The effects of fluoride and chlorhexidine varnishes on the microflora of dental root surfaces and on the progression of root-surface caries were studied. Forty-four patients, surgically treated for advanced periodontal disease, were distributed at random among three groups. All patients received a standardized preventive treatment. Furthermore, the dentition of the patients in the two experimental groups was treated, at three-month intervals, with chlorhexidine and fluoride varnish, respectively. Patients in the control group received no additional treatment. In the experimental groups, plaque samples were collected from selected sound and carious root surfaces at baseline and at three, six, and nine months after the onset of the study. The presence of root-surface caries was scored at baseline and after one year. In addition, the texture, depth, and color of the root-surface lesions were monitored. Mutans streptococci on root surfaces were suppressed significantly (p less than 0.05) during the whole experimental period in the chlorhexidine varnish group, but not in the fluoride varnish group. A non-significant increase in the number of Actinomyces viscosus/naeslundii was noted after treatment with chlorhexidine and fluoride varnish. The increase in the number of decayed and filled root surfaces after one year was significantly lower in the experimental groups than in the control group. After treatment with chlorhexidine varnish, significantly more initial root-surface lesions had hardened than in the other groups.

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The present experiments were aimed at studying the degradation of salivary glycoproteins by the oral microflora. To this end, S. sanguis I strain Ny476 and S. sanguis II (S. mitior) strain Ny581 were grown continuously in human-whole saliva. Under these conditions, the strains produced a variety of cell-associated hydrolytic activities, including glycosidases, exo- and endopeptidases, and esterases. S. sanguis II generally exhibited higher levels of enzyme activity than did S. sanguis I, in particular of neuraminidase that was produced only by S. sanguis II. In accordance, S. sanguis II had a higher cell yield and consumed a higher proportion of the sugars and sialic acid in the glycoproteins than did S. sanguis I. Interestingly, S. sanguis I, which is devoid of neuraminidase, is known to have a lectin with specificity for sialic acid, whereas S. sanguis II has affinity for galactose residues in the glycoproteins. We propose that specific binding of glycoproteins by oral bacteria constitutes a mechanism to collect nutrients in the vicinity of the cell. The special ability of S. sanguis II to utilize saliva for growth was further exemplified by its selection in batch-wise enrichments of dental plaque on saliva. The microflora in these enrichment cultures always consisted of Peptostreptococcus micros, S. sanguis II, and Fusobacterium nucleatum as the dominant organisms. Further, S. mitis and Gemella haemolysans were generally found to be present. The enrichment cultures produced a wide variety of mainly cell-bound hydrolytic enzymes. This resulted in almost complete breakdown of salivary glycoproteins in the culture.

For the isolation of Streptococcus mutans, several selective media have been developed, of which Mitis-Salivarius Sucrose Bacitracin agar (MSB) is the most widely used (Gold et al., 1973). Recently, the Trypticase Yeast-Extract Cystine agar medium (TYC, de Stoppelaar et al., 1967) was modified into a selective medium for S. mutans, called Trypticase Yeast-Extract Cystine Sucrose Bacitracin (TYCSB, van Palenstein Helderman et al., 1983). The aim of this study was to compare the recovery of S. mutans from clinical samples on Mitis-Salivarius agar (MS), MSB, TYC, and TYCSB. Further, a new simple selective medium for S. mutans was introduced. This medium, called TSY20B, was supposed to have the same qualities as TYCSB, but its preparation is less laborious. One hundred eighty-five plaque and saliva samples from 37 subjects were plated on MS, MSB, TYC, and TYCSB, and 285 samples from 23 subjects were plated on TYCSB and TSY20B. All plates were incubated at 37 degrees C in a 91% N2, 5% CO2, 4% H2 atmosphere for five days. The S. mutans counts on TYC and TYCSB were significantly higher than on MS or MSB by almost a factor of 10. Seventy-seven percent of the samples gave higher S. mutans counts on TYCSB than on MSB. Especially, samples with high S. mutans d/g numbers gave lower S. mutans counts on MSB. These data clearly indicate that MSB agar is inhibitory for S. mutans and should not be used. An additional advantage of TYCSB over MSB agar is the possibility of distinguishing S. mutans serotypes d/g from other serotypes.(ABSTRACT TRUNCATED AT 250 WORDS)

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