A Rapid and Quantitative Detection System for Streptococcus mutans in Saliva Using Monoclonal Antibodies

Microbiology-Based Instruction during Prenatal Dental Visits Improves Perinatal Oral Health Literacy

To improve oral hygiene education, we evaluated the perception and potential impact of microbiology-focused oral hygiene instructions (OHI) given to pregnant patients. Dental hygienists provided this supplemental education and administered Saliva-Check Mutans (SCM) tests to pregnant patients (n = 188) in Obstetrics and Gynecology (OB/GYN) settings. Patients reported their self-perceived understanding of the relationship between oral bacteria and dental disease and returned postdelivery to receive a second SCM test and follow-up questionnaire (n = 47). Prior to the hygienist instruction, 84% of participants understood that bacteria caused tooth decay, while only 36% understood they could transfer these bacteria to their children. After instruction, patient understanding increased to 97% and 95%, respectively. Participants attributed these increases to the hygienist’s explanation and SCM test. In postdelivery participants, >80% reported adherence to routine oral hygiene practices, and a significant decrease in patients with high-risk levels of salivary Streptococcus mutans was determined by SCM test (p = 0.0253). Participants agreed that the SCM test (89%) and microbiology explanation (95%) should be provided to every pregnant patient. Evaluation of patient perception of this intervention highlights how focused instruction on the infectious nature of dental disease can increase perinatal oral health literacy. Microbiology-focused education should be given to pregnant patients to reduce oral health disparities.

Metabolic Syndrome, Lifestyle, and Dental Caries in Japanese School Children

The number of children with Metabolic Syndrome (MetS) has recently been increasing in Japan. Few studies have investigated the relationship between MetS and oral health. The aim of this study was to investigate the association between MetS, lifestyle, and oral health status in school children. Our goal is to utilize these results in health education aimed at preventing the onset of MetS in school children and adults. A total of 689 Japanese children (365 boys and 324 girls) aged between 10 and 13 years were examined and waist circumference (WC), ratio of WC to height, blood pressure, fasting blood sugar (FBS), high density lipoprotein-cholesterol, and triglyceride values determined together with oral health status, including dental caries experience (DMFT). The results revealed that 6.5% of the children fell under the health board recognized "MetS or high risk of MetS" (MetS/HR) classification. A total of 140 (20%) children had a high Streptococcus mutans count. The mean WC, FBS, and DMFT values were significantly greater in children with a high salivary S. mutans count (p<0.05). Multiple logistic regression analysis revealed a statistically significance association between MetS/HR, non-breakfast eaters (odds ratio (OR): 2.70), no regular exercise (OR: 2.60), and a high salivary S. mutans count (≥10(5) CFU/ml; OR: 2.18; p<0.05). The present results indicate that lifestyle and salivary S. mutans count could be useful in screening children for MetS/HR. These variables may be useful in targeting interventions aimed at preventing MetS in school children.

Evaluation of Chair-Side Assays in High Microbiological Caries-Risk Subjects

The aim of this study was to evaluate the commercial chair-side assays Saliva-Check Mutans and ClinproTM Cario L-PopTM in high microbiological caries-risk dental students compared with conventional semi-quantitative colony counting culture-based technique as the reference method. Saliva samples from 93 subjects of both sexes aged 18-26 years were seeded (Köhler and Bratthall method) on plates containing SB-20M culture medium method and 12 subjects with high caries risk were selected. These 12 individuals were subjected to determination of caries risk using two commercial rapid detection chair-side assays (Saliva-Check Mutans and ClinproTM Cario L-PopTM) according to the manufacturers' instructions. The results were analyzed by the Kappa correlation test using SAS statistical software. There was a perfect agreement (Kappa=1) among the three caries risk evaluation methods - chair-side assays and semi-quantitative CFU count (control) - in all subjects. The results suggest that the commercial chair-side assays evaluated in this study may be practical and useful to identify high microbiological caries-risk subjects.

Monitoring caries risks before the window of infection and later caries increment: a caries prediction study on rapid detection of Streptococcus mutans using monoclonal antibodies

A new semi-quantitative enumeration system has been developed for the detection of Streptococcus mutans in saliva. Using two kinds of species-specific monoclonal antibodies, this system can quickly detect salivary S. mutans within 30 min and classify the results into three levels. The aim of this study was to evaluate the potential of this test kit in determining risk for the development of caries. Saliva samples collected during a compulsory dental examination from 56 children aged 18-months were tested. The children were classified into 3 groups according to the level of salivary S. mutans determined. After 18 months, 36 of the children underwent a second examination to investigate whether there was a correlation between salivary S. mutans level at the first examination and subsequent increment in caries. The results showed a good correlation between the two. This indicates that salivary S. mutans level before the window of infection is an indicator of caries risk and can be quickly detected using this test kit. This rapid test should be particularly useful in assessing risk of future caries in very young children.

Oral biofilms: molecular analysis, challenges, and future prospects in dental diagnostics

Oral biofilms are functionally and structurally organized polymicrobial communities that are embedded in an extracellular matrix of exopolymers on mucosal and dental surfaces. These biofilms are found naturally in health, and provide benefits to the host. However, this relationship can break down, and disease can occur; disease is associated with a shift in the balance of the species within these biofilms. Simple diagnostic tests have been developed that involve the culture of selected bacteria, eg, those implicated in dental caries, facilitating an assessment of risk of further disease in individual patients. However, oral diseases have a complex etiology, and because only around 50% of oral biofilm can be grown at present, culture-independent molecular-based approaches are being developed that give a more comprehensive assessment of the presence of a range of putative pathogens in samples. The diversity of these biofilms creates challenges in the interpretation of findings, and future work is investigating the ability of novel techniques to detect biological activity and function in oral biofilms, rather than simply providing a catalogue of microbial names.

Evaluation of a Japanese "Prevention of long-term care" project for the improvement in oral function in the high-risk elderly

AIM

The purpose of this study was to analyze the improvement in oral function and environment in high-risk elderly persons participating in a program to improve oral function organized by their local government.

METHODS

Participants comprised 36 high-risk elderly and the mean age was 77.11 ± 7.24 years. The program involved training sessions carried out five or six times every 2-3 weeks for 3 months. Oral function and environment was evaluated before and after the program. The research period extended from 2008 to 2010.

RESULTS

The effects of intervention were clearly observed in oral diadochokinesis score in the high-risk elderly. Persons with a lower repetitive saliva swallowing test (RSST) and oral diadochokinesis score before intervention showed a tendency toward even greater improvement. No significant changes were observed in saliva secretion or total amounts of Streptococcus mutans, Lactobacilli, Candida or total microorganisms.

CONCLUSIONS

The effects of intervention were clearly recognized in regards to oral diadochokinesis. Improvement in RSST and oral diadochokinesis scores was marked in those persons showing a lower number of articulations before intervention.

Novel and conventional assays in determining abundance of Streptococcus mutans in saliva

BACKGROUND

Effective caries control and management requires identification of susceptible children for timely intervention. Streptococcus mutans (S. mutans) is an important biomarker of caries risk.

AIM

This study aimed to comparatively evaluate the validities of a novel immunoassay and a conventional culture-based assay in detecting salivary S. mutans in a paediatric cohort.

METHODS

190 children aged 3-4 years were recruited. The abundance of S. mutans in their saliva samples was analysed with three assay systems viz. a conventional culture-based assay (Dentocult SM), a novel immunoassay system (Saliva-Check MUTANS) based on monoclonal antibody technology and a Taqman real-time PCR assay taken as a gold standard.

RESULTS

The novel immunoassay accurately differentiated saliva samples with high (≥5 × 10(5) CFU/mL) and low (<5 × 10(5) CFU/mL) S. mutans levels. The sensitivity/specificity was 97.6%/90.6%. The conventional culture-based assay reached a reasonably high sensitivity/specificity (92.8%/81.3%) in identifying children with moderate (≥10(4) CFU/mL) S. mutans level. Its sensitivity/ specificity in selecting children with high (≥10(5) CFU/mL) and very high (>10(6) CFU/mL) S. mutans levels were not sufficient (78.7%/79.8% and 25.8%/91.8%, respectively).

CONCLUSION

The monoclonal antibody-based immunoassay accurately and rapidly determines S. mutans abundance in saliva and could be useful for chairside assessment of children's caries risk.

Comparative analysis of a monoclonal antibody-based Streptococcus mutans detection method with selective culture assays using polymerase chain reaction as a gold standard

The aim of this study was to compare a recently developed monoclonal antibody (MAb)-based salivary Streptococcus mutans detection method with various selective media using polymerase chain reaction (PCR) as the gold standard. Salivary S. mutans cells were enumerated with a MAb-based method, along with three commonly used selective media, mitis-salivarius-bacitracin agar (MSB), trypticase yeast-extract cystine sucrose bacitracin agar (TYCSB), and glucose-sucrose-potassium tellurite-bacitracin (GSTB) agar. Statistical analysis showed no significant correlations between each method. With PCR as the standard, a MAb-based detection method was found to provide the highest sensitivity (91%) and specificity (96%) among these four methods. This study demonstrates that the MAb-based detection method may provide more accurate enumeration of salivary S. mutans than selective media.