Time of initial acquisition of mutans streptococci by human infants

Breastfeeding, Dental Biofilm Acidogenicity, and Early Childhood Caries

Aim: This study evaluated the acidogenicity of human milk by the dental biofilms of children with and without early childhood caries (ECC). Method: Biofilms of 16 children (7 with ECC; 9 caries free) were exposed to human milk or 10% sucrose solution in the crossover design, and the biofilm pH was determined. Results: Breastfeeding did not provoke a decrease in biofilm pH, irrespective of the children's caries status, whereas sucrose decreased the pH for both groups. In addition, higher ΔpH5min (pH variation occurring at 5 min) was observed in the biofilms of ECC children (p < 0.05). The results suggest that breastfeeding may not contribute to ECC.

Mother-to-child transmission of mutans streptococci

Mutans streptococci (MS) are the major group of pathogens implicated in dental caries. Like other infectious diseases, transmission of the causative microorganisms is the initial and essential step that should be understood relative to disease control and prevention. This review summarizes current knowledge regarding MS transmission, especially from mothers to their children. Included are methods used to study transmission, sources of MS, initial acquisition, factors concerning transmission and prevention of transmission. Information accumulated over many decades showed the involvement of MS transmission in the pathogenesis of caries, hence several preventive measurements have been proposed. Nevertheless, some essential aspects remain to be elucidated for more benefits of practical application.

Risk factors for early colonization of mutans streptococci - a multiple logistic regression analysis in Swedish 1-year-olds

BACKGROUND

Mutans streptococci (MS) are closely related to the development of dental caries and are usually established in the oral cavity during early childhood. The aim of the study was to identify factors associated with the presence of MS in Swedish 1-year-olds.

METHODS

Parents completed a questionnaire on different caries-associated factors and an oral bacterial sample was collected from 1,050 (526 boys, 524 girls) 1-year-olds. Multiple logistic regression analyses were performed to identify risk factors for colonization with MS.

RESULTS

MS were found in 27% of the 1-year-olds with teeth. High or very high MS scores (2-3) were found in 72 (7%) of the children. MS score was correlated to the number of erupted teeth (p < 0.001). No difference due to gender was found. Multiple logistic regression analysis showed that presence of bacteria was associated with: caries in a sibling, other beverages than water between meals, and more than 8 erupted teeth. High or very high MS scores (2-3) were associated with other beverages than water between meals, and more than 8 erupted teeth.

CONCLUSIONS

Number of teeth present, diet and family aspects were factors associated with presence of MS in 1-year-olds. To develop high or very high MS scores, the number of erupted teeth and dietary habits are important.

Caries prevalence associated with Streptococcus mutans and Streptococcus sobrinus in Japanese schoolchildren

BACKGROUND

Streptococcus mutans and Streptococcus sobrinus are known to be associated with dental caries in humans.

AIM

We used a polymerase chain reaction method to detect S. mutans and S. sobrinus in 128 Japanese schoolchildren and then compared their presence with the dental caries experience.

DESIGN

Plaque samples were collected from all erupted tooth sites with a sterile toothbrush, and dental examinations were performed to determine the numbers of decayed and filled teeth in primary (dft) and permanent (DFT) dentition using the WHO caries diagnostic criteria. Fisher's PLSD test was employed to compare caries scores between combinations of the detected bacteria.

RESULTS

Streptococcus mutans and S. sobrinus were present in 38.3% and 68.0%, respectively, whereas 14.8% were positive for S. mutans alone, 44.5% for S. sobrinus alone, and 23.5% for both S. mutans and S. sobrinus, with 17.2% negative for both. The DFT, dft, and total (DFT + dft) scores for subjects positive for both S. mutans and S. sobrinus were significantly higher than those positive for S. mutans alone (P < 0.05, in triplicate).

CONCLUSION

These results suggest that schoolchildren harbouring both S. mutans and S. sobrinus have a significant higher dental caries experience in both permanent and primary teeth as compared to those with S. mutans alone.

Five questions about Streptococcus mutans: theoretical study of its transmission and colonisation

PURPOSE

This theoretical study aimed to identify the decisive (and controllable) factors involved in Streptococcus mutans (Sm) infection through addressing questions about (i) the time and prevalence pattern (including the raison d'etre of the discrete period for the infection or WI) of initial Sm colonisation and (ii) the infant's selection of bacterial types and their diversity, which are not yet definitely answered by empirical works.

METHOD

A model of Sm infection (within-host type) was developed. For questions (i): using the basic model, stochastic simulation was performed to reproduce longitudinal observations of the initial colonisation time. A symmetrical or right-skewed gamma distribution was assumed for the maximum colonisable area (K(max)) and transmission rate (mx). Additionally, 3 or 4 developmental modes of colonisable area [K(t)] were assigned based on the K(max) value. For (ii): by extending the basic model to the two-bacterial type model, intraspecific competition analysis focusing on the differences in mx (received by the infancy) and colonisation ability (θD) was performed.

RESULTS

The basic model simulation showed that mx and K(t) played a pivotal role in determining the individual time of initial colonisation and their variations among infants in forming its prevalence patterns (with or without WI). The competition model simulation showed that higher mx could be more advantageous in competitive colonisation than higher θD under repeated invasions. Accordingly, it played a decisive role in infant's selection of initially, persistently and transiently colonising bacterial types, and thus in their diversity.

CONCLUSIONS

(i) The mx is the primary and controllable (risk) factor that extensively affects various aspects of the Sm infection process. (ii) Also, the growing carrying capacity, i.e., K(t) is another important factor when considering how to effectively delay the onset of the colonisation. (iii) Thus, currently, the most feasible and effective control measure for the infection should be microbiological interventions in the primary host with concurrent oral hygiene and dietary control in the exposed child.

Late Established Mutans Streptococci in Children over 3 Years Old

Acquisition of mutans streptococci has been reported to most commonly occur at approximately 26 months of age. In the present study, we detected Streptococcus mutans and S. sobrinus using polymerase chain reaction (PCR) assays in children, then re-examined the subjects to determine the time of acquisition of these bacteria over a 1-year period. The subjects were 57 children ranging in age from 3 to 5 years old, each with primary dentition. Plaque samples were collected from all erupted tooth sites using a sterile toothbrush. PCR assays were performed to detect the targeted mutans streptococci at the beginning of the study (baseline) and after 1 year. At the baseline examination, the prevalence of S. mutans and S. sobrinus was 61.4% and 54.4%, respectively, in all subjects, of whom 14 (24.6%) were positive for S. mutans alone, 10 (17.5%) for S. sobrinus alone, and 21 (36.8%) for both S. mutans and S. sobrinus, with 12 (21.1%) negative for both. After 1 year, 4 of 22 (18.2%) subjects newly had acquired S. mutans and 15 of 26 (57.7%) had aquired S. sobrinus, while 5 (8.8%) remained negative for both bacteria. The age of the first positive S. mutans finding ranged from 49 to 71 months, while that for S. sobrinus ranged from 49 to 81 months old. Our results suggest that S. sobrinus becomes established later than S. mutans in the oral cavities of children over the age of 3 years old.

Knowledge and attitude of parents or caretakers regarding transmissibility of caries disease

Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1%) adults reported that their children had already been seen by a dentist, 264 (41.3%) answered that their children had never gone to a dentist, and 4 (0.6%) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7%) answered yes, 489 (76.4%) answered no, and 44 (6.9%) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease.

Frequency and expression of mutacin biosynthesis genes in isolates of Streptococcus mutans with different mutacin-producing phenotypes

The aim of this study was to analyse the frequency and expression of biosynthesis genes in 47 Streptococcus mutans isolates with different mutacin-producing phenotypes. Detection of the frequency and expression of genes encoding mutacin types I, II, III and IV were carried out by PCR and semi-quantitative RT-PCR, respectively, using primers specific for each type of biosynthesis gene. In addition, a further eight genes encoding putative bacteriocins, designated bsm 283, bsm 299, bsm 423, bsm 1889c, bsm 1892c, bsm 1896, bsm 1906c and bsm 1914, were also screened. There was a high phenotypic diversity; some Streptococcus mutans isolates presented broad antimicrobial spectra against other Streptococcus mutans clinical isolates, including bacteria resistant to common antibiotics, as well as Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis and Streptococcus pyogenes. The expression frequency of the bsm gene was higher than that of the previously characterized mutacins (I-IV). There was no positive correlation between the number of indicator strains inhibited (antimicrobial spectra) and the number of biosynthesis genes expressed (Spearman correlation test, r=-0.03, P>0.05). In conclusion, the high diversity of mutacin-producing phenotypes, associated with high frequency of expression of the biosynthesis genes screened, reveals a broad repertoire of genetic determinants encoding antimicrobial peptides that can act in different combinations.

Dental caries and periodontitis: contrasting two infections that have medical implications

Both dental decay and periodontal disease are diagnosable and treatable bacterial infections. They are distinctly different infections, with dental decay occurring on the supragingival surfaces of the teeth and periodontal infections occurring in the gingival tissue approximating the subgingival plaque. The bacteria involved and the pathophysiology of these infections are distinctly different.

A comparative study of Streptococcus mutans and lactobacilli in mothers and children with severe early childhood caries (SECC) versus a caries free group of children and their corresponding mothers

Early childhood caries (ECC) is recognized as an infectious disease. The first step in its development is primary infection by the bacterium S. mutans which has been identified as the primary etiologic factors in dental caries. Lactobacilli were also found to play a role in the progression of the disease. However, the underlying mechanism of immune response to caries is still unclear. The purpose of this study was to assess the level of cariogenic bacteria namely S. mutans and lactobacilli in caries free children, and children with SECC and their corresponding mothers. he study also aims at correlating the children's levels to their mothers. Sixty children and their mothers attending the dental clinic in King Abdulaziz University participated in our study. Their age ranged from 3 - 5 years. The study groups consisted of 30 children with SECC and a control group comprising of 30 caries free children. Children together with their mothers were examined and their caries level was recorded. Stimulated saliva was collected from each participant for bacterial, immunological assessment, and Lactobacilli counts in each sample were determined Children with SECC had higher levels of S. mutans and Lactobacilli than caries free children. The mothers of children with SECC had a statistically higher count of Lactobacilli than caries free children's mothers. However, the difference was not statistically significant with respect to their S. mutans counts. A significant relationship exists among the mother-child pair in the SECC group with respect to S. mutans level in saliva.

Tansmission, diversity and virulence factors of Sreptococcus mutans genotypes

Dental caries is an infectious and transmissible disease, in which many genetic, environmental and behavioral risk factors interact. The mutans streptococci (MS), mainly Streptococcus mutans and Streptococcus sobrinus are the microorganisms most strongly associated with this disease. The main virulence factors associated with MS cariogenicity include adhesion, acidogenicity and acid tolerance. These properties work together to modify the physico-chemical properties of the biofilm, resulting in ecological changes in the form of increased proportions of S. mutans and other acidogenic and aciduric species. In addition, reports of higher numbers of S. mutans genotypes with increased virulence in caries-active subjects suggest the importance of microenvironmental factors in increasing the risk of caries. This review focuses on the transmission and establishment of different genotypes of S. mutans and the role they play in the development of dental caries.