Salivary Streptococcus Mutans and Lactobacilli in Relation To Rampant Caries Pattern Among Children
Salivary Streptococcus Mutans and Lactobacilli in Relation To Rampant Caries Pattern Among Children
Salivary streptococcus
ABSTRACT
Background: Several interrelated factors which are the tooth and saliva (host), microorganisms, substrate and time
are involved in the process of dental caries. Rampant caries is a severe form of tooth decay that can affect primary
or permanent teeth. It is characterized by its speed of onset and progression. Nursing caries is a type of rampant
caries affecting the primary teeth of young children and has been associated with prolonged unrestricted bottle or
breast feeding. This study was conducted in order to estimate the salivary level of streptococcus mutans and
lactobacilli among the rampant, nursing caries and control (caries free) children.
Materials and methods: Seventy five children aged 3 to 10 years old were included in the study. Forty six children
were selected for colony counting (19 children with nursing caries, 13 children with rampant and 14 children with
caries free).Dental caries was measured using dmfs, DMFS for primary and permanent teeth respectively using the
criteria of WHO. One ml of unstimulated (resting) whole saliva was collected from the children using spitting method
then diluted and applied on the surface of agar media specific for streptococcus mutans and lactobacilli growth.
Colony forming units with morphology characteristic of s. mutans and lactobacilli were counted and expressed as
numbers of CFU per ml of saliva.
Results: The results of present study showed no significant difference in the number of colonies of Streptococcus
mutans and lactobacilli among nursing, rampant and caries free groups (p>0.05) however there was a highly
significant difference in caries experience in the primary teeth among the three groups (p<0. 01) and a significant
difference in caries experience in the permanent teeth among the three groups (p<0.05).
Conclusion: The etiology of dental caries is multifactorial in that simultaneous participation of multiple factors is
required for caries to occur. Streptococcus mutans and Lactobaculli are microorganisms with cariogenic capacity,
however, their presence only do not determine the presence of dental caries.
Key words: streptococcus mutans, lactobacilli, nursing caries, rampant caries, saliva. (J Bagh Coll Dentistry
2011;23(4):153-157).
INTRODUCTION
Dental caries is a microbial disease of the
calcified tissues of the teeth characterized by
demineralization of the inorganic portion and
destruction of the organic substance of the tooth
( )
. Several interrelated factors such as: the tooth
and saliva (host), microorganisms, substrate and
time are involved in the process of dental caries
(2)
. Streptococcus mutans and lactobacilli are the
active microorganisms contributing dental caries.
The essential role of s.mutans is in the initial
process of caries while lactobacillus is correlated
with the active caries episode (3, 4).
Different types of streptococci were identified
in saliva these are s. mitis, s. oralis, s.salivarius, s.
anginosus, s. sanguis, s. vestibularis, s.mutans,
and s. gordonii (5). Different studies have shown a
correlation between counts of s.mutans in the oral
cavity and both the prevalence and incidence of
caries (6, 7, 8).However, in other studies, no
correlation has been found between the quantity
of s. mutans and the incidence of caries (9, 10). On
the other hand, some researchers have suggested
the importance of streptococci other than s.
mutans in the generation of dental caries (11).
Salivary streptococcus
DISCUSSION
The mean number of salivary streptococcus
mutans and lactobacilli represented by the colony
forming units in nursing and rampant caries group
are higher than in control group, but no significant
difference among the three groups was found p >
0.05. This finding is agreed with (9, 10, 20, 21) while
disagree with (22, 23) although the caries experience
was high in both primary and permanent teeth.
This could be attributed to that the etiology of
dental caries is multifactorial in that simultaneous
participation of multiple factors is required for
caries to occur. Streptococcus mutans are
considered to be the main etiological
microorganisms in caries disease, with lactobacilli
and other microorganisms participating in the
disease progression. Occasionally, some other
microorganisms have been traced as initiator
microorganisms (24).Children with nursing caries
harbored more types of mutans streptococci than
caries-free children (25, 26). It was found that
streptococcus mutans and Lactobacullus are
microorganisms with cariogenic capacity,
however, their presence only do not determine the
presence of dental caries (27).The multifactoriality
of the disease, including the potential action of
several species of acidogenic and aciduric
microorganisms, should be seriously considered.
A unique specificity of mutans group streptococci
has never been proved in observational studies (28).
High level of saliva mutans streptococci, bad
oral hygiene, frequent intake of sweet food, and
sugar contents in nursing bottle were the
important risk factors for dental caries on primary
teeth (29).
Nursing and rampant caries are more
commonly found in children who live in poverty
or in poor economic conditions, which belong to
ethnic and racial minorities, are born to single
mothers, and parents with low educational level,
especially illiterate mothers. In these populations
the oral hygiene of the children is usually poor,
exposure to fluoride is probably insufficient, and
there is a greater preference for sugary foods (30).
REFRENCES
1. Damle SG. Textbook of pediatric dentistry. 3rd ed.
Arya publishing house; 2009. p.33.
2. Arathi Rao. Principles and practice of pedodontics. 2nd
ed. Jaypee brothersmedical publishers Ltd; 2008.
p.164.
Salivary streptococcus
Salivary streptococcus
Table 1: ANOVA one way to compare the mean colonies number of S.Mutans and lactobacilli
among the three groups
SM
Sal.
LB
Sal.
Groups
Mean
SD.
SE.
nursing
rampant
control
nursing
rampant
control
19
13
14
19
13
14
.322
.355
.297
.316
.212
.110
.355
.444
.456
.479
.388
.175
.081
.123
.122
.110
.108
.047
df
0.067
1.169
Sig.
0.935
0.320
Table 2: ANOVA one way to compare caries experience for the primary teeth among the three
groups
dmf
ds
Groups
nursing
N
28
Mean
23.607
SD.
11.328
SE.
2.141
df
Sig.
rampant
control
nursing
rampant
control
21
26
28
21
26
42.476
0
20.571
36.762
0
19.717
0
9.555
18.692
0
4.303
0
1.806
4.079
0
68.335
.000
60.940
.000
Table 3: Least significant difference test among the three groups regarding caries experience in
the primary teeth
Dependent
variable
dmf
ds
Group
Group
nursing
nursing
rampant
nursing
nursing
rampant
rampant
control
control
rampant
control
control
Mean
difference
-18.869
23.607
42.476
-16.195
20.571
36.762
SE.
Sig.
3.607
3.403
3.666
3.308
3.211
3.362
0.000
0.000
0.000
0.000
0.000
0.000
Salivary streptococcus
Table 4: ANOVA one way to compare caries experience for permanent teeth among the three
groups
DMF
DS
Groups
nursing
rampant
control
nursing
rampant
control
N
13
9
7
13
9
7
Mean
0.846
1.667
0
0.846
1.667
0
SD.
1.214
1.658
0
1.214
1.658
0
SE.
0.337
0.553
0
0.337
0.553
0
df
Sig.
3.602
0.04
3.602
0.04
Table 5: LSD test among the three groups regarding caries experience in permanent teeth
Dependent
variable
DMF
DS
Group
Group
nursing
nursing
rampant
nursing
nursing
rampant
rampant
control
control
rampant
control
control
Mean
difference
-0.820
0.846
1.667
-0.821
0.846
1.667
SE.
Sig.
0.536
0.579
0.623
0.536
0.579
0.623
0.138
0.156
0.013
0.138
0.156
0.013