Dental plaque as a microbial biofilm

Communication in bacteria: an ecological and evolutionary perspective

Individual bacteria can alter their behaviour through chemical interactions between organisms in microbial communities - this is generally referred to as quorum sensing. Frequently, these interactions are interpreted in terms of communication to mediate coordinated, multicellular behaviour. We show that the nature of interactions through quorum-sensing chemicals does not simply involve cooperative signals, but entails other interactions such as cues and chemical manipulations. These signals might have a role in conflicts within and between species. The nature of the chemical interaction is important to take into account when studying why and how bacteria react to the chemical substances that are produced by other bacteria.

Sustained-release delivery systems of triclosan for treatment ofStreptococcus mutans biofilm

Dental diseases are chronic infections caused by oral bacteria harboring the dental biofilm. Local sustained-release delivery systems prolong the duration of a drug in the oral cavity, thus enhancing its therapeutic potential, while reducing its side effects. Triclosan is an agent that was found to have an antibacterial effect against oral bacteria. However, its substantivity in the oral cavity is low, resulting in reduced antibacterial efficiency. The purpose of this study was to develop a local sustained release device containing triclosan and to test its antibacterial efficacy on Streptococcus mutans biofilm. Our results show that we can formulate an ethylcellulose-based, nondegradable, sustained-release device in which 80% of the loaded triclosan is released over a 10-day period. The release rate of triclosan corresponded to the Higuchi's planar homogenous diffusion release model (r2 = 0.998). A degradable local sustained-release delivery based on a methacrylate ester matrix was also developed for a faster release rate of triclosan. The release kinetics in those types of sustained-release delivery systems was erosion control. The local sustained-release delivery system significantly affected the viability of S. mutans in biofilm compared to placebo as was tested by confocal laser scanning microscopy. Our in vitro results show that triclosan can be incorporated into degradable or nondegradable sustained-release drug delivery systems. The release of triclosan from the local sustained-release delivery system can be controlled, thus extending its antibacterial properties.

Inhibitory effects of cranberry polyphenols on formation and acidogenicity ofStreptococcus mutansbiofilms

Cranberry fruit is a rich source of polyphenols, and has shown biological activities against Streptococcus mutans. In the present study, we examined the influence of extracts of flavonols (FLAV), anthocyanins (A) and proanthocyanidins (PAC) from cranberry on virulence factors involved in Streptococcus mutans biofilm development and acidogenicity. PAC and FLAV, alone or in combination, inhibited the surface-adsorbed glucosyltransferases and F-ATPases activities, and the acid production by S. mutans cells. Furthermore, biofilm development and acidogenicity were significantly affected by topical applications of PAC and FLAV (P<0.05). Anthocyanins were devoid of any significant biological effects. The flavonols are comprised of mostly quercetin glycosides, and the PAC are largely A-type oligomers of epicatechin. Our data show that proanthocyanidins and flavonols are the active constituents of cranberry against S. mutans.

Caries-Preventive Effect of Chlorhexidine Gel Applications among High-Risk Children

Evidence on the caries-preventive effect of chlorhexidine (CHX) among high-risk children is inconclusive, possibly because obscured by fluoride exposure. We investigated the effect of CHX among initially 3-year-old subjects whose baseline d(3)ft was = 0 and whose only regular fluoride exposure came from toothpaste. The subjects were assigned to three groups: high-risk test (HRT, n = 70), high-risk control (HRC, n = 71), and low-risk control (LRC, n = 70). Risk classification was based on salivary mutans streptococcal levels (MS, </>or=1.0 x 10(5) cfu/ml). Basic measures (oral hygiene, dietary counselling every 4 months) were given to all groups. HRT also underwent CHX gel applications for 3 consecutive days at 3-month intervals for 15 months. Eighteen months after baseline d(3)ft increments and proportions of children with d(3)ft increment >or=1 (%d(3)ft increment >or=1) among all groups were assessed. Anti-MS effect on high-risk children and caries-preventive effect on all children were statistically analysed by residual change analysis (MS), non-parametric tests and logistic regression analysis (caries). No differences were found between the groups in basic programme compliance. CHX significantly reduced MS levels. %d(3)ft increment >or=1 and mean d(3)ft increments were 34.3%, 0.56 (HRT), 32.4%, 0.54 (HRC) and 11.4%, 0.11 (LRC), with HRT/HRC values statistically significantly higher than LRC values and no significant difference between HRT and HRC. HRT children were not less likely to show new lesions than HRC children (OR = 1.09; 95% confidence interval 0.54-2.19), while high-risk children were 4 times more likely to show new lesions than low-risk children (OR = 3.71; 95% confidence interval 1.53-9.03). CHX gel applications showed moderate anti-MS effect but negligible caries-preventive effect.

Microscopic observation of bacteria: review highlighting the use of environmental SEM

Throughout the years, various methods have been adopted to investigate bacteria involved in root canal infection and apical periodontitis. This paper reviews the most commonly used microscopic techniques and discusses their possibilities, limitations and sample preparation. In particular, a recently developed variant of scanning electron microscope (SEM), referred to as environmental SEM (ESEM), is highlighted due to its potential impact across the diverse field of biomaterials research. The performance of this ESEM technique for bacterial observation of endodontic pathogens was illustrated by a practical approach. The paper concludes with a discussion on the possible use of ESEM for testing endodontic treatment modalities under environmental conditions in situ.

Competition and coexistence between Streptococcus mutans and Streptococcus sanguinis in the dental biofilm

The human mucosal surface is colonized by the indigenous microflora, which normally maintains an ecological balance among different species. Certain environmental or biological factors, however, may trigger disruption of this balance, leading to microbial diseases. In this study, we used two oral bacterial species, Streptococcus mutans and Streptococcus sanguinis (formerly S. sanguis), as a model to probe the possible mechanisms of competition/coexistence between different species which occupy the same ecological niche. We show that the two species engage in a multitude of antagonistic interactions temporally and spatially; occupation of a niche by one species precludes colonization by the other, while simultaneous colonization by both species results in coexistence. Environmental conditions, such as cell density, nutritional availability, and pH, play important roles in determining the outcome of these interactions. Genetic and biochemical analyses reveal that these interspecies interactions are possibly mediated through a well-regulated production of chemicals, such as bacteriocins (produced by S. mutans) and hydrogen peroxide (produced by S. sanguinis). Consistent with the phenotypic characteristics, production of bacteriocins and H2O2 are regulated by environmental conditions, as well as by juxtaposition of the two species. These sophisticated interspecies interactions could play an essential part in balancing competition/coexistence within multispecies microbial communities.

Dental plaque: biological significance of a biofilm and community life-style

BACKGROUND

Most microorganisms in nature attach to surfaces and form matrix-embedded biofilms. Biofilms are highly structured and spatially organized, and are often composed of consortia of interacting microorganisms, termed microbial communities, the properties of which are more than the sum of the component species. Microbial gene expression alters markedly in biofilms; organisms communicate by gene transfer and by secretion of diffusible signalling molecules. Cells in biofilms are less susceptible to antimicrobial agents.

AIM AND MATERIALS & METHODS

To comprehensively review the literature to determine whether dental plaque displays properties consistent with those of a typical biofilm and microbial community.

RESULTS

Novel microscopic and molecular techniques have demonstrated that plaque has a structured architecture with an extracellular matrix, and a diverse composition (around 50% of cells are unculturable). The constituent species communicate by gene transfer, by secreted peptides (gram-positive bacteria) and autoinducer-2 (gram-positive and gram-negative bacteria). These organisms are functionally organized for increased metabolic efficiency, greater resistance to stress and for enhanced virulence. Plaque formation has direct and indirect effects on gene expression.

CONCLUSION

Dental plaque displays properties that are typical of biofilms and microbial communities in general, a clinical consequence of which is a reduced susceptibility to antimicrobial agents as well as pathogenic synergism.

Oral microbial communities in sickness and in health

The relationship between humans and their oral microflora begins shortly after birth and lasts a lifetime. Up until fairly recently, the associations between the host and oral bacteria were considered in terms of a multiplicity of single species interactions. However, it is becoming more apparent that the oral microbes comprise a complex community, and that oral health or disease depends on the interface between the host and the microbial community as a whole. Although it is important to continue studies of the pathogenic properties of specific microbes, these are relevant only in the context of the properties of the community within which they reside. Understanding the microbial communities that drive sickness or health is a key to combating human oral diseases.

Variation in bacterial DGGE patterns from human saliva: over time, between individuals and in corresponding dental plaque microcosms

OBJECTIVE

Eubacterial 16S rDNA fingerprints of human saliva and dental plaque microcosm biofilms grown in the multi-plaque artificial mouth (MAM) were characterised using denaturing gradient gel electrophoresis (DGGE).

DESIGN

The stability of the bacterial community in the saliva of one individual collected over 7 years was assessed and compared with bacterial patterns in the saliva of 10 different individuals. DGGE was also used to assess changes in bacterial composition between saliva and mature plaque microcosms developed in the MAM from these 10 individual saliva samples.

RESULTS

A relatively stable bacterial community (>87% concordance) was maintained within the individual oral environment of the standard donor over 7 years of monitoring. By comparison, DGGE fingerprint patterns of saliva from 10 different donors displayed greater variability (66% concordance). Variability between individual DGGE profiles increased further in mature plaque microcosms grown from the saliva of the 10 donors (52% concordance) with an increase in detected species diversity and evidence for conserved similarity and hence the maintenance of organisation during community development.

CONCLUSIONS

These results suggest that stable ecological conditions were maintained long-term within the oral environment of the individual saliva donor but that transient fluctuations also occurred. The ecology and predominating microbiota in different individuals was host-specific and these differences were maintained to a degree during development into mature plaque microcosms. These findings also demonstrate the potential usefulness of applying DGGE to monitor temporal and developmental changes and possibly pathogenic patterns in oral bacterial communities from saliva and plaque.

Phenotypic and genotypic selection of microbiota surviving under dental restorations

The effects of sealing infected carious dentine below dental restorations on the phenotypic and genotypic diversity of the surviving microbiota was investigated. It was hypothesized that the microbiota would be subject to nutrient limitation or nutrient simplification, as it would no longer have access to dietary components or salivary secretion for growth. The available nutrients would be limited primarily to serum proteins passing from the pulp through the patent dentinal tubules to the infected dentine. Ten lesions were treated, and infected dentine was sealed below dental restorations for approximately 5 months. Duplicate standardized samples of infected dentine were taken at baseline and after the removal of the restorations. The baseline microbiota were composed primarily of Lactobacillus spp., Streptococcus mutans, Streptococcus parasanguinis, Actinomyces israelii, and Actinomyces gerencseriae. None of these taxa were isolated among the microbiota of the dentine samples taken after 5 months, which consisted of only Actinomyces naeslundii, Streptococcus oralis, Streptococcus intermedius, and Streptococcus mitis. The microbiota of the final sample exhibited a significantly (P < 0.001) increased ability to produce glycosidic enzymes (sialidase, beta-N-acetylglucosaminidase, and beta-galactosidase), which liberate sugars from glycoproteins. The genotypic diversity of S. oralis and A. naeslundii was significantly (P = 0.002 and P = 0.001, respectively) reduced in the final samples. There was significantly (P < 0.001) greater genotypic diversity within these taxa between the pairs of dentine samples taken at baseline than was found in the 5-month samples, indicating that the dentine was more homogenous than it was at baseline. We propose that during the interval between placement of the restorations and their removal, the available nutrient, primarily serum proteins, or the relative simplicity and homogeneity of the nutrient supply significantly affected the surviving microbiota. The surviving microbiota was less complex, based on compositional, phenotypic, and genotypic analyses, than that isolated from carious lesions which were also exposed to salivary secretions and pH perturbations.

Bacterial Biofilms and Ocular Infections

Serious bacterial infections of the eye are often associated with abiotic prosthetic materials, such as contact lenses, intraocular lenses, and scleral buckles. In recent years, microbiologists have recognized substantial differences between bacteria growing in a sessile community attached to a surface and free-living or planktonic bacteria. These sessile surface-attached communities are known as biofilms, whose properties have important consequences for clinical medicine. As a population, bacteria in biofilms are more resistant to antimicrobial agents and the immune system, and they are more persistent than planktonic bacteria in hostile environments. These characteristics are likely the result of both biofilm-specific phenotypes and increased phenotypic diversity within biofilms as compared with planktonic communities of bacteria. Bacterial biofilm formation has been observed on human tissues, as well as on abiotic prosthetic devices. A better understanding of biofilm formation may lead to the development of novel antimicrobial agents as well as prosthetic devices that are resistant to bacterial colonization.