Effect of salivary supernatant on the glycolytic activity of the bacteria in salivary sediment

The Anticaries Efficacy of a 1.5% Arginine and Fluoride Toothpaste

Dental caries remains a world-wide disease despite the global distribution of fluoride. It has become apparent that the introduction of significant levels of sugar (fermentable carbohydrate) into the diet has resulted in a change in the biofilm, encouraging acid formation. Further, there has been a shift in the microbiota in the biofilm to a flora that produces acid, and thrives and reproduces in an acidic environment. The management of caries activity under these conditions has focused on brushing to remove the biofilm with fluoride pastes, and high-dose fluoride treatments. Kleinberg, in the 1970s, identified an arginine-containing compound in saliva that several oral biofilm bacterial species metabolize to produce base. Multiple in situ and in vivo studies have been conducted, and have discussed the ability of multiple bacteria to increase the resting pH of the biofilm and even reduce the decrease in pH when the biofilm is challenged with glucose. This shift in resting pH can shift the level of caries formation by the biofilm. Here, we present 8 clinical studies, with different clinical designs, measuring different clinical outcomes, for a diverse, world-wide population. Each of these studies demonstrates reductions in caries formation beyond that seen with fluoride alone and several demonstrate the reversal of early caries lesions. Significant clinical research has been shown that 1.5% arginine combined with fluoride toothpaste has superior anti-caries efficacy to toothpaste containing fluoride alone.

Manifestations of pain symptoms in reduced occlusion

This article presents the analysis of the relevant literature highlighting the mechanisms of the development of malocclusion and pain symptom at the reduced occlusal vertical dimension. In this case, the key complaint presented by patients is permanent steady pain described as dull, stabbing, or compressing by its character. Most often, the pain is localized within the paratoid-masticatory area as well as buccal, temporal and frontal areas, and irradiates to the upper and lower jaw or the teeth that often leads to performing unnecessary dental manipulations; to the region of the temporomandibular joint (TMJ); to the ear that sometimes is accompanied with fullness and tingling in the ears. In some cases this pain can irradiate to the hard palate and tongue. Many patients note the growing intensity of pain when chewing. Some patients experience episodic increase in pain when there are pain attacks described as compressing or stabing in the background of steady dull pain. The pain gets more intense even at the slightest movements of the head, lower jaw, or when speaking. The duration of the pain attack is approximately 20–30 minutes. A few minutes before the onset of the attack, all patients notice the emergence of somes forerunning symptoms, e.g. hyperlsalivation, paresthesia, toothache. The attacks can be provoked by conversation, overcooling, and emotional tension. It has been experimentally proven that a prolonged muscle contraction, which is often observed during emotional stress, can cause pain in the regions mentioned above. But whether will it arise or not and to what extent, it depends on the state of adaptive capacity of the body and dentofacial system. When the adaptive capacity of the body and the dentofacial system as its part are weakened, the local background for the occurrence of pain symptoms in the maxillofacial area may be: affective states (depression, anxiety), prolonged chewing load, and prolonged neck muscle tension during dental manipulations. Among the local factors that can cause pain, malocclusions rank the leading place. For example, a hyperbalancing contact is a sign of impaired muscle activity and coordination during the maximal closure of teeth in the lateral position of the mandible, and occlusal contacts on the balancing side affect the distribution of muscle activity during parafunctional closure, and this redistribution can impact on the temporomandibular joint (Andres K. H. et al.). Occlusion abnormalities may result from reduced occlusal vertical dimension, deformation of the dentitions caused by periodontal disease, partial loss of teeth, pathological tooth wearing, as well as due to improperly inserted fillings, unfit inlays, onlays, crowns. Reduced occlusal vertical dimension can also cause otalgia and some other otorhinolaryngological problems, pathogenesis of which is quite debatable and controversial in current literature. J. S. Costen considered hearing loss, tingling and other ear symptoms are associated with pressure produced by the head of the mandible joint onto the auditory tube. Reducing the vertical occlusal dimension results in increasing pressure of the head of the mandible joint onto the subtle bone arch of the articular fossa, which separates the cavity of the joint from the dura mater; this can trigger dull pain in the spine. It is important to remember that pain is a symptom that most often makes patients to search for a dental care. Pain is one of the first clinical manifestations of the body decompensation. Patients with TMJ dysfunction who experience the pain symptom is to a greater or lesser extent make up a group of patients who require a special integrated approach in their treatment.

Oral Bacterial Acid-Base Metabolism in Caries Screening: A Proof-Of-Concept Study

The objective of this cross-sectional study was to clinically validate an array of biochemical tests for oral acid/alkali generation as caries screening instruments. 185 adult subjects (mean 33.6±10.6 years) were examined clinically for dental caries using the ICDAS criteria. Bitewing radiographs were used to confirm interproximal surfaces of posterior teeth. For the purposes of this study, subjects were classified as "caries-active" if they had at least one untreated caries lesion with ICDAS 4 or higher. Pooled supragingival plaque and unstimulated saliva samples were collected and assayed for pH changes from sucrose and urea metabolism using colorimetric tests. The validity of each test to discriminate between "caries-inactive" and "caries-active" subjects was assessed and compared to a commercial bacteriological caries-screening test using roc regression and logistic regression models. The AUCs of the plaque-urea (PU: 0.59 (0.51, 0.67)), plaque-urea-glucose (PUG: 0.59 (0.51, 0.67)) and saliva-urea-glucose (SUG: 0.59 (0.51, 0.67)) tests did not differ significantly from the bacteriological tests (CRT-mutans: 0.62 (0.54, 0.70); CRT-lactobacillus: 0.63 (0.56, 0.71) (P>0.05), but the plaque-glucose (SG), saliva-glucose (SG), saliva-urea (SU) and saliva-plaque-glucose (SPG) tests had significantly smaller AUCs (P<0.05). The AUCs for the PU, PUG, SUG, and the CRT-mutans tests were higher in subjects who had no existing dental restorations (PU: 0.90 (0.77, 1.04); PUG: 0.90 (0.79, 1.01); SUG: 0.89 (0.69, 1.08); CRT-mutans: 0.90 (0.73, 1.08)). The incorporation of the biochemical tests into a multidimensional bacteriological/psychosocial caries screening model significantly increased its diagnostic values (Se+Sp: 160.6, AUC: 0.846). In conclusion, as a proof of concept, the results of this study indicate that measuring the ability of dental plaque and saliva to metabolize urea together with the ability to generate acid from sugars may have a promising role in caries screening either independently, or as part of a multidimensional biological test.

An in vitro biofilm model system maintaining a highly reproducible species and metabolic diversity approaching that of the human oral microbiome

BACKGROUND

Our knowledge of microbial diversity in the human oral cavity has vastly expanded during the last two decades of research. However, much of what is known about the behavior of oral species to date derives from pure culture approaches and the studies combining several cultivated species, which likely does not fully reflect their function in complex microbial communities. It has been shown in studies with a limited number of cultivated species that early oral biofilm development occurs in a successional manner and that continuous low pH can lead to an enrichment of aciduric species. Observations that in vitro grown plaque biofilm microcosms can maintain similar pH profiles in response to carbohydrate addition as plaque in vivo suggests a complex microbial community can be established in the laboratory. In light of this, our primary goal was to develop a robust in vitro biofilm-model system from a pooled saliva inoculum in order to study the stability, reproducibility, and development of the oral microbiome, and its dynamic response to environmental changes from the community to the molecular level.

RESULTS

Comparative metagenomic analyses confirmed a high similarity of metabolic potential in biofilms to recently available oral metagenomes from healthy subjects as part of the Human Microbiome Project. A time-series metagenomic analysis of the taxonomic community composition in biofilms revealed that the proportions of major species at 3 hours of growth are maintained during 48 hours of biofilm development. By employing deep pyrosequencing of the 16S rRNA gene to investigate this biofilm model with regards to bacterial taxonomic diversity, we show a high reproducibility of the taxonomic carriage and proportions between: 1) individual biofilm samples; 2) biofilm batches grown at different dates; 3) DNA extraction techniques and 4) research laboratories.

CONCLUSIONS

Our study demonstrates that we now have the capability to grow stable oral microbial in vitro biofilms containing more than one hundred operational taxonomic units (OTU) which represent 60-80% of the original inoculum OTU richness. Previously uncultivated Human Oral Taxa (HOT) were identified in the biofilms and contributed to approximately one-third of the totally captured 16S rRNA gene diversity. To our knowledge, this represents the highest oral bacterial diversity reported for an in vitro model system so far. This robust model will help investigate currently uncultivated species and the known virulence properties for many oral pathogens not solely restricted to pure culture systems, but within multi-species biofilms.

A mixed-bacteria ecological approach to understanding the role of the oral bacteria in dental caries causation: an alternative to Streptococcus mutans and the specific-plaque hypothesis

For more than 100 years, investigators have tried to identify the bacteria responsible for dental caries formation and to determine whether their role is one of specificity. Frequent association of Lactobacillus acidophilus and Streptococcus mutans with caries activity gave credence to their being specific cariogens. However, dental caries occurrence in their absence, and the presence of other bacteria able to produce substantial amounts of acid from fermentable carbohydrate, provided arguments for non-specificity. In the 1940s, Stephan found that the mixed bacteria in dental plaque produced a rapid drop in pH following a sugar rinse and a slow pH return toward baseline. This response became a cornerstone of plaque and mixed-bacterial involvement in dental caries causation when Stephan showed that the pH decrease was inversely and clearly related to caries activity. Detailed examination of the pH (acid-base) metabolisms of oral pure cultures, dental plaque, and salivary sediment identified the main bacteria and metabolic processes responsible for the pH metabolism of dental plaque. It was discovered that this metabolism in different individuals, in plaque in different dentition locations within individuals, and in individuals of different levels of caries activity could be described in terms of a relatively small number of acid-base metabolic processes. This led to an overall bacterial metabolic vector concept for dental plaque, and helped unravel the bacterial involvement in the degradation of the carbohydrate and nitrogenous substrates that produce the acids and alkali that affect the pH and favor and inhibit dental caries production, respectively. A central role of oral arginolytic and non-arginolytic acidogens in the production of the Stephan pH curve was discovered. The non-arginolytics could produce only the pH fall part of this curve, whereas the arginolytics could produce both the fall and the rise. The net result of the latter was a less acidic Stephan pH curve. Both kinds of bacteria are numerous in dental plaque. By varying their ratios, we were easily able to produce Stephan pH curves indicative of different levels of caries activity. This and substantial related metabolic and microbial data indicated that it is the proportions and numbers of acid-base-producing bacteria that are at the core of dental caries activity. The elimination of S. mutans, as with a vaccine, was considered to have little chance of success in preventing dental caries in humans, since, in most cases, this would simply make more room for one or more of the many acidogens remaining. An understanding of mixed-bacterial metabolism, knowledge of how to manipulate and work with mixed bacteria, and the use of a bacterial metabolic vector approach as described in this article have led to (1) a more ecological focus for dealing with dental caries, and (2) new means of developing and evaluating anti-caries agents directed toward microbial mixtures that counter excess acid accumulation and tooth demineralization.

Biological mechanisms of early childhood caries

The present paper reviews biological issues in early childhood caries (ECC) in light of the current understanding of the field. Despite the general global decline in dental caries in the past decades, ECC has become a significant problem in many developing countries and some minority communities in western industrialized nations. Like other types of caries, ECC is caused by mutans streptococci that ferment dietary carbohydrates to produce acid attacks on susceptible teeth over a period of time. However, while the general etiology of ECC appears similar to that of other types of caries, the predisposing factors are still unclear. The biology of ECC may be modified by several factors unique to young children, related to the implantation of cariogenic bacteria, immaturity of the host defense systems, as well as behavioral patterns associated with feeding and oral hygiene in early childhood.

Salivary parameters of relevance for assessing caries activity in individuals and populations

A review of the non-microbial salivary parameters with respect to their possible association with caries activity is presented. The parameters are limited to those which already are or at least in the near future will obviously be simple enough, also for clinical purposes. Salivary flow rate is undoubtedly the most important single parameter since the cariostatic activity or efficacy of practically all other salivary parameters depends on the flow rate. Flow rate as such has no linear association with dental caries but there seems to exist an individual "threshold" limit which is decisive for enhanced caries activity. This threshold limit varies among different individuals and therefore the so-called normal values for unstimulated or stimulated flow rate are more reliable on a population level than among individuals for screening purposes. In any individual a regular and longitudinal follow-up of the flow rate is of higher clinical value than only a single cross-sectional measurement. Salivary buffer effect has only a weak negative association with caries activity and again, this effect is of greater clinical significance on a population level. Since the decisive processes in caries attack occur within or under the dental plaque, the buffering effect of saliva is limited and obviously more important to screen for erosion-than caries-prone individuals. Although important for dental health, none of the salivary antimicrobial agents as such has shown any strong association with caries activity. The only ones with some evidence of a regulatory role are secretory IgA antibodies, hypothiocyanite ions, and agglutinins. However, the data are controversial and it seems that instead of measuring individual parameters, the assessment of saliva's functional properties (such as the ability to aggregate bacteria, prevent their adhesion to hydroxyapatite or sugar metabolism etc.) is more important for clinical purposes. Of the parameters involved in de- and remineralization process, only salivary fluoride content has some association with caries susceptibility but its diagnostic or predictive value is questionable.

Stoichiometry of oxygen consumption and sugar, organic acid and amino acid utilization in salivary sediment and pure cultures of oral bacteria

In each of 23 numerically or metabolically significant oral micro-organisms, and in each of the salivary sediments of 10 humans, oxygen uptake was determined quantitatively with various sugar and organic and amino acid substrates. With relatively few exceptions, the salivary sediments rapidly consumed oxygen with the array of substrates (23) tested. On the other hand, the individual pure cultures oxidized fewer substrates and did so selectively from this menu. The observation that the Gram-positive bacteria readily used oxygen when sugar substrates were provided, but were unable to use oxygen with all but one of the organic and none of the amino acids was significant. The Gram-negative bacteria, in contrast, used oxygen poorly with the sugars but most readily with many of the organic and amino acids, was significant. Only two of the Gram-positive but most of the Gram-negative micro-organisms tested showed oxygen uptake with L(+)-lactate; the Gram-negative bacteria were also active with D(-)-lactate, formate and succinate. Propionate was also tested and showed oxygen uptake only with the Gram-negative micro-organism, Neisseria subflava; acetate showed none or almost none with all of the examined bacteria. Where oxygen consumption occurred with the various pure or mixed cultures and substrates tested, the quantities of oxygen consumed were less than theoretically possible. For example, they ranged on average in the sediment results from 1.78 mumol oxygen per mumol of L(+)-lactate catabolized to 5.17 mumol oxygen per mumol of lactose. This was consistent with substrate oxidation by the oral bacteria being less than complete as in aerobic glycolysis, and with compounds other than water and carbon dioxide (such as acetate) being prominent amongst the end-products produced. The pure-culture oxygen data and other reports from this laboratory have made it possible to propose a speculative scheme as to which bacterial species might be involved in the various metabolic pathways used when different substrates are catabolized and oxidized by the mixed bacteria in salivary sediment or dental plaque. Also, it made it possible to suggest which bacteria and substrates are likely to be involved in the oxygen depletion that enables plaque to achieve anaerobiosis.

A comparative study of glucose and galactose uptake in pure cultures of human oral bacteria, salivary sediment and dental plaque

The ability to utilize glucose and the weaker sugar acidogen, galactose, was surveyed in salivary sediment, pooled dental plaque, and in pure cultures of the bacteria that numerically comprise most of the bacteria in these mixed microbial systems. Except for a veillonella isolate, which showed no uptake of either sugar, glucose was utilized more rapidly than galactose by the 27 pure cultures tested and by both sediment and plaque. This sugar difference was also seen for two other measures of glycolysis, formation of acid and previously studied ability to produce an acidic pH. Rates of uptake of the two sugars by individual pure cultures varied considerably. Generally, the Gram-positive bacteria utilized glucose and galactose at rates similar to those seen with salivary sediment and dental plaque, whereas the Gram-negative cultures tested showed much slower uptakes. Bacteria previously identified as arginolytic had lower glucose and galactose uptake rates than similar non-arginolytic micro-organisms. This, together with the ability to produce base from arginine, would explain their tendency to produce a less acidic pH. In pure culture mixtures, uptakes were generally predictable and indicated an averaging effect. When the microbial compositions of salivary sediment or dental plaque were altered by mixing with pure cultures of high glucolytic activity, such as many of the Gram-positives, glucose uptake was enhanced. The opposite was observed when the less glucolytic Gram-negative bacteria were similarly incorporated. As well as determining the glucose and galactose uptake rates of the various bacteria that collectively comprise the bulk of the salivary sediment and supragingival plaque microfloras, this study has shown how variation in microbial composition affects sugar uptake rates and has indicated how microbial composition could be manipulated to produce dental plaques with different capacities to ferment sugars and presumably different cariogenicities.

Caries-protective factors in saliva

Saliva influences caries attack mainly by its rate of flow and by its content of fluoride. The salivary flow rate influences to a high degree the rate of oral and salivary clearance of bacterial substrates included in foods and snacks. This influence is site-dependent. The basal salivary fluoride concentration is low, about 1 mumol/L, independent of salivary flow rate, and not influenced by diurnal variation. After an exposure of the oral cavity to fluoride, the increased fluoride level is decreased by a process influenced mainly by the salivary flow rate and the volumes of saliva in the mouth before and after swallowing. Other less important caries-protective factors in saliva include its buffer ability, its content of calcium, inorganic phosphate, pH-increasing substances, and anti-microbial agents.

Salivary and metabolic factors involved in oral malodor formation

Saliva plays a central role in the formation of oral malodor. Such formation has as its basis bacterial putrefaction, the degradation of proteins, and the resulting amino acids by microorganisms. Saliva provides substrates that are readily oxidized and in the process facilitates oxygen depletion. This favors the reduced conditions conducive to production of odoriferous volatiles. At the same time, saliva is a major source of oxygen for the oral bacteria which generally is inhibitory of their formation. The pH is also critical to malodor development; acidity inhibits, whereas neutrality and alkalinity favor malodor production. Since the pH on oral mucosal surfaces where odor formation occurs is largely determined by the fermentative and putrefactive activities of the adhering bacteria, these acid-base processes are necessarily of major regulatory importance. Because oral malodor and periodontitis both involve excessive oral putrefaction, a better understanding of putrefaction could lead to more substantive methods of oral malodor treatment than exists today, as well as identifying new approaches to amelioration of the bacterial attack on the soft tissues leading to the destruction associated with periodontal disease.

Oxygen uptake and its relation to pH in a human salivary system during fermentation of glucose

Oxygen consumption by the mixed bacteria in salivary sediment was examined in relation to the decrease in pH that occurs when glucose at different concentrations (2.8 mM-1.68 M) was fermented in 4 h incubations at 37 degrees C. These experiments demonstrated that (i) the use of oxygen was extremely rapid, resulting in all cases in the PO2 decreasing within 1-2 min from atmospheric PO2 (approx. 20 kPa) to levels at or near zero; (ii) a period of about 30 min of reduced oxygen uptake consistently occurred after the initial PO2 drop, so long as salivary supernatant was present and the pH was allowed to fall; (iii) except for 11.2 mM glucose, the PO2 was kept at or near zero throughout each incubation with all glucose concentrations tested because of rapid oxygen consumption by the sediment bacteria--oxidizable substrates in the sediment and in added salivary supernatant contributed significantly to the prolonged oxygen depletion; (iv) the pH was important for determining the relative contributions of glucose and supernatant to the uptake of oxygen by the sediment bacteria and for observations (ii) and (iii). When the acids produced during aerobic degradation of glucose were tested for stimulation of oxygen uptake, L(+)lactic stimulated more rapid uptake than did D(-)lactic acid, whereas acetic and propionic acids showed none. These findings were in agreement with a metabolic scheme proposed earlier for aerobic degradation of glucose by the sediment microflora, and indicated where and how oxygen utilization might be involved in glucose fermentation.

Acid-base pH curves in vitro with mixtures of pure cultures of human oral microorganisms

Pure cultures of microorganisms commonly found in supragingival plaque were incubated alone and in combinations to determine the bacterial contribution to the pH-fall-pH-rise that is the central characteristic of the Stephan-curve pH change seen in plaque in vivo after brief exposure to a sugar solution. To avoid the complicating conditions of saliva flow and plaque diffusion, experiments were done with bacterial suspensions in incubations in vitro. In an initial experimental series where each microorganism was incubated only with glucose, all but a few produced the initial pH fall. Some also showed a subsequent small, sharp rise in the pH which then quickly levelled off; this was due to metabolism of endogenous substrate accumulated by most microorganisms during their growth in culture. When arginolytic and non-arginolytic bacteria were each then incubated with both glucose and arginine present (the glucose substrate to stimulate a pH fall and the arginine to stimulate a pH rise), the non-arginolytic gave a progressively more acidic pH response with progressive increase in the cell concentration, whereas the arginolytic bacteria produced a much smaller and variable pH decrease with similar cell concentration increase. Mixing pure cultures of either arginolytic or non-arginolytic bacteria gave acid-base pH responses similar to those of their respective pure cultures, whereas mixing arginolytic with non-arginolytic bacteria resulted in an approximate averaging of their different curves. The organisms present in highest proportion in a mixture had the greatest effects. The outcome of mixing the most numerous streptococcal and actinomyces species found normally in supragingival plaque indicated that the well-established difference in the acidity level of the Stephan pH response of caries-active and caries-inactive plaques could be due to differences in the proportions of their arginolytic and non-arginolytic members.

Bioenergetics and solute transport in lactococci

During the last few years the studies about the physiology and bioenergetics of lactic acid bacteria during growth and starvation have evolved from a descriptive level to an analysis of the molecular events in the regulation of various processes. Considerable progress has been made in the understanding of the modes of metabolic energy generation, the mechanism of homeostasis of the internal pH, and the mechanism and regulatory processes of transport systems for sugars, amino acids, peptides, and ions. Detailed studies of these transport processes have been performed in cytoplasmic membrane vesicles of these organisms in which a foreign proton pump has been introduced to generate a high proton motive force.

Arginolytic and ureolytic activities of pure cultures of human oral bacteria and their effects on the pH response of salivary sediment and dental plaque in vitro

Thirty-nine different microorganisms commonly found in supragingival plaque and salivary sediment were screened for their ability to raise the pH by producing base from arginine, lysylarginine and urea. Only Actinomyces naeslundii and Staphylococcus epidermidis showed significant pH-rise activity with all three compounds. Eleven bacteria demonstrated such activity with arginine and lysylarginine but not with urea. Only one, Actinomyces viscosus, produced a pH-rise with urea but not with the two arginine compounds. The remaining 26 bacteria showed little or no base-forming activity with any of the three test substrates. The ability of the different oral bacteria to produce base (especially from urea) was a less universal function than their ability to produce acid from fermentable carbohydrate. Substituting pure cultures of arginolytic or non-arginolytic bacteria for portions of the mixed bacterial populations of plaque or sediment in test incubations containing glucose and arginine altered their ability to produce pH-fall-pH-rise responses shaped like those of the Stephen curve in vivo. In general, addition of arginolytic bacteria made these in vitro pH responses less acidic, whereas addition of non-arginolytic bacteria made the responses more acidic. Because of the relatively high arginolytic activity of the plaque harvested in this study, the effect of adding non-arginolytic bacteria was more readily seen than the converse. Similar changes in levels of ureolytic microorganisms and incubation with glucose and urea had little effect on sediment or plaque being able to produce a pH-fall-pH-rise type of response. When increasing proportions of the mixed bacteria in salivary sediment were replaced with the highly cariogenic Lactobacillus casei or Streptococcus mutans, the pH minimum became slightly more acidic and then slightly more alkaline, whereas the pH-rise became progressively and significantly less. Thus arginolytic bacteria have a different and greater effect on shaping the pH response of plaque or sediment than ureolytic bacteria. A large change in the proportions of arginolytic or non-arginolytic microorganisms may be needed to make a plaque microflora potentially non-cariogenic or cariogenic, respectively.

Response of a Streptococcus sanguis strain to arginine-containing peptides

For dental plaque organisms such as Streptococcus sanguis, the ecological importance of the ability to utilize arginine as an energy source has been established in previous studies. The present investigation was undertaken to determine the ability of a strain of S. sanguis to process unsubstituted arginine-containing peptides. The organism was grown under glucose-limited conditions in a chemically defined medium, and peptide was added to washed, resting cells in a pH-stat at pH 7.0. Filtrates taken at appropriate time intervals were assayed for peptide, free amino acids, and metabolites. Irrespective of the position of the arginine residue, all peptides tested were attacked, although those that possessed a C-terminal arginine (including a tetrapeptide) were processed at a faster rate than were those in which arginine was N terminal. However, C-terminal arginine was cleaved only slowly from a peptide containing 24 residues. In each case, most of the released arginine was converted to ornithine via the arginine deiminase pathway. Such peptidase activities appeared to occur at or near the cell surface and were probably constitutive. It was found that the organism grew in chemically defined medium containing arginine that was present solely in the form of a tripeptide, and also that a strain of S. mutans possessed only a limited ability to attack arginine-containing peptides and was unable to utilize the released arginine.

Effect of xylitol-containing carbohydrate mixtures on acid and ammonia production in suspensions of salivary sediment

pH changes and the production of lactic acid, acetic acid and ammonia were studied in suspensions of salivary sediment supplemented with mixtures of xylitol and other carbohydrate sweeteners. The only mixtures which increased the pH values of the suspensions were those containing xylitol alone or mixtures of xylitol and sorbitol. Mixtures of xylitol and Lycasin 80/55 caused a relatively small pH reduction. Xylitol was not able to inhibit the acid production from the easily fermented glucose, fructose and Lycasin 05/60. The levels of lactic acid, determined in the incubation mixtures, directly reflected these pH changes. The levels of acetic acid and ammonia were, however, relatively similar in all incubation mixtures. The results suggest that the inhibitory effects of xylitol on acid production of oral flora should be retained, provided that xylitol is used either alone or in mixtures with slowly fermentable carbohydrates, such as sorbitol and Lycasin 80/55.

The effect of arginine on in-vitro acid production by the oral bacterium Streptococcus mutans 10449 in various concentrations of glucose

Acid production was measured both with constant pH and with the pH being allowed to fall. Under both conditions 10 mM arginine reduced it. There was also evidence that arginine reduced the rate of uptake of glucose by the bacterium. Thus arginine may affect the rate of glucose transport or catabolism by Strep. mutans 10449, and has more than a simple buffering effect on these cultures.

Metabolic differences between saliva from caries-active and caries- and restoration-free children

Sucrose consumption and lactic-acid production by saliva, and the effects of pH, were first evaluated by radio-isotope techniques in populations of caries- and restoration-free (CF), and caries-active from sucrose than saliva from CA subjects. Sucrose consumption also was significantly greater in saliva of CF subjects. These results occurred at pH 7.2 but not at pH 6.0 and 5.0. Lactic acid, total volatile products and carbon-dioxide (CO2) production by saliva were then evaluated in different CF and CA populations of children. Metabolic parameters in the presence and absence of salivary supernatant (SS) also were determined. Saliva of these CF subjects also formed significantly more lactic acid from sucrose than did CA subjects. The presence of SS increased lactic-acid formation in this saliva; the increase was significant in CF subjects. Total volatile products and CO2 were greater in saliva of CF subjects but were not affected by SS. Partial microbial characterization of each salivary specimen was conducted in both series of experiments. CF subjects harboured less Streptococcus mutans (parts I and II), total lactobacilli (parts I and II) and Actinomyces species (part II) than CA subjects. Differences for lactobacilli in the first population and Actinomyces species in the second were significant.

A comparison of the acid-base and aciduric properties of various serotypes of the bacterium Streptococcus mutans associated with dental plaque

Of the 20 strains tested, Strep. mutans Ingbritt (c), LM-7(e), QP50 -1(f) and K-1R(d/g) produced the largest decreases in pH with glucose, sucrose and starch whereas E-49(a), OMZ-61(a), FA-1(b), BHT(b), GS-5(c) and OMZ-176(d/g) produced the least. In the absence of saliva, catabolism of starch was less than catabolism of either glucose or sucrose but, with saliva present, the differences were considerably reduced. The strains varied in ability to accumulate and degrade stored polysaccharide (a means of producing a more acidic pH), but without relation to serotype. No strains showed pH-rise activity with saliva supernatant, sialin or urea but the b serotypes showed pH rise with arginine and lysylarginine . All strains showed activity from endogenous substrates. Aciduricity was determined by assessing the ability to grow on brain-heart-infusion agar adjusted to pH 5.0 to 7.0. All strains grew better at pH 7.0 than 5.0. Among the least aciduric strains were those of b serotype which being among those least able to decrease the pH with fermentable carbohydrate and the only one to raise pH with arginine and arginine peptide, suggested that this serotype might appear more often in caries-free than in caries-active plaques and in plaques showing a less acidic Stephan pH response. The acid-base and aciduric properties of the non-b serotype strains indicated that any one or more of these could be associated with caries-active plaques.

A comparison of the acid-base metabolisms of pooled human dental plaque and salivary sediment

The acid-base metabolisms of the mixed bacteria in pooled dental plaque and salivary sediment sampled from the same subjects were compared in vitro. Plaque at a suspension concentration of 8.3 per cent (v/v) was found to produce pH responses like those of sediment at 16.7 per cent (v/v) with all substrates and under all incubation conditions tested. The substrates examined included several carbohydrates (glucose, sucrose and starch) and several nitrogenous substrates (urea, arginine and the arginine peptide glycyl-glycyl-lysyl-arginine also called sialin). Also examined were the effects of endogenous substrates and of salivary supernatant and fluoride. A difference in suspension concentration was necessary to achieve similarity in pH response which was attributed to the presence of more non-viable epithelial cells in sediment than in plaque. Under these conditions, salivary sediment showed a slightly greater buffering capacity than plaque, a difference that was not evident if salivary supernatant was present. It was clear from this study that salivary sediment and pooled dental plaque from the same subjects have similar acid-base metabolisms and that the more abundant and readily available sediment could be used to study such metabolism in dental plaque.

Salivary pH-rise activities in caries-free and caries-active naval recruits

Kleinberg (1967) (Archs oral Biol. 12, 1457-1473) has observed that the incubation of a salivary sediment/supernatant mixture with a low concentration of glucose produces a pH drop followed by a pH rise. As this pH-rise effect could elevate oral pH in vivo, the degree of such activity could be directly related to caries resistance. The pH-rise of paraffin-stimulated whole saliva samples from 54 caries-free and 54 caries-active male naval recruits was compared in two assays. The first, conducted with sediment/supernatant/2.8 mM glucose mixtures, showed no significant differences for mean pH versus time profiles for 26 caries-free and 26 caries-active subjects. Concomitant assays, in which 3.33 mM arginine and water replaced the supernatants in the assay mixtures, showed slightly higher mean pH/time profiles, with higher minima for the caries-free subjects. These profile differences were statistically significant for the arginine-containing mixtures, a result attributed to different microbial distributions for the caries-free and caries-active sediments. The second assays were conducted on saliva supernatants from 28 caries-free and 28 caries-active subjects, employing a strain of Lactobacillus casei in place of salivary sediment in the assay system. No statistically significant differences were evident between the mean pH/time profiles for the two groups of subjects, although a significant positive correlation was observed between pH minimum and bicarbonate content of the samples. Thus no relationship of salivary pH-rise activity and caries experience were found.

Quantitative assessment of urea, glucose and ammonia changes in human dental plaque and saliva following rinsing with urea and glucose

The rates of three processes associated with the rise and fall in plaque pH, that normally occur following a urea rinse, were determined: (i) disappearance of urea from plaque, (ii) disappearance of urea from saliva and (iii) formation and disappearance from plaque of the ammonia produced by the plaque bacteria from the urea. Also examined were two processes associated with the fall and rise in pH following a glucose rinse: the disappearance of glucose from plaque and from saliva. Entry into plaque of either urea or glucose during rinsing was immediate; the subsequent disappearance of both from the plaque was slow and followed first-order kinetics. The ammonia formation and urea-disappearance results suggested that clearance of urea from the plaque occurred mainly by bacterial degradation and not by diffusion out of the plaque. The rate constants for ammonia formation and for its subsequent disappearance from the plaque made it clear why a rapid rise and a slow subsequent fall in the pH occurs after urea rinsing. The rate constants enabled calculation of the ammonia produced as a percentage of the urea utilized. Only 16-26 per cent of the urea was recovered as ammonia and the remainder of the urea-N was stored probably as NH2 moieties of certain amino acids. Such storage may enable the plaque bacteria to maintain the pH at an elevated level for an extended period of time by bacterial production of ammonia from these stored compounds after the urea ceases to be available as a source of substrate.

Catabolism of arginine by the mixed bacteria in human salivary sediment under conditions of low and high glucose concentration

The catabolism of glucose by the oral mixed bacteria results in a lowering of the pH whereas arginine degradation favours a rise. In the mouth, low and high levels of glucose cause different plaque pH conditions which, in turn, might affect the rate and mode of degradation of arginine. This possibility was examined in the suspended salivary-sediment system where these pH conditions can be simulated. With the pH, the metabolic parameters examined were arginine utilization, ammonia, carbon dioxide and putrescine formation, utilization of glucose and changes in levels of L(+)- and D(-)-lactic acid. At the lower glucose concentration, the pH rapidly fell and then slowly rose whereas, with the higher glucose level, the pH showed a greater fall and no subsequent rise. The more acidic pH conditions favoured by the higher glucose level inhibited arginine degradation and the appearance of its various end-products and intermediates. Arginine degradation with arginine-[U-14C] and paper chromatography-autoradiography showed successive appearance of citrulline, ornithine and putrescine and, depending upon the pH, some succinate. When the pH was held constant at several different values, arginine degradation was optimal when the pH was near neutrality. In supplementary experiments, arginine had little effect on the ability of the oral mixed bacteria to utilize glucose and produce and utilize lactic acid, whereas the arginine peptide, arginylisoleucine and saliva supernatant stimulated these processes. Thus glycolysis enhancement and a more rapid clearance of fermentable carbohydrate by the oral bacteria would accompany pH-rise activity with arginine peptide and saliva but would not accompany pH-rise activity with arginine.

Bacteriolysis of Streptococcus mutans GS5 by lysozyme, proteases, and sodium thiocyanate

Streptococcus mutans GS5 was grown in a synthetic medium containing radioactive thymidine to monitor cell lysis by assay of the release of DNA. Bacteriolysis was achieved by sequential treatment of the cells with either hen egg white lysozyme and sodium thiocyanate or a combination of hen egg white lysozyme and a proteolytic enzyme followed by addition of the thiocyanate. In the absence of sodium thiocyanate, a small percentage of the total macromolecular thymidine was released in control reaction mixtures during incubation. This amount of released DNA more than doubled in trypsin-treated cells, but the inclusion of lysozyme in reaction mixtures prevented assay of the DNA. Lysis was found to be optimal in the late log phase of growth and was dependent on the concentrations of both lysozyme and protease. Concentrations of trypsin or chymotrypsin as low as 0.01 microgram/ml were found to be effective in enhancing the lytic process. The addition of protease to lysozyme-inorganic salt reaction mixtures altered both the pH and ionic strength profiles of cell lysis. At pHs of 5.5 or lower, both the lysozyme-NaSCN and the lysozyme-trypsin-NaSCN systems were inactive in mediating lysis. The loss of insoluble cell wall peptidoglycan by lysozyme treatment was pH independent and did not appear to be affected by the addition of protease. Either diluted whole saliva or neutrophil extracts could replace trypsin to enhance cell lysis further.