A 30-month Longitudinal Study of the Effects of Some Oral Hygiene Measures on Streptococcus mutans and Approximal Dental Caries

Abstract

The effects of some oral hygiene measures on Streptococcus mutans and approximal dental caries were evaluated. One hundred and eighty-seven 13-year-old individuals with high levels of salivary S. mutans (>10⁶/mL) were selected. They were randomly distributed into three groups. Group I initially received professional mechanical toothcleaning, tongue-scraping, chlorhexidine treatment, and oral hygiene instructions concentrated on the approximal surfaces most colonized by S. mutans. The treatment was given four times with intervals of two days, followed by one single treatment every six months throughout the experimental period. The initial treatment period for group II, also consisting of four visits, included the same oral hygiene instructions as for group 1. The instructions were repeated every six months. Group III was maintained in the preventive program provided by the local Dental Health Office, based on mechanical plaque control and topical use of fluorides and chlorhexidine at individualized intervals. Group I showed a significant immediate reduction of S. mutans in saliva as well as on approximal tooth surfaces. After six months, there were no differences among the three groups regarding these variables. Compared with baseline, there was a significant reduction of S. mutans in all groups. There was no significant difference in caries progression among the three groups. However, the selected "high-risk" individuals in group I developed 0.25 new manifest caries lesions approximallylyear, compared with 0.27 for all children of the same age group in the area. Seventeen individuals had approximal surfaces with consistently high or consistently low S. mutans levels. Forty-six percent of the surfaces with high values developed new or progressive caries, compared with 2% of the surfaces with low values.

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References

Axelsson, P. (1969): EVA-systemet. Ett Nytt Hjalpmedel for Approximal Rengöring, Puts och Polering, Sv Tandläk Förb Tidn 21:1086-1104.

Axelsson, P. and Lindhe, J. (1974): The Effect of a Preventive Programme on Dental Plaque, Gingivitis and Caries in Schoolchildren. Results after One and Two Years, J Clin Periodontol 1:126-138.

Axelsson, P. (1981): Concept and Practice of Plaque-control, Pediat Dent 3:101-113.

Bellini, H.T. ; Arneberg, P. ; and Von Der Fehr, F.R. (1981): Oral Hygiene and Caries. A Review, Acta Odontol Scand 39:257-265.

Caufield, P.W. and Gibbons, R.J. (1979): Suppression of Streptococcus mutans in the Mouths of Humans by a Dental Prophylaxis and Topically-applied Iodine, J Dent Res 58:1317-1326.

Emilson, C.-G. (1981): Effect of Chlorhexidine Gel Treatment on Streptococcus mutans Population in Human Saliva and Dental Plaque, Scand J Dent Res 89:239-246.

Emilson, C.-G. ; Axelsson, P. ; and Kallenberg, L. (1982): Effect of Mechanical and Chemical Plaque Control Measures on Oral Microflora in Schoolchildren, Community Dent Oral Epidemiol 10:111-116.

Gold, O.G. ; Jordan, H.V. ; and Van Houte, J. (1973): A Selective Medium for Streptococcus mutans, Arch Oral Biol 18:1357-1364.

Grondahl, H.-G. ; Hollender, L. ; Malmcrona, E. ; and Sund-Qvist, B. (1977a): Dental Caries and Restorations in Teenagers. I. Index and Score System for Radiographic Studies of Proximal Surfaces, Swed Dent J 1 :45-50.

10.

Grondahl, H.-G. ; Hollender, L. ; Malmcrona, E. ; and Sund-Qvist, B. (1977b): Dental Caries and Restorations in Teenagers. II. A Longitudinal Radiographic Study of the Caries Increment of Proximal Surfaces Among Urban Teenagers in Sweden, Swed Dent J 1:51-57.

11.

Klimek, J. ; Prinz, M. ; Mellwig, E. ; and Ahrens, G. (1985): Effect of a Preventive Program Based on Professional Toothcleaning and Fluoride Application on Caries and Gingivitis, Community Dent Oral Epidemiol 13:295-298.

12.

Klock, B. and Krasse, B. (1977): Microbial and Salivary Conditions in 9- to 12-Year-Old Children, Scand J Dent Res 85:56-63.

13.

Klock, B. and Krasse, B. (1979): A Comparison Between Different Methods for Prediction of Caries Activity, Scand J Dent Res 87:129-139.

14.

Kohler, B. and Bratthall, D. (1979): Practical Method to Facilitate Estimation of Streptococcus mutans Levels in Saliva, J Clin Microbiol 9:584-588.

15.

Kristoffersson, K. and Bratthall, D. (1982): Transient Reduction of Streptococcus mutans Interdentally by Chlorhexidine Gel, Scand J Dent Res 90:417-422.

16.

Kristoffersson, K. ; Axelsson, P. ; and Bratthall, D. (1984): Effect of a Professional Tooth Cleaning Program on Interdentally Localized Streptococcus mutans, Caries Res 18:385-390.

17.

Kristofferson, K. ; Grondahl, H.-G. ; and Bratthall, D. (1985): The More Streptococcus mutans, the More Caries on Approximal Surfaces, J Dent Res 64:58-61.

18.

Loesche, W.J. (1979): Clinical and Microbiological Aspects of Chemotherapeutic Agents Used According to the Specific Plaque Hypothesis, J Dent Res 58:2404-2412.

19.

Maltz, M. ; Zickert, I. ; and Krasse, B. (1981): Effect of Intensive Treatment with Chlorhexidine on Number of Streptococcus mutans in Saliva, Scand J Dent Res 89:445-449.

20.

Rugg-Gunn, A.J. and Holloway, P.J. (1974): Methods of Measuring the Reliability of Caries Prevalence and Incremental Data, Community Dent Oral Epidemiol 2:287-294.

21.

Sandham, H.J. ; Brown, J. ; and Chan, D. (1985): Clinical Elimination of S. mutans with Chlorzoin® and Polyurethane Varnishes. J Dent Res 64:213, Abst. No. 343.

22.

Togelius, J. and Bratthall, D. (1982): Frequency of the Bacterium Streptococcus mutans in the Saliva of Selected Human Populations, Arch Oral Biol 27:113-116.

23.

Togelius, J. ; Kristoffersson, K. ; Anderson, H. ; and Bratthall, D. (1984): Streptococcus mutans in Saliva: Intra-individual Variations and Relation to the Number of Colonized Sites, Acta Odontol Scand 42:157-163.

24.

Zickert, I. ; Emilson, C.-G. ; and Krasse, B. (1982a): Streptococcus mutans, Lactobacilli and Dental Health in 13-14-Year-Old Swedish Children, Community Dent Oral Epidemiol 10 :77-81. 1.

25.

Zickert, I. ; Emilson, C.-G. ; and Krasse, B. (1982b): The Effect of Caries Preventive Measures in Children Highly Infected with the Bacterium Streptococcus mutans, Arch Oral Biol 27:861-868.