Effects of Nicotine on Oral Microorganisms, Human Tissues, and the Interactions between Them

Peri-implant clinical profile and subgingival yeasts carriage among cigarette-smokers with peri-implant mucositis

BACKGROUND

The present observational clinical investigation is based on the hypothesis that subgingival yeast carriage (SYC) is higher in cigarette-smokers with peri-implant mucositis (PM) than non-smokers with and without PM.

OBJECTIVE

The aim was to assess peri-implant clinical profile and SYC among cigarette-smokers with PM.

METHODOLOGY

Participants were divided into four groups: Group-1-Cigarette-smokers with PM; Group-2-Cigarette-smokers without PM; Group-3-Non-smokers with PM; and Group-4-Non-smokers without PM. Information on duration and daily frequency of cigarette smoking (pack years), age, gender, familial history of smoking and most recent visit to a dentist and/or dental hygienist was collected. The following information was retrieved from healthcare records: implant dimensions, implant insertion torque, depth of insertion (credidastal or subcrestal), implant abutment connection, jaw location, implant surface characteristic, and mode of implant prosthesis retention. Peri-implant modified plaque and gingival indices (mPI and mGI), probing depth (PD) and crestal bone loss were recorded. Subgingival biofilm samples were collected, and SYC was recorded in colony forming units per milliliter (CFU/ml). P < 0.05 were considered statistically significant.

RESULTS

Eighty male individuals (20, 19, 21 and 20 individuals were included in groups 1, 2, 3 and 4, respectively) were included. The mPI was higher in Group-1 than groups 2 (P < 0.05) and 4 (P < 0.05). The mPI was higher in Group-3 than groups 2 (P < 0.05) and 4 (P < 0.05). The mGI was higher in Group-3 than groups 1 (P < 0.05), 2 (P < 0.05) and 4 (P < 0.05). The PD was higher in Group-1 than groups 2 (P < 0.05) and 4 (P < 0.05). The PD was higher in Group-3 than Groups 2 (P < 0.05) and 4 (P < 0.05). The CFU/ml were higher in Group-1 than groups 2 (P < 0.05) and 4 (P < 0.05). The CFU/ml were higher in Group-3 than groups 2 (P < 0.05) and 4 (P < 0.05).

CONCLUSION

Peri-implant soft-tissue inflammatory parameters are worse and SYC is higher in moderate smokers than light smokers with PM and non-smokers without PM.

Subgingival Yeasts Species Amongst Smokers and Nonsmokers With Peri-implantitis

BACKGROUND

There is a dearth of studies that have assessed yeast species in the subgingival biofilm (SB) samples collected from smokers and nonsmokers with peri-implantitis. This study assesses peri-implant clinical and radiographic profiles and yeasts species in the subgingival SB of cigarette smokers and nonsmokers with peri-implantitis.

METHODS

Participants were divided into 3 groups: group 1, cigarette smokers with peri-implantitis; group 2, nonsmokers with peri-implantitis; and group 3, nonsmokers without peri-implantitis. Information on smoking pack-years and patient demographics was collected. Implant-related parameters were retrieved from health care records. Peri-implant modified plaque and gingival indices (mPI and mGI, respectively), probing depth (PD), and crestal bone loss (CBL) were recorded. The SB samples were collected, subgingival yeasts colonisation was recorded, and yeasts species were identified. P < .05 was considered statistically significant.

RESULTS

Respectively, 22, 22, and 24 individuals were included in groups 1, 2, and 3. In group 1, cigarette smokers had a smoking history of 29.7 ± 7.9 pack-years. The PD, mPI, and mesial and distal CBL were higher in groups 1 (P < .01) and 2 (P < .01) than in group 3. The mGI was higher in group 2 (P < .01) than in groups 1 and 3. The total number of implants in groups 1, 2, and 3 were 22, 22, and 24, respectively. In group 3, implants were in function for a longer duration (12.2 ± 2.3 years; P < .05) than in groups 1 (5.6 ± 1.9 years) and 2 (5.1 ± 0.7 years). Yeasts levels in CFU/mL were higher in group 1 than in groups 2 (P < .05) and 3 (P < .05); they were also higher in group 2 than in group 3 (P < .05). Candida albicans was the most isolated yeasts species, followed by Candida tropicalis, in all groups.

CONCLUSIONS

Cigarette smokers and nonsmokers present similar peri-implant clinicoradiographic profiles, and oral yeasts (predominantly C albicans) seem to play a role in the progression of peri-implant disease in these individuals.

Effects of cocaine, nicotine, and marijuana exposure in Drosophila Melanogaster development: A systematic review and meta-analysis

Abuse-related drug usage is a public health issue. Drosophila melanogaster has been used as an animal model to study the biological effects of these psychoactive substances in preclinical studies. Our objective in this review is to evaluate the adverse effects produced by cocaine, nicotine, and marijuana during the development of D. melanogaster. We searched experimental studies in which D. melanogaster was exposed to these three psychoactive drugs in seven online databases up to January 2023. Two reviewers independently extracted the data. Fifty-one studies met eligibility criteria and were included in the data extraction: nicotine (n = 26), cocaine (n = 20), and marijuana (n = 5). Fifteen studies were eligible for meta-analysis. Low doses (∼0.6 mM) of nicotine increased locomotor activity in fruit flies, while high doses (≥3 mM) led to a decrease. Similarly, exposure to cocaine increased locomotor activity, resulting in decreased climbing response in D. melanogaster. Studies with exposure to marijuana did not present a profile for our meta-analysis. However, this drug has been less associated with locomotor changes, but alterations in body weight and fat content and changes in cardiac function. Our analyses have shown that fruit flies exposed to drugs of abuse during different developmental stages, such as larvae and adults, exhibit molecular, morphological, behavioral, and survival changes that are dependent on the dosage. These phenotypes resemble the adverse effects of psychoactive substances in clinical medicine.

Oral Microbiome: A Review of Its Impact on Oral and Systemic Health

PURPOSE OF REVIEW

This review investigates the oral microbiome's composition, functions, influencing factors, connections to oral and systemic diseases, and personalized oral care strategies.

RECENT FINDINGS

The oral microbiome is a complex ecosystem consisting of bacteria, fungi, archaea, and viruses that contribute to oral health. Various factors, such as diet, smoking, alcohol consumption, lifestyle choices, and medical conditions, can affect the balance of the oral microbiome and lead to dysbiosis, which can result in oral health issues like dental caries, gingivitis, periodontitis, oral candidiasis, and halitosis. Importantly, our review explores novel associations between the oral microbiome and systemic diseases including gastrointestinal, cardiovascular, endocrinal, and neurological conditions, autoimmune diseases, and cancer. We comprehensively review the efficacy of interventions like dental probiotics, xylitol, oral rinses, fluoride, essential oils, oil pulling, and peptides in promoting oral health by modulating the oral microbiome.

SUMMARY

This review emphasizes the critical functions of the oral microbiota in dental and overall health, providing insights into the effects of microbial imbalances on various diseases. It underlines the significant connection between the oral microbiota and general health. Furthermore, it explores the advantages of probiotics and other dental care ingredients in promoting oral health and addressing common oral issues, offering a comprehensive strategy for personalized oral care.

Depression and dental caries in US adults, NHANES 2015-2018

PURPOSE

This study aimed to investigate the link between depression and untreated dental caries among adults in the United States.

METHODS

Data were collected from the National Health and Nutrition Survey (2015-2018); respondents aged 20 years or older who completed a patient health questionnaire and underwent a comprehensive oral examination were included. Participants were categorized into three groups according to depressive symptoms as follows: those with no, mild, or moderate to severe depression. Data were weighted, and multiple potential covariates were included in the analysis to provide national estimates and account for the complex sample design. A multivariable weighted logistic regression model was performed to test the hypothesis that varying degrees of depression in American adults are associated with untreated dental caries. Subgroup analyses were performed based on age and gender after adjusting for potential covariates. A P value of <.05 was considered significant.

RESULTS

Among 8740 participants, the prevalence of untreated coronal and root caries was 20.50% and 12.92%, respectively. Moderate to severe depression was a significant risk factor (odds ratio, 1.25; 95% confidence interval, 1.09-1.66) for untreated root caries. The risk of untreated root caries increased by 87% in young adults (aged 20-44 years) and by 46% in women with moderate to severe depression. The suest analysis revealed that the impact of moderate to severe depressive disorder on untreated root caries was non-significantly different between the age subgroup (p=0.09) and sex subgroup (p=0.51). However, depression was non-significantly associated with untreated coronal caries (mild depression: OR, 1.07; 95% CI, 0.85-1.34; moderate to severe depression 1.06; 95% CI, 0.83-1.36; respectively).

CONCLUSION

The results of this study suggested a significant association between moderate and severe depression and untreated root caries; however, the association with untreated coronal caries was non-significant. In the United States, moderate and severe depression in adults is associated with root caries.

Association of Interdental Cleaning and Untreated Root Caries in Adults in the United States of America

PURPOSE

This study aimed to evaluate the association between interdental cleaning and untreated root caries amongst middle-aged and older adults in the US.

MATERIALS AND METHODS

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) (2015-2016 and 2017-2018). Adults aged ≥40 years who underwent full mouth examination and root caries assessment were included. Participants were classified based on their interdental cleaning frequency as none, 1-3 d/wk, and 4-7 d/wk. Associations between interdental cleaning and untreated root caries were assessed using a weighted multivariable logistic regression model adjusted for sociodemographics, general behaviour, general health condition, oral conditions, oral health behavior, and dietary factors. Subgroup analyses stratified by age and sex were performed after adjusting for covariates in the logistic regression models.

RESULTS

The prevalence of untreated root caries was 15.3% amongst 6217 participants. Interdental cleaning for 4-7 d/wk was a significant risk factor (odds ratio, 0.67; 95% confidence interval, 0.52-0.85). It was associated with a 40% reduction in the risk of untreated root caries in participants aged 40 to 64 years and a 37% reduction in women. Untreated root caries was also significantly associated with age, family income, smoking status, root restoration, number of teeth, untreated coronal caries, and recent dental visit.

CONCLUSIONS

Interdental cleaning for 4-7 d/wk was associated with fewer untreated root caries amongst middle-aged adults and women in the US. The risk of root caries increases with age. Low family income was a risk indicator for root caries amongst middle-aged adults. Additionally, smoking, root restoration, number of teeth, untreated coronal caries, and recent dental visits were common risk factors for root caries in middle-aged and older people in the US.

Effect of Cigarette and E-Cigarette Smoke Condensates on Candida albicans Biofilm Formation and Gene Expression

Smoking triggers environmental changes in the oral cavity and increases the risk of mucosal infections caused by Candida albicans such as oral candidiasis. While cigarette smoke has a significant impact on C. albicans, how e-cigarettes affect this oral pathogen is less clear. Here, we investigated the effect of cigarette and e-cigarette smoke condensates (CSC and ECSC) on C. albicans growth, biofilm formation, and gene expression. Whereas pure nicotine (N) at the minimum inhibitory concentration (MIC, 4 mg/mL) prevented C. albicans growth, enhanced biofilm formation was observed at 0.1 mg/mL. In contrast, at this nicotine sub-MIC (0.1 mg/mL) concentration, CSC and ECSC had no significant effect on C. albicans biofilm formation. Additionally, N, CSC, and ECSC increased the expression of HWP1 and SAP2 genes. The ECSC group exhibited elevated expression levels of the EAP1 and ALS3 genes, compared to the nicotine-free ECSC (-) control. Moreover, our in vitro study illustrated that the antifungal drugs, fluconazole and amphotericin B, alleviated the effect of nicotine on C. albicans gene expression. Overall, the results of the study indicated nicotine from different sources may affect the pathogenic characteristics of C. albicans, including hyphal growth, biofilm formation, and particularly the expression of virulence-related genes.

Altered microbiomes in thirdhand smoke-exposed children and their home environments

INTRODUCTION

Tobacco smoke contains numerous toxic chemicals that accumulate in indoor environments creating thirdhand smoke (THS). We investigated if THS-polluted homes differed in children's human and built-environment microbiomes as compared to THS-free homes.

METHODS

Participants were n = 19 THS-exposed children and n = 10 unexposed children (≤5 years) and their caregivers. Environmental and biological samples were analyzed for THS pollutants and exposure. Swab samples were collected from the built-environment (floor, table, armrest, bed frame) and child (finger, nose, mouth, and ear canal), and 16S ribosomal RNA genes were analyzed for bacterial taxa using high-throughput DNA sequencing.

RESULTS

Phylogenetic α-diversity was significantly higher for the built-environment microbiomes in THS-polluted homes compared to THS-free homes (p < 0.014). Log2-fold comparison found differences between THS-polluted and THS-free homes for specific genera in samples from the built-environment (e.g., Acinetobacter, Bradyrhizobium, Corynebacterium, Gemella, Neisseria, Staphylococcus, Streptococcus, and Veillonella) and in samples from children (esp. Corynebacterium, Gemella, Lautropia, Neisseria, Rothia, Staphylococcus, and Veillonella).

CONCLUSION

When exposed to THS, indoor and children microbiomes are altered in an environment-specific manner. Changes are similar to those reported in previous studies for smokers and secondhand smoke-exposed persons. THS-induced changes in child and built-environmental microbiomes may play a role in clinical outcomes in children.

IMPACT

Despite smoking bans, children can be exposed to tobacco smoke residue (i.e., thirdhand smoke) that lingers on surfaces and in settled house dust. Thirdhand smoke exposure is associated with changes in the microbiomes of the home environment and of the children living in these homes. Thirdhand smoke is associated with increased phylogenetic diversity of the home environment and changes in the abundances of several genera of the child microbiome known to be affected by active smoking and secondhand smoke (e.g., Corynebacterium, Staphylococcus, Streptococcus). Thirdhand smoke exposure by itself may induce alterations in the microbiome that play a role in childhood pathologies.

Analyses of the Effects of Arginine, Nicotine, Serotype and Collagen-Binding Proteins on Biofilm Development by 33 Strains of Streptococcus mutans

Streptococcus mutans serotype k strains comprise <3% of oral isolates of S. mutans but are prominent in diseased cardiovascular (CV) tissue. Collagen binding protein (CBP) genes, cbm and cnm, are prevalent in serotype k strains and are associated with endothelial cell invasion. Nicotine increases biofilm formation by serotype c strains of S. mutans, but its effects on serotype k strains and strains with CBP are unknown. Saliva contains arginine which alters certain properties of the extracellular polysaccharides (EPS) in S. mutans biofilm. We examined whether nicotine and arginine affect sucrose-induced biofilm of S. mutans serotypes k (n = 23) and c (n = 10) strains with and without CBP genes. Biofilm mass, metabolism, bacterial proliferation, and EPS production were assessed. Nicotine increased biomass and metabolic activity (p < 0.0001); arginine alone had no effect. The presence of a CBP gene (either cbm or cnm) had a significant effect on biofilm production, but serotype did not. Nicotine increased bacterial proliferation and the effect was greater in CBP + strains compared to strains lacking CBP genes. Addition of arginine with nicotine decreased both bacterial mass and EPS compared to biofilm grown in nicotine alone. EPS production was greater in cnm + than cbm + strains (p < 0.0001). Given the findings of S. mutans in diseased CV tissue, a nicotine induced increase in biofilm production by CBP + strains may be a key link between tobacco use and CV diseases.

Microorganisms: crucial players of smokeless tobacco for several health attributes

Global consumption of smokeless tobacco (SLT) reached 300 million users worldwide majorly from middle-income countries. More than 4000 chemical compounds represent it as one of the noxious consumable products by humans. Besides toxicants/carcinogens, the heavy microbial load on smokeless tobacco further keeps human health at higher risk. Several of these inhabitant microbes participate in biofilm formation and secrete endotoxin/mycotoxins and proinflammatory-like molecules, leading to several oral diseases. Tobacco-associated bacteria exhibit their role in tobacco-specific nitrosamines (TSNAs) formation and acetaldehyde production; both are well-documented carcinogens. Moreover, tobacco exhibits the potential to alter the oral microbiome and induce dysbiotic conditions that lead to the onset of several oral and systemic diseases. Traditional cultivation approaches of microbiology provide partial information of microbial communities of a habitat; therefore, microbiomics has now been employed to study the metagenomes of entire microbial communities. In the past 5 years, few NGS-based investigations have revealed that SLT harbors four dominant phyla (Firmicutes, Proteobacteria, Actinobacteria, and Bacteroidetes) dominating Bacillus spp. and/or Pseudomonas spp. However, functional characterization of their genetic elements will be a more informative attribute to understand the correlation between inhabitant microbial diversity and their relatedness concerning abundance and diseases. This review provides an update on the microbial diversity of SLT and its associated attributes in human health. KEY POINTS: • Heavy microbial load on smokeless tobacco alarms for poor oral hygiene. • Inhabitant microorganisms of SLT participate in TSNA and biofilm formation. • SLTs alter the oral microbiome and causes oral dysbiosis.

Microbiology of the American Smokeless Tobacco

Smokeless tobacco products (STP) contain diverse microbial communities that contribute to the formation of harmful chemical byproducts. This is concerning since 300 million individuals around the globe are users of smokeless tobacco. Significant evidence has shown that microbial metabolic activities mediate the formation of carcinogens during manufacturing. In recent years, studies have revealed a series of additional health impacts that include lesions and inflammation of the oral mucosa and the gastrointestinal tract, as well as alterations of the endogenous microbiota. These findings are due to recent developments in molecular technologies that allowed researchers to better examine the microbial component of these products. This new information illustrates the scale of the STP microbiota and its diversity in the finished product that is sold for consumption. Additionally, the application of metagenomics and metatranscriptomics has provided the tools to look at phylogenies across bacterial, viral, and eukaryotic groups, their functional capacities, and viability. Here we present key examples of tobacco microbiology research that utilizes newer approaches and strategies to define the microbial component of smokeless tobacco products. We also highlight challenges in these approaches, the knowledge gaps being filled, and those gaps that warrant further study. A better understanding of the microbiology of STP brings vast public health benefits. It will provide important information for the product consumer, impact manufacturing practices, and provide support for the development of attainable and more meaningful regulatory goals. KEY POINTS: Newer technologies allowed quicker and more comprehensive identification of microbes in tobacco samples, encapsulating microorganisms difficult or impossible to culture. Current research in smokeless tobacco microbiology is filling knowledge gaps previously unfilled due to the lack of suitable approaches. The microbial ecology of smokeless tobacco presents a clearer picture of diversity and variability not considered before.

The burden of root caries: Updated perspectives and advances on management strategies

BACKGROUND

Root caries has gained much attention in the last few years. As the world's population is ageing and people currently tend to retain more teeth compared with older generations, there is an increased prevalence of periodontal disease and gingival recession, which may accelerate the onset of root caries.

OBJECTIVE

This review aims to summarise recent findings related to the diagnosis, prevention and treatment of root caries.

MATERIALS AND METHODS

MEDLINE (OVID) and Scopus (Elsevier) searches were performed to identify and discuss articles that address the pathogenicity and clinical management of root caries.

RESULTS

Root caries is a multifactorial disease. Cariogenic species involved in root caries are less dependent on carbohydrates since collagen degradation inside the dentinal tubules can provide nutrients and microcavities for the invading microorganisms. Furthermore, the root surface has fewer minerals in comparison with enamel, which may accelerate the onset of demineralisation. Root caries could be prevented by patient education, modification of risk factors, and the use of in-office and home remineralisation tools. The use of non-invasive approaches to control root caries is recommended, as the survival rate of root caries restorations is poor. When plaque control is impossible and a deep/large cavity is present, glass ionomer or resin-based restorations can be placed.

CONCLUSION

The assessment of root carious lesions is critical to determine the lesion activity and the required intervention. Dental practitioners should also be aware of different prevention and treatment approaches to design optimum oral health care for root caries-affected patients.

In-Vitro Model of Scardovia wiggsiae Biofilm Formation and Effect of Nicotine

Recently, Scardovia wiggsiae has been reported to be strongly associated with caries formation. This study aimed to establish an in vitro model of S. wiggsiae biofilm and to investigate the effect of nicotine on S. wiggsiae colony-forming units (CFUs) growth. S. wiggsiae biofilm was grown overnight using brain-heart infusion (BHI) broth supplemented with 5 g of yeast extract/L (BHI-YE). The overnight culture was used as an inoculum to grow S. wiggsiae biofilm on standardized enamel and dentin samples. Samples were incubated with different nicotine concentrations (0, 0.5, 1, 2, 4, 8, 16 and 32 mg/mL) for 3 days. The dissociated biofilms were diluted, spiral plated on blood agar plates, and incubated for 24 h. CFUs/mL were quantified using an automated colony counter. A two-way ANOVA was used to compare the effect of different nicotine concentrations on S. wiggsiae CFUs. This study demonstrated that S. wiggsiae biofilm could be initiated and formed in vitro. Increased CFUs was observed through 0.5-4 mg/mL and 0.5-8 mg/mL of nicotine using enamel and dentin substrates, respectively. 16 and 32 mg/mL of nicotine were determined as the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC), respectively. S. wiggsiae formed greater biofilm on enamel than dentin specimens in response to the nicotine stimulus. This study demonstrated the negative effect of smoking on increasing S. wiggsiae biofilm. Establishing S. wiggsiae biofilm in vitro may allow researchers in the future to have a better understanding of caries pathogenesis and bacterial interaction.

Oral Health Effects of Combusted and Smokeless Tobacco Products

The oral cavity is usually the first part of a consumer's body exposed to the constituents of tobacco products or their emissions. Consequently, the oral cavity is a frequent site for carcinogenic, microbial, immunologic, and clinical effects of tobacco use. This article summarizes 5 presentations on various aspects of oral health affected by combusted or noncombusted tobacco products from a recent conference, "Oral Health Effects of Tobacco Products: Science and Regulatory Policy," sponsored by the American Association for Dental Research and the Food and Drug Administration.

Correlation between tobacco smoking and dental caries: A systematic review and meta-analysis

INTRODUCTION

Tobacco is responsible for infaust oral conditions and many oral diseases. Dental caries is one of the most prevalent oral diseases. The association between tobacco smoking and dental caries has become an important recent topic of research. A systematic review and meta-analysis was conducted to evaluate the association between tobacco smoking and dental caries.

METHODS

A literature search was conducted in the databases PubMed, EMBASE, Medline and Cochrane, up to December 2018. Original observational articles that estimated relevance between tobacco smoking and dental caries in adults were included. Caries were determined by measurements of decayed, missing or filled teeth (DMFT), or decayed, missing or filled surface (DMFS), or caries-related microflora levels. Trials did not include a non-smoking group, exposure to smokeless tobacco products, or participants under 16 years old. Also, literature reviews, comments, case reports and letters to the editor were not considered. Both methods of systematic review and meta-analysis were adopted. Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of all the included studies.

RESULTS

Ten out of eleven of the included studies indicated a positive association between tobacco smoking and dental caries. Two meta-analyses were performed: one included five studies using DMFT as an outcome; the other included two studies of DMFS. A random effects model was used. Both were highly heterogeneous (I²=93%, chi-squared p<0.00001; I²=70%, chi-squared p=0.07, respectively) and statistically significant (mean difference, MD=1.20, 95% confidence interval, CI: 0.40-2.00, z-test p=0.003; MD=1.88, 95% CI: 0.99-2.77, z-test p<0.0001, respectively). The quality scores of all varied from 7 to 9.

CONCLUSIONS

There is a correlation between tobacco smoking and an increased risk of dental caries. However, the overall representativeness of the studies is not good. More prospective and extensive research on this topic is needed to get validation. Even so, it is imperative that people quit tobacco smoking.

Inhibition of nicotine-induced Streptococcus mutans biofilm formation by salts solutions intended for mouthrinses

OBJECTIVES

Biofilm formation is critical to dental caries initiation and development. The aim of this study was to investigate the effects of nicotine exposure on Streptococcus mutans (S. mutans) biofilm formation concomitantly with the inhibitory effects of sodium chloride (NaCl), potassium chloride (KCl) and potassium iodide (KI) salts. This study examined bacterial growth with varying concentrations of NaCl, KCl, and KI salts and nicotine levels consistent with primary levels of nicotine exposure.

MATERIALS AND METHODS

A preliminary screening experiment was performed to investigate the appropriate concentrations of NaCl, KCl, and KI to use with nicotine. With the data, a S. mutans biofilm growth assay was conducted using nicotine (0-32 mg/mL) in Tryptic Soy broth supplemented with 1% sucrose with and without 0.45 M of NaCl, 0.23 M of KCl, and 0.113 M of KI. The biofilm was stained with crystal violet dye and the absorbance measured to determine biofilm formation.

RESULTS

The presence of 0.45 M of NaCl, 0.23 M of KCl, and 0.113 M of KI significantly inhibited (p < 0.05) nicotine-induced S. mutans biofilm formation by 52%, 79.7%, and 64.1%, respectively.

CONCLUSIONS

The results provide additional evidence regarding the biofilm-enhancing effects of nicotine and demonstrate the inhibitory influence of these salts in reducing the nicotine-induced biofilm formation. A short-term exposure to these salts may inhibit S. mutans biofilm formation.