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Objectives: The purpose of this study was to examine the associations between daily habits, Streptococcus mutans, and caries using International Caries Detection and Assessment System Caries Index (ICDAS CI); and compare it to the DMF index., Subjects and Methods: Altogether 122 children were examined and interviewed. Saliva and plaque samples were collected and analyzed by Dentocult SM(®) Strip Mutans test. ICDAS CI was calculated by counting all ICDAS caries scores of all surfaces divided by total number of carious teeth., Results: ICDAS CI was significantly (p<0.01) and strongly associated with DMFT/dmft (ρ=0.72), DMFS/dmfs (ρ=0.72), total number of carious teeth (DT/dt) (ρ=0.77), enamel caries surfaces (ρ=0.61) and dentine caries surfaces (ρ=0.75). Plaque S. mutans was significantly (p<0.05) correlated with ICDAS CI and DT/dt. Children who brushed once a day or more had significantly lower ICDAS CI (p<0.01). Children who consumed sweets or drank soft drinks more than once a day had significantly higher ICDAS CI (p<0.05). No significant association was found between ICDAS CI and frequency of flossing, use of mouthrinse, or gum chewing., Conclusion: ICDAS CI seems to have similar trends as DMF indices, but includes more information about the stage, severity, and progress of the caries lesions of the patient., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Bioactive TiO(2) coatings have been found to enhance fibroblast adhesion and gingival attachment on the titanium surfaces, but no information is available whether the coatings also promote the adhesion of periodontal pathogens., Aim: The purpose of this study was to investigate protein adsorption and the adhesion of Aggregatibacter actinomycetemcomitans (Aa) and Fusobacterium nucleatum (Fn) on bioactive TiO2 surfaces., Materials and Methods: Commercially pure titanium discs (diameter 11.0 mm, grade 2) were coated with sol-gel derived bioactive TiO2 coatings (MetAlive, Vivoxid, Turku, Finland) and preincubated in 1.5 ml PBS/diluted serum/diluted saliva at room temperature to mimic the clinical situation after implantation and to allow serum/saliva proteins to adhere on the substrates. Uncoated titanium discs were used as controls., Results: SDS-PAGE revealed similar protein profiles on bioactive and control titanium substrates. No differences were noticed in Aa or Fn adhesion between bioactive and control titanium. However, serum and saliva conditioning diminished Aa adhesion on both surfaces (p<0.001)., Conclusion: It can be concluded that bioactive TiO2 coating does not promote adhesion of Aa and Fn., (© 2012 John Wiley & Sons A/S.)

Objectives: The purpose of this study was to prepare antibacterial and radiopaque dental resin through adding one polymerizable quaternary ammonium compound with iodine as counter anion into Bis-GMA/TEGDMA (50/50, wt/wt) dental resin system, and evaluate the degree of monomer conversion, mechanical properties, radiopacity, and antibacterial effectiveness of the polymer., Methods: 2-Dimethyl-2-dodecyl-1-methacryloxyethyl ammonium iodine (DDMAI) (3 wt.% and 5 wt.%) was added into a Bis-GMA/TEGDMA (50/50, wt/wt) resin system with CQ (0.7 wt.%) and DMAEMA (0.7 wt.%) as photoinitiation system. Degree of monomer conversion (DC) was determined by FT-IR analysis. The flexural strength (FS) and flexural modulus (FM) of the polymer were measured using a three-point bending set up. Radiographs were taken to determine the radiopacity of the polymer, and aluminum step-wedge (0.5-4mm) was used as calibration standard. A single-species biofilm model with Streptococcus mutans as the tests organism was used to evaluate the antibacterial property of the polymer. Bis-GMA/TEGDMA without DDMAI was used as control material in all of the tests., Results: ANOVA analysis revealed that there was no significant difference in DC between polymer with and without DDMAI (p>0.05). Polymer with 3 wt.% DDMAI had higher FS than the control material (p<0.05), while polymer with 5 wt.% DDMAI had comparable FS with the control material (p>0.05). Though average FM of control material was lower than that of 3 wt.% DDMAI containing polymer and higher than 5 wt.% DDMAI containing polymer, but the differences were statistically insignificant. By increasing the quantity of DDMAI, the radiopacity of the polymer increased. Of the three formulations, the polymer with 5 wt.% DDMAI inhibited biofilm the formation of the clinically relevant young biofilm., Significance: Incorporation of DDMAI into resin system could endow it with radiopacity and antibacterial effectiveness, and these two properties seem to be improved with increasing the quantities of DDMAI., (Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

In clinical studies, probiotic bacteria have decreased the counts of salivary mutans streptococci (MS). We compared the effects of probiotic Lactobacillus strains on the biofilm formation of Streptococcus mutans. The bacterial strains used included four S. mutans strains (reference strains NCTC 10449 and Ingbritt and clinical isolates 2366 and 195) and probiotic strains Lactobacillus rhamnosus GG, L. plantarum 299v, and L. reuteri strains PTA 5289 and SD2112. The ability of MS to adhere and grow on a glass surface, reflecting biofilm formation, was studied in the presence of the lactobacilli (LB). The effect of LB culture supernatants on the viability of the MS was studied as well. All of the LB inhibited the biofilm formation of the clinical isolates of MS (P < 0.001). The biofilm formation of the reference strains of MS was also inhibited by the LB, but L. plantarum and L. reuteri PTA 5289 showed a weaker inhibition when compared to L. reuteri SD2112 and L. rhamnosus GG. Viable S. mutans cells could be detected in the biofilms and culture media only when the experiments were performed with the L. reuteri strains. The L. reuteri strains were less efficient in killing the MS also in the tests performed with the culture supernatants. The pHs of the supernatants of L. reuteri were higher compared to those of L. rhamnosus GG and L. plantarum; P < 0.001. In conclusion, our results demonstrated that four commonly used probiotics interfered with S. mutans biofilm formation in vitro, and that the antimicrobial activity against S. mutans was pH-dependent.

Xylitol consumption decreases counts of mutans streptococci. However, the mechanism behind this decrease is not well understood. We studied not only type strains and clinical isolates of mutans streptococci, but also other polysaccharide-forming oral streptococci. Growth inhibition and adherence of cells to a smooth glass surface-reflecting synthesis of water-insoluble polysaccharides were studied in the presence of 2% (0.13 mol/l) and 4% (0.26 mol/l) xylitol. The effect of xylitol was compared to a novel polyol sweetener, erythritol. Except for Streptococcus mutans 10449 and S. sobrinus OMZ 176, the glass surface adhesion of most polysaccharide-forming streptococci was reduced by the presence of both 4% xylitol and erythritol. For the S. mutans and S. sobrinus type strains, the growth inhibition with 4% xylitol and erythritol was 36-77% and for the clinical S. mutans isolates 13-73%. Of the other oral streptococci, only S. sanguinis was inhibited with 4% xylitol (45-55%). For both polyols, the magnitude of the growth inhibition observed was not associated with the magnitude of the decrease in adherence (xylitol: r = -0.18; erythritol: r = 0.49). In conclusion, both xylitol and erythritol can decrease polysaccharide-mediated cell adherence contributing to plaque accumulation through a mechanism not dependent on growth inhibition.

No studies on the concentration dependency of the inhibition of Streptococcus mutans with xylitol are available. We studied xylitol-induced growth inhibition of two type strains, S. mutans NCTC 10449 and Ingbritt, and three clinical isolates of S. mutans. The strains were grown in Brain Hearth Infusion Medium in the presence of 0.001% (0.066 mM), 0.005% (0.33 mM), 0.01% (0.66 mM), 0.1% (6.6 mM), and 1% (66 mM) xylitol. Growth was followed by measuring the absorbance at a wavelength of 660 nm. The highest xylitol concentration tested in this study, 1%, showed mean inhibition percentages ranging from 61% to 76% when the growth inhibition of the five strains was compared to the control without xylitol at log-phase. For 0.1% xylitol, the inhibition percentages ranged from 22% to 59%. A concentration dependency was seen in the growth inhibition, with 0.01% xylitol being the lowest xylitol concentration inhibiting all five strains significantly (p < 0.001). The growth inhibition percentages determined for 0.01% xylitol, however, were low, and the inhibition was significantly weaker as compared to 0.1% and 1% xylitol. Our results suggest that low xylitol concentrations of 0.1% (6.6 mM) could inhibit mutans streptococci in vivo but even lower xylitol concentrations may be inhibitory.

Aim: To investigate the use of xylitol-containing chewing-gums in public elementary schools as a means to affect the growth of salivary and plaque mutans streptococci and salivary lactobacilli., Design: Over a period of 24 months, 750 8- to 9-year-old children chewed xylitol (X group; n = 255) or xylitol-sorbitol (XS group; n = 264) gum on school days (454 days over 2 years), or chewed no gum at all (C group; n = 231). Consumption of xylitol in the X and the XS groups was 6.6 and 5.4g per day, respectively. Use of gum took place at school in four daily episodes of which three were supervised by teachers. Following the 24-month chewing-gum period, the subjects were re-examined after 15 months (total follow-up period: 39 months) at which time an extraneous comparison group (ExC; n = 117) was also examined. The numbers of subjects examined after 39 months were: X, 239; XS, 248; C3 217., Methods: Salivary and plaque levels of mutans streptococci and the salivary levels of aerobically cultured aciduric bacteria (mostly representing lactobacilli) were determined using the Orion Diagnostica Dentocult SM and LB test kits, respectively., Results: There were statistically significant differences after 24 and 39 months between the two xylitol chewing-gum groups and the C group with regard to salivary and plaque mutans streptococci and salivary lactobacilli: the use of xylitol-containing chewing-gums significantly reduced these bacterial scores. The reductions were statistically more significant in the X group than in the XS group. The bacterial scores of groups C and ExC were similar., Conclusions: Long-term use of xylitol-containing chewing-gum can reduce the growth of mutans streptococci in saliva and dental plaque, and lactobacilli-type bacteria in saliva, even if xylitol is used only on school days. The results also suggest that xylitol gum use can have a long-term, delayed growth-retarding effect on these micro-organisms, since reduced bacterial growth was still observed 15 months following the termination of xylitol use. The results indicate a close biochemical relationship between xylitol and mutans streptococci, and suggest that a similar relationship may exist regarding aerobically cultured aciduric bacteria present in saliva.

Objective: The aim of this study was to assess the dental health and presence of mutans streptococci (MS) in 2-4-year-old Estonian children., Methods: The dental health of 472 2-4-year-old children was examined using a mirror and a penlight in 14 daycare centres representing seven communities around Estonia. The mean (+/-SD) age of the children was 41.4+/-4.1 months (n=222). Plaque samples of 222 children were employed to determine the presence of MS using the Dentocult SM Strip mutans test., Results: Caries was diagnosed in 42% of the children, and the average (+/-SD) dmft index was 1.6+/-2.5, ranging from 1.1+/-1.2 in Tartu to 2.4+/-3.1 in Võru. The proportion of caries-free children decreased from 82% in the younger to 63% in the older group (P=0.001). Among the tested subjects, 58% were colonized with MS, and those with caries were colonized more often than children with no visible caries (80% and 51%, respectively; P=0.001)., Conclusions: The prevalence of dental caries in Estonian 2-4-year-olds is higher than in the Nordic countries, but similar to other Baltic nations. Colonization by MS was associated with dental caries.

Objective: The aim of the current study was to test the impact of dentin powder on the antimicrobial efficacy of bioactive glass S53P4 (BAG)., Study Design: BAG was suspended (preincubated) in saline at 37 degrees C for different time periods with or without human dentin powder, hydroxylapatite, or decalcified dentin. Subsequently, Enterococcus faecalis ATCC 29212 cells were added to these suspensions and bacterial recovery measured with and without the use of gentle sonication. Furthermore, survival of bacteria in test and control suspensions was assessed over time. Supernatants of suspensions were analyzed for their element contents using atomic absorption spectrophotometry. The effects of pH, silica, and osmolarity on E faecalis viability were assessed using specifically prepared solutions., Results: BAG preincubated with dentin powder caused a significant (P < .05) decrease in viability compared to pure BAG suspensions. This was not based on adherence of bacteria to solid particles or agglutination of the cells, because sonication did not increase bacterial yields. Hydroxylapatite and decalcified dentin did not increase BAG killing efficacy. The additive effect of BAG + dentin powder was dose dependent, occurred only with solids in suspension, and increased with suspension time. An augmented dissolution of glass components, especially silicon, was measured in BAG + dentin powder compared to pure BAG suspensions or counterparts containing hydroxylapatite or decalcified dentin. High osmolarity per se did not affect E faecalis viability, whereas high pH and silica levels did., Conclusion: The observed phenomenon was related to an increased BAG dissolution triggered by dentin powder, causing elevated local pH and silica levels.

In the present study, two different fibre-reinforced composites (FRCs) (glass and polyethylene FRC), dental ceramic and restorative composite were compared with respect to early plaque formation in vivo. Disc-shaped specimens were randomly distributed among the upper first and second molars of 14 healthy adult volunteers. Plaque samples were collected 24 h after the attachment of the specimens. Mutans streptococci (MS), non-mutans streptococci and total facultative bacteria were cultured. The plaque recovered from polyethylene FRC harboured significantly more MS than the plaque of ceramic, restorative composite and glass FRC. For the counts of non-mutans streptococci and total facultative bacteria, polyethylene FRC showed the highest counts, and ceramic showed a trend towards lower counts. The amount of plaque accumulation showed an association to the earlier reported surface roughness values of the studied materials. It was concluded that in the oral environment, polyethylene FRC promotes plaque accumulation and adhesion of MS more than glass FRC, restorative composite and dental ceramic. Glass FRC resembles restorative composite with respect to plaque accumulation and the adherence of MS.

Aim: To investigate the use of polyol-containing chewing gums in a day-care centre (kindergarten) setting as a means to affect the growth of mutans streptococci and dental plaque., Design: Over a period of six months, 123 five-year-old children chewed xylitol (X group), sorbitol (G group), or did not chew gum (C group). Consumption of xylitol, and sorbitol was 4.5 to 5.0 g per day and subjects consumed in five supervised daily chewing episodes four at the day-care centres and one at home., Methods: Interproximal dental plaque was sampled at baseline and after six months for a laboratory study of mutans streptococci counts. The Quigley & Hein plaque index procedure was used. Interviews and questionnaires elucidated the acceptability of the programme., Results: Parents and kindergarten personnel regarded the programme as an important, additional procedure to promote better oral health. The children regarded the use of chewing gum as a pleasurable experience. Compared with groups G and C, there was a statistically significant reduction of mutans streptococci in the interproximal plaque in the X group. The Quigley & Hein plaque index scores tended to decrease in the X group, while no such trend was observed in the G group., Conclusions: Habitual use of relatively small daily quantities of polyol-containing chewing gum by young children may be regarded as an important additional caries-preventive procedure in a combined day-care centre and home setting. Especially xylitol-containing chewing gum may significantly reduce the growth of mutans streptococci and dental plaque which may be associated with dental caries.

Calcium hydroxide is the "gold standard" endodontic medication, but it may fail to eliminate certain facultative bacteria and yeasts found in root canal systems. In this study, standardized bovine dentin blocks infected with Enterococcus faecalis were treated with an aqueous calcium hydroxide or bioactive glass S53P4 (BAG) powder suspension. While calcium hydroxide was ineffective, the BAG suspension eliminated the infection in the sampled dentin layers after 5 days. In a direct exposure test, preincubation with human dentin boosted the BAG-killing efficacy against E. faecalis ATCC29212, Candida albicans CCUG19915, Pseudomonas aeruginosa ATCC9027, Streptococcus sanguis ATCC10556, and S. mutans ATCC25175. BAG placed in the root canals of extracted teeth did not alter root-dentin pH. Consequently, the conditions under which the microbiota were killed were not pH-mediated. Further studies are ongoing to help clarify the antimicrobial BAG effect in the presence of dentin.

The use of fiber-reinforced composites (FRC) in dentistry has increased during recent years. In marginal areas of crowns and removable partial dentures the fibers may become exposed and come into contact with oral tissues, saliva, and microbes. To date, few articles have been published on oral microbial adhesion to FRCs. The aim of this study was to compare different FRCs, their components, and conventional restorative materials with respect to S. mutans ATCC 21752 adhesion and adsorption of specific S. mutans binding proteins. Surface roughness of the materials was also determined. Four different FRCs, a restorative composite, and a high-leucite ceramic material were studied. Polyethylene FRC was found to be significantly rougher than all other materials. Aramid FRC also showed higher surface roughness in comparison with all materials but polyethylene FRC. Without a saliva pellicle, adhesion of S. mutans coincided with surface roughness and polyethylene and aramid FRC promoted S. mutans adhesion better than the other smoother materials. In the presence of salivary pellicle, ceramic and polyethylene FRC bound more bacteria than the other materials studied. Higher quantities of S. mutans binding proteins in the pellicles may in part account for the higher S. mutans adhesion to saliva-coated ceramic and polyethylene FRC., (Copyright 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 66B: 391-398, 2003)

Background/aims: A novel approach for reducing the undesired irritating properties of detergents on skin might be offered by betaine, which is a natural product derived from the sugar beet. The aim of the study was to explore the ability of betaine to reduce the irritating effects of two surfactants, sodium lauryl sulphate (SLS) and cocoamidopropylbetaine (CAPB). For evaluation of changes in skin reactions visual scoring, electrical impedance, transepidermal water loss and histology were used., Methods: Twenty-one healthy subjects were patch tested for 24 h with SLS and CAPB alone and together with betaine, betaine alone, and the two controls distilled water and an unoccluded test site on both volar forearms. Responses were evaluated by measuring electrical impedance and transepidermal water loss before exposure and 24 h after the removal of the test substances, and also by visual inspection and histology. The electrical impedance device enables measurements at 31 frequencies and relevant information was extracted from the spectra using four indices., Results: CAPB was found to be less irritating than SLS. The used detergents gave rise to distinctive impedance patterns also reflected by different types of histopathological skin responses. After the adding of betaine, the irritant reaction decreased for both detergents., Conclusions: Betaine is a promising ingredient to reduce the side effects of detergents and electrical impedance is a suitable tool both to quantify the degree of irritation as well as to differentiate between various types of reactions., (Copyright Blackwell Munksgaard 2003)

The aim was to compare the effects of two sodium lauryl sulphate (SLS)-containing toothpaste formulations with and without betaine on human oral mucosa in vivo. The results are compared with the effect of a dry mouth toothpaste without SLS. Twenty subjects participated in the double blind, crossover study. The toothpastes with 1.2% SLS, 1.2% SLS and 4% betaine and with 4% betaine but not with SLS were placed on buccal mucosa in a test chamber and kept in place for 15 min. The condition of the mucosa was studied both visually and using electrical impedance (EI) for up to 45 min. Both SLS-containing pastes had a similar, irritating effect on the mucosa as judged both by the appearance of the mucosa and the EI measurements. The dry mouth toothpaste (with betaine only) showed no significant irritation of the mucosa. Betaine did not reduce the mucosa-irritating effect of the SLS-containing toothpaste formulation. The surfactant-free toothpaste did thus not irritate the human oral mucosa in vivo while the SLS-containing pastes did.