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This study aimed at investigating the subgingival plaque microorganisms of shallow pockets (< or = 5 mm) in subjects who previously received irradiation in the head and neck region for treatment of nasopharyngeal carcinoma. Direct microscopy and anaerobic culture were used. Subgingival paper point samples were taken from 6 tooth-sites (one/sextant) per subject for direct microscopy (n = 108). Another set of paper points was taken from the deepest of the previously selected sites (one per subject) with: group A) no bleeding on probing to the sulcus depth (n = 9) and group B) bleeding on probing to the sulcus depth (n = 6) for microscopic and anaerobic culture study. Under the microscope, the microflora was found to be a complex mixture comprising gram-positive and gram-negative cocci, rods and filaments, fusiforms, curved rods and spirochetes. Low level of fungi were observed and mycelia were occasionally detected. There was no significant variation in the plaque bacterial morphotypes observable according to sites of isolation and no significant difference between group A and group B in morphotypes of the different microflora. The predominant cultivable microflora comprised several species of facultative and obligate anaerobic bacteria: Gemella, Peptostreptococcus, Staphylococcus, Stomatococcus, Streptococcus, Actinomyces, Eubacterium, Lactobacillus, Propionibacterium, Neisseria, Veillonella, Bacteroides, Campylobacter, Capnocytophaga, Fusobacterium, Kingella, Porphyromonas and Prevotella species. There was no difference between the two groups except the significantly higher proportion of Kingella dentrificans isolated from group B sites. However, colonization of the gingival sulcus in these individuals by microbes that are normal flora of: skin (Peptostreptococcus prevotii and Propionibacterium granulosum) and gut (Eubacterium aerofaciens, Fusobacterium mortiferum and Fusobacterium varium) was detected. These findings appear to suggest that the major components of the subgingival microflora of shallow sites in previously head- and neck-irradiated individuals are similar to that of gingivitis sites in the normal population although they may contain bacterial or fungal species uncommon in normal subjects.

Nine strains of oral Fusobacterium were examined for their ability to coaggregate in vitro with four strains of the oral yeast. Candida albicans. All of the Fusobacterium nucleatum strains and Fusobacterium periodontium and Fusobacterium sulci coaggregated to various degrees with all of the Candida strains. Fusobacterium alocis, Fusobacterium mortiferum and Fusobactrium simiae strains did not coaggregate with any of the Candida strains. Exposure of the coaggregating Fusobacterium strains but not the Candida strains to heat, trypsin, and proteinase K eliminated coaggregation. Amphotericin B or trichodermin treatment of the yeast species had no effect. The reactions were inhibited by addition of 0.1 M mannose, glucosamine and alpha-methyl mannoside. All coaggregating pairs were disaggregated by the addition of sodium dodecyl sulfate, but nonionic detergents had no effect. The addition of 2.0 M urea completely reversed coaggregation. Candida strains were sensitive to periodate oxidation, whereas the Fusobacterium strains were stable to this treatment. All coaggregations occurred in the presence of saliva and appeared stronger than in buffer. These data suggest that the coaggregations involve either a protein or glycoprotein on the Fusobacterium surface, which may interact with carbohydrates or carbohydrate-containing molecules on the surface of the Candida. These observations expand the known range of intergeneric coaggregations occurring between human oral microbes and indicate that coaggregation of C. albicans and Fusobacterium species may be an important factor in oral colonization by this yeast. The authors believe this to be the first description of coaggregation concerning a carbohydrate component on the yeast cell and a protein component on the oral bacterial cell.