Adherence and Streptococcus mutans infections: in vitro study with saliva from noninfected and infected preschool children

An in vitro adherence experiment was designed to mimic the transmission of Streptococcus mutans from mother to child to test the hypothesis that differences in initial adherence reflect differences in susceptibility to infection. The data show that the pretreatment of S. mutans cells with the saliva of the mother in a mother-child pair and the pretreatment of spheroidal hydroxyapatite with that of the child may result in combinations which counteract or foster the initial adherence to a varying extent. The findings indicate that such combinations may determine the risk of S. mutants infection.

Streptococcus mutans in plaque and saliva and the development of caries

Plaque samples from 10 different tooth surfaces of 10 schoolchildren with varied caries experience (DFS 10-33) were collected five times during 2.5 years. The samples were examined with an immunofluorescent technique for identification and enumeration of Streptococcus mutans serotypes c/e/f and d/g. At each sampling occasion the children were scored for caries. A stimulated saliva sample was also collected and the number of S. mutans per ml saliva was determined. The saliva level of S. mutans was shown to reflect the prevalence and proportion of this microorganism on the selected surfaces. Five surfaces carried S. mutans at each sampling. Four of these surfaces showed progressive cries S. mutans infection was also found to precede the development of incipient caries on four surfaces. Eighty percent of the surfaces that stayed sound were only transiently carriers of S. mutans in mainly very low numbers. Serotype c/e/f dominated in prevalence and proportion on the surfaces with a history of caries during the study.

[Bilateral cysts of the brain, an unusual manifestation of multiple sclerosis in childhood (author's transl)]

In a 14 year old boy symptoms of an acute demyelinating disease (Multiple Sclerosis) were characterized by the history of retrobulbar neuritis, signs of increased intracranial pressure, asymmetric bilateral hemiparesis and generalized convulsion. Computerized tomograms and neuropathologic examinations revealed large bilateral cystic lesions one of which had to be operated. Clinical and pathological relations of this unique acute myelinoclastic form of severe demyelination are shown and discussed.

Practical method to facilitate estimation of Streptococcus mutans levels in saliva

A method was developed to facilitate the estimation of Streptococcus mutans levels in saliva. Saliva-contaminated wodden spatulas were pressed directly against an elevated agar plate containing a selective medium. The results were compared with the number of S. mutans per 1 ml of paraffin-stimulated saliva. It was shown that the spatula method gave a good estimation of the level of S. mutans infection. The incubation was also made in expired air instead of 95% N2-5% CO2. The outgrowth was in good agreement with that after conventional incubation. The method is useful in epidemiological studies or in selecting persons at a high caries risk, and when ordinary saliva sampling cannot be done, for example in small children. Compared with conventional saliva sampling, this method requires less time and material at sampling as well as at the laboratory.

[Significance of microscopy preparations in periodontal diseases]

A simple microscopic method for the quantitative determination of bacteria, leucocytes and epithelial cells was tested on 24 healthy subjects and 75 patients with the diagnosis of periodontal disease. It was found that the microscopic picture is on principle, in correlation with exact clinical data, suited for detecting periodontal disease.

Intrafamilial levels of Streptococcus mutans and some aspects of the bacterial transmission

The number of S. mutans (S.m.) in saliva of parents and their children was studied. Thirty-six children, 4 1/2-5 years old, and their parents participated. A quantitative correlation was found between the number of S.m. in the mothers and their children. The degree of infection also seemed to reflect the caries experience of the child. When adults with different levels of S.m. in saliva contaminated metal spoons with saliva, a correlation between the salivary count of S.m. and the number of microorganisms transferred to the spoon was found. The survival of S.m. on saliva-contaminated test-plates was tested. After 7 h the number of viable S.m. had decreased considerably but a few cells could be found after 24-48 h. To study the presence of S.m. on objects in the city often touched by hands, MSB-containing agar dishes were pressed against several objects such as doorhandles. Only four out of 24 objects were found to be contaminated by S.m.

Artificial embolisation of inoperable dura and sinus angioma in an infant

A seven month old boy suffered fron an inoperable extensive bilateral vascular malformation of the dura and the sinus system. This congenital lesion was artificially embolised in two sessions by injecting several hundred small steel spheres through the external carotid arteries. Clinical and neuroradiological reexaminations revealed a favourable result in this case. The technique and risks of this method which so far had not been applied in infants are demonstrated.

Streptococcus mutans serotypes: some aspects of their identification, distribution, antigenic shifts, and relationship to caries

For an immunologic point of view, several facts are worth consideration. S mutans can be separated into at least seven serotypes. Five of the types are based on antigens that may be specific for S mutans. One type, e, is related to the Lancefield group E streptocci, and one type, f, may lack an antigen that shows serological specificity. Analyses of plaque samples from individuals with a high caries activity have, in most instances, shown the presence of c, d, and possibly the g types. This does not necessarily mean that they are per se more cariogenic than the other types, but if all the serotypes cannot be combatted simultaneously, the c, d, and g types are an obvious first choice. S mutans strains do have antigens other than those used for serological identification, and it is not known which antigens can evoke antibodies with the highest protective capacity in humans. The phenomenon of antigenic shifts may make it possible for the bacteria to elude antibodies. However, the number of possible changes may be restricted. If certain antigens are of importance for the cariogenicity of S mutans, a change in their structure might result in a less cariogenic flora.