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Aims: The present study aimed to compare the effectiveness of Chlorhexidine (CHX) and Chlorine dioxide (ClO2) mouthwashes in reducing the microbial load in saliva. Place and Duration of Study: Department of Periodontics, Government Dental College and Hospital, Afzalgunj, Hyderabad, between January and March 2020. Methods and Materials: 60 Patients with gingivitis were included in the study. Ultrasonic scaling was done and saliva samples of the participants were collected and transferred onto blood agar plates. These plates were sent for the microbial count. Later they were given the mouthwash (Chlorhexidine or Chlorine dioxide or Distilled water by random selection) which they used for four weeks. Each group of participants was instructed to rinse 10 ml of 0.2% CHX for one minute twice per day. (Group A) 10 ml of ClO2 (Freshclor) for one minute twice per day. (Group B) 10 ml of Distilled water for one minute twice per day. (Group C) After four weeks of usage of prescribed mouthwashes, the participants were recalled and salivary samples were again collected and sent for the microbial count. Results: The intergroup comparison of CFU between the groups after four weeks showed significant reduction of CFU Groups A and B when compared to Group C. When compared to Group A (CHX), Group B (ClO2) witnessed statistically significant reduction of CFU in with a mean difference of 0.26±0.09 (p

Objective-The purpose of the present study is to compare the efficacy of three commercially available mouth rinses containing chlorhexidiene and sodium fluoride-triclosan- xylitol respectively against salivary bacteria, streptococcus mutans. Materials and Methods: A sample of 72 subjects was selected from the single school and was randomly equally divided into 3 groups. The subjects were instructed to rinse the mouthwash 10 ml of mouthwash for one minute twice daily for fifteen days. Number of colony of Streptococcus mutans were counted by using Mitis Salivarius agar plate, at the beginning and at the end of the study period. Inter group and intra group comparisons were done. Intra group comparisison was assessed usingWilcoxon signed rank test (non-parametric equivalent to paired‘t’ test) whereas the difference between three groups was assessed using Kruskal-Wallis Annova. Results: In the present study, no statistically significant difference was found between the mouthwashes with regard to their efficacy in reducing S mutans. Conclusion: All the commercial available mouthwashes are equally potent in reducing s mutans counts effectively. Keywords: Chlorhexidine.

Aim: The purpose of this prospective study was to determine if there is a difference in number and distribution of salivary bacteria between patients with tonsillar infection and healthy volunteers. Background: The etiology of peritonsillar abscess (PTA) is unclear. Smoking, periodontal disease, and infection of minor salivary glands have been suggested as predisposing factors for PTA. Material and methods: Patients with acute tonsillitis (AT) (n = 54), peritonsillitis (PT) (n = 36), PTA (n = 58), and healthy volunteers (n = 52) were prospectively recruited and evaluated. Saliva bacteria were analyzed with flow cytometry. Patients and their treating physicians completed a questionnaire about patients' current disease, smoking habits, alcohol consumption, and oral health. Results: There were no differences in the total number of saliva bacteria between patients with acute throat infection and healthy volunteers (p = .104) or between AT, PT, and PTA patients (p = .273). Smoking habits, alcohol consumption, oral hygiene, or prior antibiotics had no effect on total amount of salivary bacteria in patients with acute throat infection. Conclusions: The effects of smoking on salivary bacteria do not seem to be the mechanism that promotes development of PTA in smokers.

Introduction: Early childhood caries (ECC) is a complex, multifactorial oral disease that is a major public health concern because it is prevalent, profoundly alters a child’s quality of life, is difficult to treat effectively, and has a distressing tendency to recur following treatment. Objectives: The purpose of the study was to examine social, psychological, and behavioral predictors of salivary bacteria and yeast in young children at risk for ECC. Methods: A sample of 189 initially caries-free preschool children was assessed for child stress physiology from salivary cortisol, child and family stress exposure, diet, oral health behaviors, and sociodemographic risks. Multiple logistic regression analysis was implemented to examine the associations between these risk factors and cariogenic microorganisms: mutans streptococci (MS), lactobacilli (LB), and Candida species. Results: Higher baseline salivary cortisol (odds ratio [OR] = 6.26; 95% confidence level [CL], 1.69–23.16) and a blunted response to an acute laboratory stressor (OR = .56; 95% CL, .37–.83) were associated with an increased likelihood of elevated salivary MS (≥105 colony-forming units/mL) in caries-free children. Sociodemographic risk for cariogenic microorganisms was also found. Specifically, lower education attainment of the parent/primary caregiver was associated with children being more likely to carry salivary Candida species and elevated salivary MS; in addition, children from households with an unemployed parent/primary caregiver were more likely (OR = 3.13; 95% CL, 1.2–8.05) to carry salivary Candida species and more likely (OR = 3.03; 95% CL, 1.25–7.33) to carry elevated levels of MS and/or salivary Candida and/or LB. Conclusions: The impact of sociodemographic risk and stress physiology on cariogenic disease processes are evident prior to ECC onset. The findings provide novel data on the early onset of cariogenic processes in children and the importance of considering sociodemographic, psychosocial, and behavioral factors when judging ECC risk. Knowledge Transfer Statement: The findings provide valuable and novel findings that, pre-ECC onset, the caries disease process is explicable from a detailed assessment of behavioral, sociodemographic, and psychosocial stress variables.

Aim: The purpose of this study was to create an alternative protocol for the DNA-based identification of salivary microbiota focused on the distinguishing of Streptococcus species. Materials & methods: Salivary bacteria were identified using 16S rDNA sequencing and proteins and lipids profiling using MALDI-TOF/MS as well as FTIR analysis. Results: Most of the isolates belonged to streptococci - mostly the salivarious group indistinguishable by the molecular technique. In turn, MALDI analysis allowed for their fast and reliable classification. Although FTIR spectroscopy demonstrated the correct species classification, the spectra interpretation was time consuming and complicated. Conclusion: MALDI-TOF/MS demonstrated the biggest effectiveness in the identification and discrimination between the salivary streptococci, which could be easily incorporated in the workflow of routine microbiological laboratories.

Background Oral functions are known to decline with aging. However, there is limited evidence that supports the relationship between oral health and frailty. This study aimed to clarify the relationship between oral hygiene conditions, measured by remaining teeth and mucosa, and frailty among elderly people dwelling in a Japanese rural community. Methods We surveyed self-reliant elderly individuals aged ≥65 years who were dwelling in the Sasayama-Tamba area of Hyogo, Japan. Frailty was evaluated according to the total score of the Kihon Checklist (KCL). Based on the KCL score, elderly participants were divided into three groups: robust, pre-frail, and frail. The items measured to evaluate oral environment included the number of remaining teeth, denture usage condition, oral hygiene status, dry mouth condition, and salivary bacterial count. For statistical analysis, Fisher’s exact test, one-way analysis of variance, and multiple comparison technique were used. Results Of 308 elderly participants, 203 (65.9%), 85 (27.6%), and 20 (6.5%) belonged to the robust, pre-frail, and frail groups, respectively. The proportion of participants who were judged to have poor hygiene was significantly higher in the frail group than in the other two groups. The bacterial count was significantly smaller in the frail group than in the robust group, and the frail group had fewer number of remaining teeth than the other two groups, suggesting that the number of remaining teeth may be associated with bacterial count. Conclusion In elderly adults, physical frailty may affect the oral hygiene status and condition of the remaining teeth.

Background: Pluchea indica (L.) Less leaf contains antibacteria substances that can inhibit the growth of bacteria that cause dental and oral diseases. Previous research shows that Pluchea indica (L.) Less leaf extract can inhibit the growth of Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa bacteria. This research aimed to find out effectiveness of Pluchea indica (L.) Less leaves to decrease in the number of salivary bacteria colony. Method: This research used a sample of saliva obtained from a person who has dental caries. The saliva had been treated with Pluchea indica (L.) Less leaves ethanol extract with concentration 2,5%, 3,5%, 4,5%, 5,5%, and 6,5%. Bacterial colonies were calculated using a colony counter and no identification was performed. Result: The mean of bacteria colony number in Plate Count Agar media without Pluchea indica (L.) Less leaves ethanol extract is 142,67. After being given Pluchea indica (L.) Less leaves ethanol extract with concentration of 2,5%, 3,5%, and 4,5%, the mean of bacteria colony number sequentially are 15,67, 10,67, 4, and at a concentration of 5.5% and 6.5% no more bacterial colonies were found. Conclusion: Pluchea indica (L.) Less leaves ethanol extract effective to inhibit and eliminate oral bacteria.

Attention deficit hyperactivity disorder (ADHD) is a childhood neurological disorder. Studies have shown that children with ADHD are more prone to caries than those without. The study investigated children diagnosed with ADHD, both with and without pharmacological intervention, and the following: DMFT\dmft, plaque index (PI), mutans streptococci (MS) levels, lactobacilli (LB) levels, salivary flow, salivary buffer capacity, oral hygiene, and diet. DMFT/dmft index, PI, MS and LB levels, salivary flow, and salivary buffer capacity were examined in three groups of children: ADHD1—diagnosed with ADHD with no pharmacological intervention (N = 31), ADHD2—treated with medications for ADHD (N = 30), and a healthy control group (N = 30). Diet and oral health habits were assessed through questionnaires completed by parents. There were no differences in the DMFT/dmft index, MS and LB counts, salivary buffer capacity, and parent reported diet and oral health behavior between the three groups. Children with ADHD demonstrated a higher plaque index. Although children with ADHD did not report different diet and oral health behavior from children without ADHD, this group had significantly higher levels of plaque than the control group, which combined with hyposalivation may be a risk factor for caries at an older age. Medicated and non-medicated ADHD children were similar to control children in their caries rate, MS and LB counts, salivary buffer capacity, and diet and oral health behavior. They differed in the amount of plaque found on their teeth. As a group, ADHD children demonstrated hyposalivation compared with the control.

Objective:To determine the difference in the levels of Streptococcus mutans and S sobrinus in stimulated saliva in orthodontic patients with different bracket types (stainless steel and esthetic brackets) using polymerase chain reaction and cultivation method.Materials and Methods:Thirty-two patients, aged 13 to 30 years, were selected following these criteria: 1) orthodontic treatment indication, 2) systemic health, and 3) no tobacco and antibiotic consummation for three months prior to the commencement of the study. Patients were divided into two groups according to the bracket type; 16 patients formed the conventional bracket group (stainless steel brackets), and 16 patients formed the esthetic bracket group (plastic brackets). The levels of S mutans and S sobrinus in stimulated whole saliva samples were collected prior to fixed orthodontic appliance placement (T1) and 12 weeks after placement (T2), as were the Decayed, Missing, and Filled Surface Index (DMFS) and Oral Hygiene Index-Simplified (OHI-S). Mann-Whitney, Wilcoxon, and chi-square tests were used for statistical analysis.Results:Statistical analysis (chi-square test) showed no difference in S mutans and S sobrinus counts among patients with different brackets at either T1 or T2. There was no difference in total bacteria counts after fixed orthodontic appliance placement.Conclusion:The number of colony-forming units of S mutans and S sobrinus in stimulated saliva samples does not seem to be significantly different between patients with stainless steel brackets and patients with plastic brackets.

Aim: The purpose of this study was to evaluate the effect of gravity and capillarity on penetration of human salivary bacteria into the entire length of obturated root canals, and to demonstrate the dye penetration configuration. Materials and methods: Fifty single-rooted premolars were decoronated, prepared to a standardized length of 15 mm, instrumented, and randomly divided into two groups (A and B) of 25 teeth each. Each group consisted of experimental (15 samples) and negative and positive controls (five samples each). The experimental groups were obturated with gutta-percha and root canal sealer. The positive control groups were obturated with a single cone of gutta-percha and root canal sealer. The outer surfaces (except for the apical 2 mm) were covered with two layers of nail varnish. An apparatus containing Brain Heart Infusion broth was designed, in which the teeth were placed. The samples in Group A were placed upside down, while Group B was placed normally. The coronal portions of the samples were placed in contact with fresh saliva. The number of days required for bacteria to penetrate the entire length of canals was determined. The samples were then immersed in India ink to determine the dye penetration configuration. Data were analyzed using Student’s t-test. Results: The extent of dye penetration was significantly greater in Group B compared to Group A, and they were in a pattern rather than linear form. Conclusions: Gravity and capillarity insignificantly affected bacterial leakage. Although gravity and capillarity did not affect bacterial penetration when applied to the coronal access of endodontically treated teeth, it seems that they can promote penetration of India ink into the canal after the bacterial test on the same tooth. Keywords: Bacterial leakage, Dye penetration, Gravity, Capillarity, Obturated root canal

Rubber dam is essential for effective isolation of the root canal and operating field from salivary bacteria, as well as protection of the airway. In this article, Richard Johnson and Barry Quinn provide an concise guide to the efficient application of rubber dam

Distinguishing between bloodstains caused by a spatter pattern or by expirated blood may be crucial to a forensic investigation. Expirated blood is likely to be contaminated with saliva but current techniques have limited sensitivity, especially with small bloodstains. We report that a PCR assay, designed to detect salivary bacteria, can amplify streptococcal DNA from saliva stains applied to fabrics for at least 62 days after seeding. Bacterial DNA was detected when 0.01 µl of saliva was present in the stain and the amplification was not affected by contamination with blood. These findings indicate that PCR amplification of salivary microbial DNA may have application in the identification of expirated bloodstains in forensic case-work.

International Journal of Paediatric Dentistry 2010; 20: 179–185 Objectives. This study examined caries level, amount of calculus, and oral microbial environment in gastrostomy tube (GT)-fed children compared with healthy children and children with disabilities orally fed (PO). Study design. The study group consisted of 12 GT-fed children and the two control groups consisted of 16 children with disabilities orally fed and 17 healthy children. DMF-T/dmf-t index, calculus index, Mutans Streptococci (MS), Lactobacilli (LB) levels and salivary buffer capacity were examined. Results. DMF-T/dmf-t index was significantly lower in the tube-fed group. Calculus index was highest in the tube-fed group. MS and LB levels were the lowest in the tube-fed children. Correlation was found between MS and DMF-T/dmf-t. Conclusions. Tube-fed children demonstrated significantly higher calculus levels and less caries, MS, and LB levels then healthy children or children with disabilities eating PO.

Objective: The objective of this study was to investigate the differences activity of salivary Streptococcus mutans bacteria in children suffer acute lymphoblastic leukemia (ALL) in phase of chemotherapy, induction, intensification/consolidation, and maintenance.Methods: This study was a laboratory observational, and cross-sectional method, conducted 19 ALL children in phase of chemotherapy, induction, intensification/consolidation, and maintenance. 2 mm of dental plaque was collected from mesiobuccal first permanent molar and incubated for 48 h at 37°C, and the bacterial activity of S. mutans measured by Cariostat.Results: Odds ratio analysis among chemotherapy phase of induction, intensification/consolidation, and maintenance is not significant (p>0.05) differences.Conclusion: The highest activity bacteria of S. mutans were found in the induction phase

ObjectiveTo study associations between reported sugar intake and salivary bacteria (mutans streptococci, MS and lactobacilli, LB), and sugar intake in relation to body mass index (BMI), in women and adolescents.DesignCross-sectional study. Habitual dietary intake was reported in a questionnaire and whole saliva samples were collected and cultivated.SettingStockholm, Sweden.SubjectsFour hundred and fourteen mothers and their 16-year-old children (57% girls).ResultsReported total sugar intake was significantly associated with LB in mothers (P= 0.001), but not in daughters and sons (P= 0.03 for mother–son interaction). When excluding lactose, the associations with LB and MS were significant in daughters (P= 0.032 and 0.005, respectively). High BMI and sugar intake from milk were independently associated with MS counts in mothers in a multiple regression model (R2= 0.053). In daughters, sugar from beverages, candies/chocolates and fruits were all independently associated with MS counts (R2= 0.074), whereas in sons, only mothers’ MS counts were associated (R2= 0.084). High BMI, low intake from cooked meals and high intake of candies/chocolates were all independently associated with LB in mothers (R2= 0.076), while, except for candies/chocolates in daughters, no significant associations were found in children. BMI was significantly associated with bacteria counts in both mothers and children, whereas reported sugar intake was not.ConclusionThe associations between reported sugar intake and bacteria were generally weak. In mothers and daughters, some significant associations were found, but not in sons. Bacteria counts, but not reported sugar intake, were positively associated with BMI.

Background/aims: Clinical studies have demonstrated the considerable effects of chlorhexidine on dental plaque and oral microbiota as well as improvements in indices of oral health. This investigation examined the efficacy of lower concentrations of chlorhexidine. Methods: Mouthrinses with 0.03%, 0.06%, 0.12% chlorhexidine and a control rinse without chlorhexidine were examined. Alamar blue, an oxidation-reduction dye with fluorescent end-points proportional to bacterial viability, was used to determine bacterial viability. Further clinical studies examined the effects of these rinses on salivary bacteria and on bacteria producing hydrogen sulfide (H2S) and implicated in halitosis. Results: In laboratory tests, a significant dose-dependent effect was observed with Actinomyces viscosus as a model system using the Alamar blue procedure (P

A clinical procedure was developed to examine the effects of short-term and extended use of a triclosan/copolymer dentifrice and a commercial fluoride dentifrice on oral bacteria, including those producing hydrogen sulfide. Healthy adults volunteered for this double-blind, crossover design clinical study and provided saliva samples for culturing on enriched and indicator media to enumerate all salivary bacteria and those producing hydrogen sulfide (odorigenic), respectively. Subjects brushed with an assigned dentifrice for 7 d and were sampled on day 8 to assess the long-term effects on bacteria. Extended use of the triclosan/copolymer dentifrice resulted in a 49% and 66% reduction of salivary and odorigenic bacteria, respectively, compared with the fluoride dentifrice. To examine short-term effects, subjects subsequently brushed with their assigned dentifrice and were sampled at 2 h and 4 h post-brushing. At 2 h and 4 h post-brushing, the triclosan/copolymer dentifrice resulted in a 62% and 52% decrease for salivary bacteria and 79% and 72% decrease for odorigenic bacteria, respectively, vs. the fluoride dentifrice. The results indicate a significant decrease of all salivary bacteria and hydrogen sulfide-producing odorigenic bacteria following use of the triclosan/copolymer dentifrice and explain previous results on the efficacy of this dentifrice on oral malodor.

But: Evaluer l'activite antimicrobienne in vitro et in vivo de 4 formules commerciales de bains de bouche a 0.12% de chlorhexidine. Materiel et Methodes: Le test d'activite antimicrobienne in vitro a consiste en un test de contact modifie au cours duquel 20 especes bacteriennes selectionnees sont testees pendant 1 min avec chaque produit test. Apres le contact, l'inoculum a ete mis en culture et les resultats furent exprimes en terme de survie/ resistance et en pourcentage de survie par rapport a une solution saline controle. Le test in vivo consistait en une etude de comptage bacterien salivaire en double aveugle, randomisee, croisee sur 10 volontaires qui prirent chacun des produits testes pendant I minute. Les echantillons salivaires ont ete preleves juste avant le bain de bouche et apres 5 min, et 1, 3, 5 et 7 h. Ces echantillons etaient mis en culture a a fois en aerobie et en anaerobie. Les pourcentages de survie, par rapport au debut de l'experience, furent calcules pour chaque temps. Des comparaisons des produits furent effectuees par ANOVA et le t-test apparie. Resultats: Le test de contact in vitro n'entrainait pas de survie chez aucune espece testee CHX+CPC, alors que 3 especes (L.casei, S. mitis et P. micros) etaient resistantes aux 3 autres produits. CHX et CHX+NaF entrainait des resistances pour des especes supplementaires (3 et 4 especes, respectivement). Le test in vivo de comptage des bacteries salivaires montrait que CHX+CPC et CHX+ALC entrainaient des reductions plus importantes des bacteries en aerobie et en anaerobie, et ce pendant 5 h. De significatives differences furent detectees lors des multiples moments test, lorsque l'on comparait ces deux produits au controle et aux autres produits testes. Conclusion: D'importantes differences en terme d'activite, parmi les produits a 0.12% de CHX, ont ete detectees aussi bien par les tests in vitro que par les tests in vivo. Les formules avec alcool etaient plus actives que celles sans alcool, sauf la formule avec CHX+CPC, dans laquelle l'addition de CPC, non seulement compense, mais augmente plutot l'activite in vitro.

The aim of this study was to evaluate clinically and microbiologically the effects of a preventive oral health program in a long-term care facility. A total of 116 dentate elderly residents agreed to participate, and half of them were included in an experimental group. Almost all of the residents were mentally or physically handicapped, and many were dependent on care-givers for daily living activities. Oral examination and microbiological sampling were performed at baseline and 18 months later. The experimental group benefited from a preventive program, including an oral hygiene course for the health care providers and regular recalls by dental hygienists of the residents. After 18 months, the plaque indices were statistically similar to those at baseline in both groups. Mutans streptococci counts and active root caries at 18 months were lower compared to baseline in the experimental group but did not change significantly in the control group. Thus, it seems that, while the preventive program failed to decrease plaque indices, it was effective in reducing mutans streptococci colonisation and caries prevalence.

Background: Dental caries is defined as an infectious disease of microbial origin which is related to every specialty of dentistry in one or the other way. Genetic susceptibility to dental caries is dependent on certain factors, which if evaluated, can help in estimating disease situation prematurely. The present study was done to estimate dermatoglyphic dependence of dental caries and its relation with salivary bacteria levels, primarily Streptococcus mutans. Aims: To determine if there is any significant correlation between salivary bacteria interactions, dermatoglyphics, and dental caries. Settings and Design: In the present study, 90 subjects were evaluated for dermatoglyphics in conjunction with bacteria levels. Methods and Materials: Dermatoglyphic interpretation was done using stamp-pad method and S. mutans levels were estimated by microbial culture of salivary samples collected. Statistical Analysis : Z-test (standard normal variate, proportion) was used to analyze dermatoglyphic patterns and bacteria levels. Results and Conclusions: 1. Subject group had a decreased frequency of loops, whereas control group had an increased frequency of loops on all palmar digits. 2. Subject group had high S. mutans growth, whereas control group had low S. mutans growth. Subject group had positive correlation with loops and S. mutans growth likened to control group that had negative correlation with both.

Introduction The aim of this study was to examine whether Enterococcus faecalis isolates from endodontic patients (from saliva and from a root canal) are able to prevail against salivary bacteria when grown in coculture in a biofilm reactor. Methods Saliva that was tested to be free of E. faecalis was used as the inoculum. The fate of E. faecalis was examined by using culture techniques and fluorescence in situ hybridization (FISH). Results The root canal isolate accounted for 37.4% of the biofilm and 31.9% of the planktonic phase when examined by the culture technique, whereas the proportions examined by FISH showed 15.3% in the biofilm and 11.7% in the planktonic phase. The saliva isolate (as examined by the culture technique) accounted for 32.4% in the biofilm and 27.1% in the planktonic phase, respectively, compared with 14.1% in the biofilm and 9.5% in the planktonic phase when examined by FISH analysis. Conclusions These results led to the suggestion that E. faecalis could persist in the biofilm of the human oral cavity. Because of the ubiquitous presence of E. faecalis , root canal infections may arise from different sources.

The in vivo antimicrobial activity of 0.12% and 0.2% chlorhexidine (CHX) on the salivary flora up to 7 h after its application, using epifluorescence microscopy with the SYTO 9/propidium iodide dual staining, was evaluated. Fifteen volunteers performed a single mouthrinse with sterile water (SM-water), a single mouthrinse with 0.12% CHX (0.12% SM-CHX) and a single and double mouthrinse with 0.2% CHX (0.2% SM-CHX and 0.2% DM-CHX). Samples of saliva were taken at 30 s, and 1, 3, 5, and 7 h after each application. In comparison with SM-water, 0.2% CHX (SM and DM) showed a significant antibacterial effect up to 7 h after the mouthrinse, whereas this effect only persisted up to 5 h after the 0.12% SM-CHX mouthrinse. On comparing the two concentrations of CHX, significantly higher percentages of bacterial vitality were observed in all the saliva samples after the use of 0.12% CHX than after 0.2% CHX. On comparison of the 0.2% SM-CHX and 0.2% DM-CHX, significantly higher percentages of live bacteria were observed in the saliva samples taken at 1, 3, 5, and 7 h after the single mouthrinse compared with the double mouthrinse. The 0.2% CHX mouthrinse had the greatest antimicrobial activity on the salivary flora up to 7 h after its application, with a progressive recovery in bacterial vitality. The differences observed with respect to the 0.12% CHX mouthrinse demonstrate the influence of the concentration on its immediate antimicrobial activity and substantivity.

Context: This study evaluates the antimicrobial efficacy of commercially available chlorhexidine (CHX) mouthrinses of different concentrations. Aims: To evaluate and compare the antimicrobial efficacy of commercially available CHX mouthrinses of different concentrations (0.2%, 0.12%, and 0.1%) against specific standard strains of oral microflora at full strength (FS) and 1:1 dilution at 24 h. Settings and Design: Ten commercially available 0.2% (Rexidine, Hexidine, Smilehex, Chlorhex, Hexidale, Hex, Everfresh, and Gargwell), 0.12% (Periogard), and 0.1% (Eludril) CHX mouthrinses were selected to evaluate the efficacy against specific oral microflora using agar well diffusion Method. Materials and Methods: The standard strains of Streptococcus mutans American Type Culture Collection (ATCC 21293), Streptococcus sanguis Microbial Type Culture Collection (MTCC 442), Actinomyces viscosus (ATCC 3268), Staphylococcus aureus (ATCC 25923), Streptococcus pyogenes (MTCC 442), and Candida albicans (MTCC 183) were selected. The antimicrobial efficacy was calculated by measuring mean inhibitory zones formed on agar media. Statistical Analysis Used: Independent t-test, one-way ANOVA, Kruskal-Wallis tests, and Tukey′s Post hoc analysis were used. Results: Among 0.2% of CHX mouthrinses at FS and 1:1 dilution, hexidine was effective against most of the microorganisms except with S. pyogenes and C. albicans, where Hex and Hexidale were effective, respectively. When the concentration of 0.1% and 0.12% CHX was considered, Eludril was more effective at FS against all except with S. aureus and S. pyogenes which were more sensitive to Periogard at both FS and 1:1 dilution. Conclusions: 0.12% and 0.1% of CHX mouthrinses showed comparable efficacy with 0.2% CHX mouthrinses irrespective of their formulations.

Oral biofilms are mixed-species microbial communities, and their uncontrolled outgrowth can express as oral diseases. Antimicrobial peptides represent alternative classes of antimicrobials that exhibit selectivity for prokaryotes. We wanted to test the effect of a synthetic decapeptide antimicrobial, KSL, on the development of oral biofilms formed by isolated human salivary bacteria. We used differential interference contrast microscopy, coupled with a dual-flow cell system, to determine the effect of KSL on oral biofilm development. We used reductions of viable counts and confocal microscopy to assess the bactericidal activity of KSL on mature oral biofilms. KSL effectively blocked biofilm development. A significant effect on the viability of mature biofilms was observed when KSL was used in the presence of a surface-active agent, or after biofilms were mechanically disrupted. This study shows that KSL may be a useful adjunct for conventional oral hygiene to prevent plaque-mediated dental diseases.

The purpose of this study was to establish criteria for the visual evaluation of oral hygiene by analyzing the relationship between status of oral hygiene and number of oral bacteria in saliva for use in predicting the development of pneumonia. A total of 145 Japanese people of advanced age living in nursing homes were enrolled in the study. We evaluated the Dental Plaque Index (DPI) and Tongue Plaque Index (TPI) as simple measures of status of oral hygiene. We also determined the number of viable microorganisms in the saliva of each subject. The relationship between the status of oral hygiene and episodes of pneumonia was investigated over a period of one year. Dentate patients with poor oral hygiene as indicated by their DPI and TPI scores demonstrated significantly higher salivary bacterial counts than those with a good score for oral hygiene (p < 0.01 and p < 0.05, respectively). Both the number of febrile days was significantly higher (p = 0.0012), and number of patients developing pneumonia larger (p < 0.01) in dentate patients with DPI-based poor scores than those with DPI-based good scores. These results demonstrate a significant positive correlation between salivary bacteria and visual evaluation of oral hygiene in dentate patients according to number of febrile days and development of pneumonia.

During the months of November 1996, August 1997, and March 1998, saliva and plasma samples were collected for isolation of aerobic bacteria from 26 wild and 13 captive Komodo dragons (Varanus komodoensis). Twenty-eight Gram-negative and 29 Gram-positive species of bacteria were isolated from the saliva of the 39 Komodo dragons. A greater number of wild than captive dragons were positive for both Gram-negative and Gram-positive bacteria. The average number of bacterial species within the saliva of wild dragons was 46% greater than for captive dragons. While Escherichia coli was the most common bacterium isolated from the saliva of wild dragons, this species was not present in captive dragons. The most common bacteria isolated from the saliva of captive dragons were Staphylococcus capitis and Staphylococcus capitis and Staphylococcus caseolyticus, neither of which were found in wild dragons. High mortality was seen among mice injected with saliva from wild dragons and the only bacterium isolated from the blood of dying mice was Pasteurella multocida. A competitive inhibition enzyme-linked immunosorbent assay revealed the presence of anti-Pasteurella antibody in the plasma of Komodo dragons. Four species of bacteria isolated from dragon saliva showed resistance to one or more of 16 antimicrobics tested. The wide variety of bacteria demonstrated in the saliva of the Komodo dragon in this study, at least one species of which was highly lethal in mice and 54 species of which are known pathogens, support the observation that wounds inflicted by this animal are often associated with sepsis and subsequent bacteremia in prey animals.

Introduction Rubber dam is essential for effective isolation of the root canal and operating field from salivary bacteria as well as protection of the airway. Rubber dam is easy to apply once the basic components and principles are understood. The most common reasons for not using rubber dam for a procedure were patients inconvenience and belief that it is unnecessary. The purpose of the present study was to evaluate the patients attitude to rubber dam after educating them about the use and benefits of rubber dam. Materials and methods A questionnaire containing 11 questions was circulated to 20 male and 20 female patients undergoing root canal treatment after explaining about the rubber dam. Information sought included attitude toward the current and anticipated use of rubber dam for a variety of endodontic treatments. Results A total of 24 patients out of 40 said that they had a pleasant experience and preferred its use next time. Around 30 patients felt that the use of rubber dam benefits both patient and the doctor. Conclusion There was not much of a difference in patient's attitude to rubber dam and mean application time. Those who had a good current experience preferred rubber dam use next time also.

This study evaluated the effect of an alternate delivery system for chlorhexidine on salivary levels of mutans streptococci (MS) and other selected oral bacteria. On the basis of salivary MS levelsor = 10(4) CFU/ml, 22 subjects were enrolled. All caries lesions were restored prior to treatment. Two pretreatment paraffin-stimulated saliva samples were obtained for culturing at least 1 week apart. Complete-arch vacuum-adapted mouthguards were individually fabricated and coated internally with a 3% w/v chlorhexidine varnish. Mouthguards were worn for an average of 7 h/night for 7 nights. Saliva samples were obtained immediately after treatment and 1 and 3 months later. There was no significant change in levels of any of the monitored bacteria between the two pretreatment samples. A significant and specific reduction in salivary MS levels was observed in the three after-treatment samples as compared with baseline values (p0.001, p0.001, p0.05, respectively). The levels of Actinomyces viscosus were also measured, and there was a significant reduction immediately after treatment (p0.05), a return to baseline values at 1 month, and a significant increase above baseline values at 3 months, (p0.001). There was no significant change in saliva volume, in total numbers of facultatively anaerobic bacteria, or in levels of lactobacilli or Streptococcus sanguis. This treatment system is capable of significant and specific suppression of MS levels for up to 3 months without retreatment.

The purpose of this study was to assess the effect of pre-procedural rinsing (2 consecutive rinses) with 0.12% chlorhexidine gluconate (CHX) on salivary bacteria during scaling and root planing procedures (S&RP). Because blood and debris arising from S&RP could inactivate CHX and decrease its antimicrobial effect, patients were evaluated throughout their appointment. Forty subjects rinsed with either 15 ml of CHX rinse or control (sterile water) for 30 seconds, expectorated and immediately rinsed again for 30 seconds. Unstimulated saliva samples were obtained at baseline (immediately before rinsing), and at 1 minute, 30 minutes, and 60 minutes after baseline. All 30 and 60 minute samples contained visible blood and debris. Samples were immediately diluted in transport fluid containing a CHX-neutralizer and then plated on trypticase soy agar for enumeration of the total aerobic and facultative bacterial load. The dual rinses with 0.12% CHX immediately reduced the salivary bacterial load 97% and this reduction persisted for 60 minutes during S&RP. At 30 minutes and at 60 minutes aerobic bacteria were reduced 77% compared to control, and 96% compared to baseline. CHX was not inactivated by the high organic load (blood and debris) present during the procedure. Pre-procedural rinsing with CHX has a profound and sustained effect on the aerobic and facultative flora of the oral cavity, which may contribute to a variety of clinical benefits. Pre-procedural rinsing may also be of value in protecting patients and dental professionals during dental manipulations.

– In order to find out if it is possible to prevent caries and gingivitis by periodical use of chlorhexidine-fluoride mouthrinses with or without strontium, and to find out what effects they have on salivary mutans streptococci and lactobacilli counts, a total of 243 schoolchildren aged 11 yr with high DMFS scores were randomly divided into four groups. One group (C) served as a basic control. Subjects in the second group (GXF) rinsed their mouths twice a day every third week with a rinsing solution containing 0.05% chlorhexidine gluconate and 0.04% NaF. In the third group (CXFS) the rinsing solution contained 500 ppm Sr during the first and second year and 15 ppm during the last 6 months, in addition to chlorhexidine and fluoride. In the fourth group (CX) the solution contained only 0.05% chlorhexidine gluconate. All the rinsing solutions had pH 5.8 buffered with succinic acid-NaOH buffer. After 2 yr and 9 months, the mean DMFS (SD) increments in the C, GXF, GXFS, and GX groups were 3.8 (5.7), 2.5 (3.2), 3.5 (4.8), and 3.4 (5.5), respectively. The percentage of subjects with bleeding gingival units had decreased from initial to final values as follows: C, 81–38; GXF, 88–42; GXFS, 89–56; GX, 89–37. The number of lactobacilli and mutans streptococci in saliva remained virtually unchanged throughout the study. For caries increment and gingival bleeding, the differences between groups were not statistically significant. The chlorhexidine-fluoride combination tended to prevent caries, but the effect on gingival bleeding and salivary counts of mutans streptococci and lactobacilli was negligible.

Bacteriocins are bacteriocidal proteinaceous molecules produced by the Gram-positive bacteria not active against the produced strain. Many investigations have revealed that certain bacteria using antibacterial or the inhibitory substance inhibit some other bacteria. A study was conducted in a group of 60 children to ascertain whether any correlation exists between the proportion of salivary bacteria inhibiting and stimulating Streptococcus mutans and the oral health indices (DMFT, deft and Community Periodontal Index of Treatment Needs). A definite inverse correlation was observed between the percentage of salivary inhibiting S. mutans and untreated carious teeth (UCT).

The pH effects of urea metabolism were studied in washed salivary-sediment bacteria from subjects that had up to 10-fold variation in oral ureolytic activity, and in dispersed artificial-mouth plaques. Adequate evaluation required analysis of the [OH−] as well as the pH curve. An initial constant rate of pH-change, lasting until pH 7.8, was derived from the pH curve; this gave the best correlation (r = 0.95) with the ureolysis rate. From the [OH−]-curve, between pH 7.8 and 8.3 (approx.), a constant and maximal rate of change in [OH−] was determined. Although theoretically this was directly related to the rate of ammonia release, it was 10−2 to 10−3 times its value and correlated less well (r = 0.83) with ureolysis. Together with the initial and final pH, these two rates largely described urea-induced pH changes. After 12.5-fold dilution of the cells, changes in the pH curve were minor. Although the rate of ureolytic ammonia release was proportional to cell-protein concentration, the reduction in ureolytic activity was compensated by a corresponding reduction in cell pH-buffering. Consequently, in order to relate pH and [OH−] changes to ureolysis, it was necessary to control, or correct for, variations in the cell mass present. Buffering capacity in plaques was greater than in sediments. The 10-fold range in oral ureolytic activity by salivary bacteria gave a 10–20-fold range in base changes.

Nine commercial dental amalgams were tested for antibacterial properties in vitro. A bactericidal test on salivary bacteria, a growth inhibition test on Streptococcus mutans OMZ 176, and a time-dependent bactericidal test on Strep. mutans were used. All amalgams displayed some antibacterial properties. Dispersalloy and Revalloy were strongly antibacterial in all tests; ANA 2000 and Sybraloy killed Strep. mutans but were less potent in the salivary test and in the growth inhibition experiments. The copper amalgams, Neo-Silbrin and Cupromuc, were the most active in the salivary test but less inhibitory in the growth curve experiments. Spheraloy, Indiloy, and Amalcap showed intermediate activity in the salivary bactericidal test but were relatively weak in the growth inhibition studies. Analysis of Hg, Ag, and Cu in media from the growth inhibition studies showed release of Hg from the copper amalgams and, particularly, from Revalloy; Indiloy gave off Ag, whereas Neo-Silbrin, Cupromuc, Sybraloy, and ANA 2000 released more Cu than the other brands.

Concentrations of free iodine in dilute solutions of povidone-iodine (PVP-I) gargle and its bactericidal activity were examined during 21 days of storage at various temperatures. Free iodine was reduced a little when 15-30-fold dilute solutions were stored for 21 days in a dark place at 5°. On the other hand free iodine in a 30-fold dilute solution was reduced extremely and its residual rate of iodine was around 50% on 21 days after it was stored in a dark place at 35°. Reduction of free iodine was found to be dependent on temperature. However, the 30-fold dilution of PVP-I gargle stored at 35° kept sufficient bactericidal activity for Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas cepacia, Pseudomonas aeruginosa, Streptococcus pyogenes and Esherichia coli even after the storage for 21 days. Further, salivary bacteria were killed by 60-fold dilute solution of PVP-I gargle, as well as by 30-fold.These findings indicate that 15-30-fold dilute solutions of the PVP-I gargle are effective for 3 weeks if they are stored under 5°, and its 60-fold solution has a sufficient bactericidal effect in the mouth.

The viscosity of the saliva was investigated using a Hess viscometer. The viscosity of mixed saliva regularly sank rapidly after secretion. Pure mandibular saliva often showed greater stability. No certain influence on the viscosity was found with α-amylase or suspensions of salivary bacteria. The viscosity was rapidly reduced by ascorbic acid in the presence of hydrogen peroxide or traces of cupric ions. Parallels are pointed out with the viscosity reduction of various polysaccharides and with the disappearance of the group antigens of the saliva.

Comparison between two methods of counting shows that method B (the Lewis method) is more accurate and reproducible than method A (the Hadley method). A great advantage of Method B is the ease and rapidity of recognizing and counting the organisms. Variations in counts from organisms not L. acidophilus were found to be less than 1 per cent by either method and variations due to the individual workers are within the reported deviations of either method. The number of L. acidophilus is found to change at an unpredictable rate after collection of saliva samples, and the hydrogen-ion concentration also varies erratically and not in parallel with the numbers of L. acidophilus found.

— The plaque-inhibiting effect of three commercial toothpastes and three test toothpastes was tested in a series of clinical trials. Cap splint applicators were used to avoid the effect of toothbrushing and the test persons teeth were rinsed with sucrose during the experimental periods to provoke plaque formation. Two of the test dentifrices which contained chlorhexidine digluconate (0.6 % and 0.8 % respectively) reduced plaque formation. In some individuals a certain plaque inhibition was observed also by the commercial dentifrices tested. The chlorhexidine-containing toothpastes showed stronger antibacterial activity against salivary bacteria in vitro than the commercial dentifrices. It is concluded that the method used for testing the plaque-inhibiting effect of dentifrices may be useful, and that it is possible to maintain the plaque-inhibiting effect of chlorhexidine previously described in several mouthrinse experiments when a toothpaste is used as a vehicle for the agent.

A double blind crossover trial was carried out to assess the effect of povidone iodine on plaque accumulation in vivo and to measure the total salivary aerobes and anaerobes throughout the study. When compared to the placebo preparation, povidone iodine was without effect on plaque accumulation in all the subjects and there was a progressive increase in plaque throughout the 10-day periods. A 30 to 40 % overall reduction in aerobes and anaerobes occurred with the active preparation which was significant. There appears to be no indication for the use of povidone iodine as an adjunct to oral hygiene or in the treatment of chronic gingivitis.

A double-blind crossover trial was carried out to assess the effect of zinc citrate on plaque accumulation in vivo and to measure total salivary aerobes and anaerobes both during the trial and throughout the day following a single rinse. When compared to the placebo, zinc citrate significantly reduced the plaque accumulation in the subjects. However, the mean reduction was small and of questionable clinical importance. A progressive increase in plaque was observed throughout both active and placebo 7-day rinsing periods. There was no significant reduction in salivary bacterial counts either during the crossover study or during the day following a single rinse with zinc citrate.

Dentally-induced stress and relaxation-induced anxiety reduction have been correlated with salivary changes in dental patients in two recent studies. In two subsequent studies, test anxiety-induced stress and relaxation-induced anxiety reduction were correlated with salivary changes in dental students. In another study using the resazurin dye indicator, increased salivary bacterial levels were correlated with an increased dental caries incidence. As a result of these findings, it was decided to reinvestigate the effects of stress and relaxation on salivary changes and in addition to examine the effects of those conditions on salivary bacteria. The hypotheses under consideration were: (1) Salivary changes from stress to relaxation will be from opaque to translucent and from high to low protein levels; and (2) salivary bacteria will increase under the condition of stress and decrease under the condition of relaxation. The subjects were twelve dental students. Stress and relaxation were evaluated be...

In one experimental series, 19 rats were fed a nutritionally adequate diet (20% protein) and 19 rats a protein-deficient diet (5% protein). After 18 days, pilocarpine/isoproterenol-stimulated saliva w

Artificial-mouth plaques were cultured for 7 days from the saliva of two individuals, one with high and one with low salivary ureolytic activity. There was a 7.5-fold range in the resulting plaque ureolysis rates (per mg of protein), and the composition of the flora varied widely. The average rate of ureolysis of artificial plaque was similar to that in natural plaques but higher than in salivary sediment (after correction of sediment rates for the presence of 50 per cent non-bacterial protein). The average rate of ureolysis per ureolytic bacterium was 2.5 times higher in the artificial plaques than in saliva. Although the saliva inocula were from subjects with a 3-fold difference in salivary ureolysis rate, this difference was not reflected in the ureolytic activity of the artificial plaques. Neither was this difference evident in the ureolytic activity of the corresponding natural plaques. The established hypothesis that plaque ureolysis is derived mainly from an unidentified active segment of the total ureolytic flora was tested in the artificial plaques by analysis of variance to determine the contribution of the known ureolytic bacteria. Plaque ureolysis rates were almost entirely explained (r2 = 86 per cent) by the percentage of total detectable ureolytic bacteria in the plaque flora. The plaque bacteria giving strong ureolytic reactions on agar plates were all Gram-positive cocci and in 6 of the 9 plaques were streptococci only. Therefore, in artificial plaques the physiologically significant bacteria comprise a high proportion of the total ureolytic flora and are Gram-positive cocci, mainly streptococci.

Clean dry dental handpieces harbour few bacteria, but contamination of the handpiece lumen with salivary bacteria readily occurs in use. Wiping the outside of the handpiece with disinfectant does not eliminate the potential cross-infection risk. Water issuing from dental units is heavily infested with bacteria, some of oral origin, which presumably colonize the water piping of the units. Attempts to reduce this contamination with hydrogen peroxide were only partially successful.

IT IS WELL KNOWN that saliva contains large numbers of bacteria. These organisms have been thought to be dislodged from dental plaque or from gingival debris through the washing action of saliva. Consequently saliva has often been utilized as a substitute for dental plaque or gingival crevice debris in studies designed to elucidate the role of bacteria in either dental caries or periodontal disease. However, KRASSE (1954a) studied the distribution of Streptococcus salivarius in plaque, saliva, and on the tongue and cheeks. He found that Streptococcus salivarius comprised a large proportion of the facultative streptococci present in saliva and on the tongue, but this organism comprised only a small percentage of the facultative streptococci present in dental plaque. As a result of these and other studies, KRAUSE (1953,1954a,b)

Saliva from subjects who had rinsed with 2.2mM (0.2 per cent) chlorhexidine retained antibacterial properties for at least 2 hr after the rinse. Hydroxyapatite, coated apatite, proteins and streptococci treated with chlorhexidine exhibited activity against salivary bacteria which resisted washings in distilled water. It is suggested that the marked plaque-inhibiting activity of chlorhexidine, previously reported, is based on the long-term effect of chlorhexidine in the mouth, which may be caused by adsorption by this agent on tooth surfaces, pellicle substance, plaque and mucous membranes.