/-0.4) compared with the control (2.1+/-0.3). Asthmatic children expressed better oral-health habits with more frequent tooth- brushing and usage of fluorides. CONCLUSION: The results from our study suggest a higher caries-susceptibility among asthmatic children undergoing treatment with short-acting beta2-agonists, but a clear association between these drugs, salivary changes and dental caries among children, still remains to be demonstrated.     

Oral status, oral hygiene habits and caries risk factors in home-dwelling elderly dependent on moderate or substantial supportive care for daily living

Strömberg E, Hagman‐Gustafsson M‐L, Holmén A, Wårdh I, Gabre P. Oral status, oral hygiene habits and caries risk factors in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living. Community Dent Oral Epidemiol 2011;. © 2011 John Wiley & Sons A/S Abstract – Objectives: Elderly people with disabilities have an increased risk of developing oral diseases as compared with the healthy elderly. The aim of this study was to investigate oral hygiene habits, clinical variables related to oral self‐care and caries risk in elderly individuals living at home with moderate and substantial needs of home care. Methods: A random sample of 151 elderly people with moderate needs and 151 with substantial needs of home care were examined. Data concerning general health, social conditions and oral hygiene habits were collected using a questionnaire. Data showing the prevalence of caries, plaque scores and gingival bleeding were obtained through clinical examinations. Results: Elderly subjects with substantial needs of home nursing had more active caries (P < 0.01) and more often gingival bleeding (P < 0.05), as compared with elderly people with moderate needs. Forty‐nine per cent of the elderly with moderate needs performed acceptable self‐care, as compared with 25% of the individuals with substantial needs. Good self‐care was associated with women, low plaque scores, less bleeding and less caries. Factors increasing the risk of having caries were low saliva secretion, high plaque scores and a large number of fillings, while having a dentist and good oral hygiene habits increased the chance of not developing caries. Conclusions: Good oral hygiene habits were associated with less prevalence of plaque and oral disease in the elderly irrespective of extent of needs of home nursing. However, the elderly with moderate needs more often performed good self‐care, indicating that the possibilities of strengthening self‐care and learning new routines are better when functions are less affected.     

口腔尿素分解活性与乳牙龋相关性的研究

目的：调查儿童患龋情况及其唾液和菌斑中的尿素分解活性,探讨儿童口腔内尿素酶活性与乳牙龋齿是否存在相关性。方法：采集98名3~6周岁儿童牙面菌斑和唾液样本,检查患龋情况,并将样本分为无龋、中龋和高龋组,各组对象的性别、年龄等基本信息无显著差异。采用纳氏试剂比色法测定样品中氨氮浓度,分析尿素分解活性。采用SPSS19.0,使用方差分析、相关性检验等方法统计分析调查对象的口腔患龋情况、菌斑和唾液内尿素分解活性,并分析它们之间是否存在相关性。结果：无龋组、中龋组和高龋组的菌斑样品中尿素分解活性差异具有统计学意义（P=0.007）。无龋组、中龋组和高龋组的唾液样品中尿素分解活性无显著差异。龋失补指数与菌斑尿素分解活性具有显著正相关性,Pearson相关系数为0.345;龋失补指数与唾液尿素分解活性无显著相关性。结论：本研究结果显示,口腔细菌产碱能力的下降与患龋风险的上升有相关,为今后口腔内细菌产碱能力与机体健康的相关性研究提供了新的证据。     

Prevalence of <Emphasis Type="Italic">Candida albicans</Emphasis> and <Emphasis Type="Italic">Candida dubliniensis</Emphasis> in caries-free and caries-active children in relation to the oral microbiota—a clinical study

Objectives

The correlation between caries and the oral prevalence of Candida spp. in children is contradictory in literature. Thereby, authors focused on Candida albicans as the most isolated Candida species from the oral cavity. Therefore, the aim of the present study was to compare caries-free and caries-bearing children regarding their oral carriage of Candida spp.

Material and methods

Twenty-six caries-free (CF group) and 26 caries-active children (CA group) were included into this study. Three different types of specimens were assessed, saliva and plaque, and in the case of caries, infected dentine samples were microbiologically analyzed for aerobic and anaerobic microorganisms and their counts. Special attention was given to the differentiation between C. albicans and Candida dubliniensis. Additionally, different biochemical tests, VITEK 2 (VITEK®2, bioMérieux, Marcy-l’Etoile, France) and 16S and 18S ribosomal DNA (rDNA) sequencing, were applied for identification.

Results

The detection of C. albicans did not differ between the CF and CA groups. C. dubliniensis was never detected in any specimen of the CF group, but occurred in one quarter of the CA group (27 % in plaque, 23 % in saliva), thus leading to a statistically significant difference between the two groups (p < 0.05). In six of these cases, C. dubliniensis was detected concomitantly in saliva and plaque and once only in plaque. CA group harbored statistically more Streptococcus mutans than the control group revealing a correlation between S. mutans and C. dubliniensis regarding the caries group.

Conclusions

This is the first study reporting a frequent detection of C. dubliniensis in caries-active children, which could have been underestimated so far due to difficulties in differentiation between this yeast species and C. albicans.

Clinical relevance

Microbiological diagnostic—especially of oral Candida species—is an important determinant for identifying etiological factors of dental caries in children.

     

Caries prevalence, caries-related factors and plaque pH in adolescents with long-term asthma

The aim of the present case-control study was to investigate dental caries, various caries-related factors as well as gingival condition, in 12- to 16-year-olds with long-term asthma (n = 20) and a matched healthy control group (n = 20). Data on dietary and oral hygiene habits, numbers of mutans streptococci and lactobacilli in saliva were also obtained. The plaque pH drop after a sucrose rinse was measured up to 40 min at 2 approximal tooth sites. A lower salivary flow rate was found in the asthma group compared to the control group (p < 0.05). The mean (± SD) of DFS, including manifest and initial caries, was 4.9 ± 5.5 in the asthma and 1.4 ± 2.3 (p < 0.01) in the control group. Only 1 adolescent in the asthma group was caries free compared to 13 in the control group. Concerning pH in plaque, adolescents with asthma had a lower initial value (p < 0.01) and final pH (p < 0.05) than the control group. The Cariogram data showed that 55% of the subjects in the control group had 'a high chance of avoiding caries' compared to 10% in the asthma group (p < 0.01). The asthmatic adolescents had higher numbers of sites with gingival bleeding (p < 0.01). To conclude, adolescents with long-term asthma had a higher total DFS and caries risk (according to Cariogram), decreased salivary rate, more gingival bleeding and lower plaque pH than adolescents without asthma.     

Efficacy of chlorhexidine varnish applications in the prevention of early childhood caries.

AIM: A prospective clinical study was conducted to evaluate the influence of 3-monthly applications of the chlorhexidine- containing varnish Cervitec on the colonisation of a child's oral cavity by mutans streptococci (MS) and on caries prevalence. METHODS: 200 children aged 11.7 +/- 0.7 months were examined. Children's caries risk was assessed on the basis of their MS scores in saliva. Out of the 48 children in whom a high caries risk (> or =10(5) CFU/ml) was expected, 23 were treated with Cervitec at 3-month intervals (CHX group). The remaining 25 children of the high-risk group received no treatment and served as controls (group C). All parents received detailed information on the prevention of early childhood caries. 172 children had completed the study after one year. RESULTS: During the course of the study the percentage of children with visible plaque on their maxillary incisors increased from 17.8% to 40.1% and the percentage of children given sweetened drinks in nursing bottles for the night rose from 16.3% to 18.0%. At the closure of the study 26.2% of the two-year-olds had salivary scores of MS > or =10(5) CFU/ml of saliva. The mean d(1-4)mft value increased from 0.05 -/+ 0.4 to 0.8 -/+ 2.9 and the mean d(1-4)mfs value rose from 0.08 -/+ 0.8 to 1.8 -/+ 5.9. No significant differences were demonstrable between the two-year-olds in groups CHX and C for colonisation of the oral cavity by MS or for d(1-4)mft values. In contrast the d(1-4)mfs values were significant lower in the CHX group as in the group C. CONCLUSION: Poor feeding habits and deficits in oral hygiene cannot be compensated by the application of Cervitec.     

Allergic rhinitis, feeding and oral habits, toothbrushing and socioeconomic status. Effects on development of dental caries in primary dentition

The aim was to determine the effect of feeding and oral habits, toothbrushing, socioeconomic status and allergic rhinitis on the development of dental caries in primary dentition. In a cross-sectional study, data were obtained by means of a structured questionnaire on 1,160 children, 4-5 years old (mean = 4.5 +/- 0.5) and born in 1999, 2000 or 2001. The children also had a physical examination by an allergist and dentists. Dental caries was diagnosed according to WHO criteria. Caries experience was measured as number of deft and defs. Logistic regression analysis assessed the association between dental caries and independent variables. The dental caries prevalence was 17.9%, 28.8% of the children had allergic rhinitis symptoms, digit sucking was reported by 9.8% and pacifier use by 13.6% of the children. The mean number of deft of the sample was 1.02 (SD = 2.37) and that of defs was 1.33 (SD = 3.54). Analysis showed that breast-feeding for >12 months (p < 0.01), toothbrushing frequency (p < 0.01), sugar consumption (p < 0.01) and pacifier use (p < 0.01) each had a significant association with dental caries occurrence in primary dentition. Children with pacifier use and allergic rhinitis had more than double the risk of dental caries development. Allergic rhinitis alone has no effect on dental caries. Healthcare professionals attempting to limit dental caries should consider the effect of prolonged breast-feeding, sugary product consumption between meals and nonnutritive habits on dental caries.     

Oral hygiene in relation to caries development and immigrant status in infants and toddlers

The purpose of this study was to describe oral hygiene factors in infants and toddlers living in Sweden with special reference to caries prevalence at 2 and 3 yr of age and to immigrant status. The study was designed as a prospective, longitudinal study starting with 671 children aged 1 yr. At 3 yr, all the children were invited to a further examination. A total of 298 children, randomly selected from the original group, were also examined at 2 yr. The accompanying parent was interviewed about the child's oral health habits. Children who were free of caries at 3 yr had had their teeth brushed more frequently at 1 and 2 yr of age, had used fluoride (F)-toothpaste more often at 2 yr of age, and had a lower prevalence of visible plaque at 1 and 2 yr of age than children with caries. Immigrant children had had their teeth brushed less frequently, had used less F-toothpaste, and had a higher prevalence of visible plaque at 1 yr of age than nonimmigrant children. Early establishment of good oral hygiene habits and regular use of F-toothpaste seem to be important for achieving good oral health in pre-schoolchildren.     

Correlations of oral bacterial arginine and urea catabolism with caries experience

Background/aim: Alkali generation by oral bacteria plays a key role in plaque pH homeostasis and may be a major impediment to the development of dental caries. To determine if the capacity of oral samples to produce ammonia from arginine or urea was related to caries experience, the arginine deiminase system (ADS) and urease activity in saliva and dental plaque samples were measured in 45 adult subjects. Methods: The subjects were divided into three groups according to caries status; 13 caries‐free (CF) individuals (decayed, missing, and filled teeth = 0); 21 caries‐active (CA) individuals (decayed teeth ≥ 4); and 11 caries‐experienced (CE) individuals (decayed teeth = 0; missing and filled teeth > 0). Real‐time polymerase chain reaction was used to quantify the proportion of certain acid‐ or alkali‐producing organisms in the samples. Results: The amount of ammonia generated from the test substrates by plaque samples was generally higher than that produced by salivary samples in all groups. Significantly higher levels of salivary ADS activity and plaque urease activity were observed in CF subjects compared to CA subjects (P = 0.0004 and P = 0.014, respectively). The proportions of Streptococcus mutans from saliva and dental plaque of CA subjects were significantly higher than those from the CF group (P = 0.0153 and P = 0.0009, respectively). In the CA group, there was an inverse relationship between urease activity and the levels of S. mutans (P < 0.0001). Conclusion: This study supports the theory that increased caries risk is associated with reduced alkali‐generating capacity of the bacteria colonizing the oral cavity; providing compelling evidence to further our understanding of oral alkali‐generation in health and disease.     

Number of mutans streptococci or lactobacilli in a total dental plaque sample does not explain the variation in caries better than the numbers in stimulated whole saliva

Abstract For practical reasons the numbers of mutans streptococci (MS) and lactobacilli (LB) in plaque are commonly estimated from saliva samples. The saliva counts are considered to be a reasonable indicator of the entire dentition's total microbial load. However, the value of salivary counts for explaining and predicting caries have been found to be low. There was therefore reason to compare the relationships between caries on the one hand and, on the other, the number of MS or LB in plaque and in saliva, respectively, in order to assess their relative merits for explaining the variation in caries, both in a total material and in subgroups with less favourable oral hygiene. Sixty children aged 14–15 years participated in the study. Caries and plaque were registered and the number of MS and LB was estimated in total plaque and in stimulated saliva samples. The results showed that the number of MS or LB in plaque did not explain the variation in caries to a greater degree than did the salivary counts. For both bacteria the explanatory values increased, as expected, in subgroups with less favourable oral hygiene, but not even at this higher level of explanation was there any difference between plaque and saliva. The LB count was a stronger explanatory variable than the MS count. It was concluded that the number of MS and LB, estimated in total plaque as well as in saliva samples, is not a useful tool in prediction.     

Caries‐related plaque microcosm biofilms developed in microplates

In vivo dental plaque biofilms consist of complex communities of oral bacteria that are a challenge to replicate in vitro. The aim of this investigation was to establish human dental plaque microcosms in microplates to reflect conditions that are relevant to dental caries. Microcosm plaque biofilms were initiated from the saliva of two different donors, grown for up to 10 days in 24‐welled microplates on Thermanox^TM coverslips in various types of artificial saliva with and without sucrose, which were replaced daily. Microbiota composition of 40 species associated with oral health and dental caries was monitored in the plaques using Checkerboard DNA–DNA hybridization analysis. pH was measured as an indicator of cariogenic potential. The composition of the saliva inocula was different, and yielded plaque microcosms with different composition and growth responses to sucrose. Artificial saliva type and presence of sucrose, and the resulting growth and pH conditions, modified the growth of individual species and hence the ecological profile of the microplate plaques during development. Complex population shifts were observed during development, and older plaques comprised predominantly facultative anaerobic species. Sucrose supplementation limited the decline of Streptococci over time but did not increase the abundance of mutans Streptococci. Sucrose at 0.15% increased levels of caries‐associated species including Lactobacillus fermentum, Lactobacillus acidophilus and Actinomyces gerensceriae; these were further increased with sucrose at 0.5%, in addition to Actinomyces israelii, Rothia dentocariosa and Capnocytophaga gingivalis. The microplate plaques demonstrated complex community dynamics that appeared to reflect the maturation of natural plaques, and sucrose induced a cariogenic plaque composition and pH.     

Short term effect of mechanical plaque control on salivary concentration of S. mutans and lactobacilli

Abstract — All visible plaque was professionally removed from teeth of 40 children who were highly infected with S. mutans and lactobacilli. Shortly before and after the removal of plaque the concentrations of those bacteria were assessed in saliva stimulated by chewing. S. mutans and lactobacilli correlated well at baseline but not after plaque elimination, e.g. more than 80% of children who were heavily infected with S. mutans could be identified by a lactobacillus test at baseline. After the elimination of plaque, the mean concentration of S. mutans dropped by 64% but lactobacilli remained unchanged. The results indicate that oral hygiene measures taken by the patient prior to sampling of saliva may mask the true concentration of salivary S. mutans and complicate the identification of high caries risk patients.