Comparison of immunological and microbiological characteristics in children and the elderly with or without dental caries.

The purpose of this study was to determine the relationships among early childhood caries (ECC), root caries (RC), the quantity of Streptococcus mutans in saliva, and the concentrations of total and specific secretory IgA (sIgA). Saliva samples were collected from 70 children, 3-4 yr of age, with and without ECC, and from 43 adults, ≥60 yr of age, with and without RC. The decayed, missing, and filled teeth (dmft) and decayed, missing, and filled surfaces (dmfs) scores of each child, and the root decayed and filled teeth (RDFT) and root decayed and filled surfaces (RDFS) scores of each elderly subject, were determined. The S. mutans levels, total sIgA, and specific sIgA against two virulence antigens of S. mutans in saliva were analysed using quantitative real-time PCR (qPCR) and ELISAs. The quantity of S. mutans was significantly higher in caries-positive subjects within the two populations than in the caries-free subjects; and a positive correlation was found between the quantity of S. mutans and the dmft, dmfs, RDFT, and RDFS scores. In addition, the salivary total sIgA was significantly higher in children with severe early childhood caries (SECC) and in the elderly subjects with RC. Moreover, although the S. mutans level was significantly higher, the concentrations of specific sIgA against S. mutans antigens were significantly lower in samples from elderly subjects than in samples from children. These results support the concept that S. mutans is positively associated with ECC and RC. Furthermore, the levels of S. mutans-specific antibodies in saliva are too low to prevent infection with cariogenic bacteria and to inhibit development of ECC and RC.

Differential activation of human neutrophils by Streptococcus mutans isolates from root surface lesions and caries-free and caries-active subjects.

Phagocytosis of bacterial pathogens is an important defense mechanism and may contribute to regulating Streptococcus mutans-induced dental caries, particularly at root surfaces. This study was undertaken to examine and compare differences in polymorphonuclear leukocyte or neutrophil activation by clinical isolates of S. mutans collected from the saliva of caries-free or caries-active individuals with S. mutans isolates from root surface lesions. S. mutans clinical isolates (5 caries-free, 5 caries-active, 5 root caries isolates and a laboratory strain) were incubated with neutrophils in the presence of normal human serum and the luminol dependent chemiluminescence was measured for 1 h at 37 degrees C. Results indicated that the caries active and laboratory strains activated neutrophils equally. The mean integration stimulated by caries-free strains, however, displayed a 25-30% enhanced neutrophil activation over the caries-active and laboratory strains. In contrast, neutrophil activation by root caries strains of S. mutans was 45-50% lower than all other S. mutans strains, possibly suggesting a natural selection for S. mutans strains that can evade neutrophil recognition and subsequent phagocytosis. Stimulation of neutrophils with the cell wall and membrane surface component preparations indicated that extracts from all four groups activated neutrophils significantly. Again, caries-free preparations activated neutrophils significantly more than caries active, laboratory strain and root caries isolates. This selection may become more important on root surfaces due to increased exposure to crevicular fluid and neutrophils. The data provide evidence for the presence or onset of mechanisms or biological alterations in S. mutans developed to circumvent neutrophil recognition and/or phagocytosis, thus increasing S. mutans survival and colonization on tooth surfaces, resulting in an enhanced risk of dental caries, particularly at root surfaces.