Ponad 7000 publikacji medycznych!
Statystyki za 2021 rok:
odsłony: 8 805 378
Artykuły w Czytelni Medycznej o SARS-CoV-2/Covid-19

Poniżej zamieściliśmy fragment artykułu. Informacja nt. dostępu do pełnej treści artykułu tutaj
© Borgis - Nowa Stomatologia 3/2017, s. 120-128
*Elżbieta Pels, Izabela Tkacz-Ciebiera
Early childhood caries vs. the number of colonies of Streptococcus mutans and Lactobacillus spp. in saliva
Próchnica wczesnego dzieciństwa w odniesieniu do liczebności bakterii Streptococcus mutans i Lactobacillus spp. w ślinie
Department of Paedodontics, Medical University of Lublin
Head of Department: Professor Maria Mielnik-Błaszczak, MD, PhD
Streszczenie
Wstęp. Próchnica wczesnego dzieciństwa (ECC) jest obecnym na całym świecie, szeroko rozpowszechnionym problemem zdrowotnym.
Cel pracy. To badanie stawia hipotezę, że rozwój ECC jest ściśle związany z rozwojem bakterii próchnicotwórczych Streptococcus mutans i Lactobacillus spp.
Materiał i metody. W badaniu uczestniczyło 346 dzieci w wieku od 7. do 48. miesiąca życia. Na podstawie danych zebranych w badaniu klinicznym oceniano frekwencję próchnicy oraz intensywność próchnicy zębów mlecznych. Uzyskane dane zostały poddane analizie statystycznej w odniesieniu do liczebności kolonii bakteryjnych Streptococcus mutans i Lactobacillus spp.
Wyniki. Badanie potwierdziło istotny statystycznie wzrost czynnych ognisk próchnicowych zębów mlecznych (liczba p) przy wzroście liczby kolonii bakteryjnych Streptococcus mutans oraz Lactobacillus spp. w ślinie badanych dzieci. Analiza statystyczna wykazała, że liczebność bakterii Lactobacillus spp. w ślinie zwiększa ryzyko nasilenia ECC średnio o 57,017 raza, natomiast obecność Streptococcus mutans – 209-krotnie.
Wnioski. Zwiększona intensywność próchnicy wczesnego dzieciństwa była istotnie powiązana ze zwiększoną liczebnością bakterii Streptococcus mutans i Lactobacillus spp. w ślinie dzieci w wieku żłobkowym. Należy zintensyfikować działania edukacyjne skierowane do rodziców małych dzieci dotyczące profilaktyki i leczenia choroby próchnicowej, aby zwiększyć szanse na zachowanie zdrowego uzębienia mlecznego do okresu fizjologicznej wymiany.
Summary
Introduction. Early childhood caries (ECC) is a widespread health problem all over the world.
Aim. The present study proposes a hypothesis that ECC is closely related to cariogenic bacteria Streptococcus mutans and Lactobacillus spp.
Material and methods. The investigation was carried out in a group of 346 children, aged 7-48 months. Based on the data collected in clinical examination, the prevalence of caries in deciduous teeth and its intensity were evaluated. Statistical analysis was carried out to assess the number of bacterial colonies of Streptococcus mutans and Lactobacillus spp.
Results. The investigation confirmed a statistically significant increase in the number of active foci of decay in deciduous teeth (d) at an increased number of bacterial colonies of Streptococcus mutans and Lactobacillus spp. detected in the saliva of the examined children. The statistical analysis revealed that the salivary content of Lactobacillus spp. increased the risk of ECC intensity 57.017 times, and Streptococcus mutans increased the risk 209 times.
Conclusions. Higher intensity of caries in early childhood is significantly associated with an increased count of cariogenic bacteria in the saliva of infants and children attending nursery schools. Therefore, more intensive education of parents and carers of young children is needed in terms of the prophylaxis and treatment of caries to facilitate preservation of healthy deciduous teeth until their physiological replacement by permanent dentition.
Introduction
The development of dentition is long, complex, and closely related to the development and function of other organs involved in mastication. It depends upon various genetic, paragenetic and environmental factors (1, 2). Dental caries is a widespread health problem on a global scale. Some researchers believe dental caries to be the most widespread chronic disease among children (3). Early childhood caries (ECC) was first defined by the American Dental Association (ADA) and American Academy of Pediatric Dentistry (AADP) as the presence of one or more deciduous teeth affected by caries or resultant fillings, or a tooth that was extracted because of carious lesions in children aged 71 months or younger (2-8).
The fastest development of caries is favored by a combination of factors, including the presence of a great number of pathogenic bacteria, frequent exposition to sugar consumption and stagnation in the oral cavity due to improper oral hygiene habits, and weaker structure of dental tissues (7). Cariogenic bacteria are extremely potent, as they quickly transform sugars into acids (cariogenicity), are able to survive at a lower pH level (acidophilia), produce extracellular polysaccharides (EPS) and intracellular polysaccharides (IPS) (9). Streptococcus mutans and Streptococcus sobrinus are thought to be responsible for the initiation of dental decay. The infectivity window, i.e. the time of increased susceptibility of the oral cavity to colonization by cariogenic streptococcal species occurs between 7 months and 2 years of age (it is called the first window of infectivity). Another period of increased development of streptococcal colonies is observed between 6 and 12 years of age, when the first permanent teeth begin to erupt (the second window of infectivity) (10, 11). Nonetheless, in later studies, Milgrom et al. showed the colonization with S. mutans to occur in 25% of children even before the eruption of teeth (12).
Cross-sectional studies have shown a combination of factors to have a very complex effect on the development of caries, including the socioeconomic status, ethnic background, immigrant status, infant feeding patterns, exposure to fluoride, poor or inadequate oral hygiene, and the presence of EEC in children of preschool age (12-14).
The risk of dental caries is evaluated with various tools, e.g. microbiological examination, the rate of saliva secretion, pH of saliva, the condition of teeth and oral hygiene. Microbiological tests are performed to detect primarily bacterial species of Streptococcus mutans and Lactobacillus spp. Quantitative scores help to evaluate the degree of risk, and select those at the highest risk for dental caries. Moreover, a quantitative test measuring the number of Lactobacillus spp. colonies can be used to evaluate the diet, since the count of bacteria increases with higher consumption of carbohydrates, and persists for up to two weeks (4).
Aim
The study was aimed at the evaluation of early childhood caries prevalence and analysis of correlations between decayed deciduous teeth and the number of Streptococcus mutans and Lactobacillus spp. colonies in nursery school children.
Material and methods
The study was carried out in a group of 346 nursery school children, aged 7-48 months, mean age 26.28 ± 8.49 months. The examined group consisted of infants and children attending nurseries, 54.34% boys (n = 188), and 45.66% girls (n = 158). The deciduous teeth were clinically examined, with saliva samples collected and microbiologically examined.
The clinical examination of the current condition of the teeth was carried out by means of disposable diagnostic sets in artificial light. The findings were charted on examination sheets, and the following parameters were marked: deciduous teeth present or missing, active foci of caries, the number of teeth filled, and the number of teeth extracted due to caries. The prevalence of caries and intensity of decayed deciduous teeth was evaluated on the basis of the dmft index and its components: dt, mt, and ft.
Microbiological tests were carried out to evaluate the number of bacterial colonies of Streptococcus mutans in the saliva by means of Dentocult SM Strip mutans microbiological kit (Orion Diagnostica), and of Lactobacillus – with Dentocult LB (Orion Diagnostica). The samples were cultured, and the results read according to the instructions provided by the manufacturer. Considering the age of the subjects, the recommended method of saliva collection was modified. Paraffin chewing cubes were not used. Instead, the submandibular area and the area around the ears were massaged to obtain mixed saliva. The saliva was collected from the floor of the mouth into disposable syringes. The samples were cultured on a medium specific for S. mutans and Lactobacillus spp., and grown in an incubator at 37°C. SM tests were retrieved after 48 h, and LB tests after 4 days, and the density of colony forming units (CFU) per 1 ml of saliva was compared with the guide included in the testing kit.
Statistical analysis
The results of the clinical examination and microbiological scores were coded and analyzed statistically. To evaluate the differences between the analyzed groups for nominal features χ2 test was applied, and to establish the differences between two analyzed groups for quantitative features t-Student test was used. To determine the difference between several groups, one-way analysis of variance ANOVA was used. To establish the correlations between the parameters, Spearman’s test (R) was used.
To present dependences between multiple properties and demonstrate correlations between data, the odds ratio (OR) was calculated, with 5% conclusion error and p < 0.05 assumed as the level of significance. The database and statistical analyses were performed with Statistica 10.0 software (StatSoft, Poland).
All patients and their parents consented to the clinical examination and to the collection of saliva, in accordance with the Declaration of Helsinki. The study was approved by the local Bioethics Committee KE-0254/7/2014 at the Medical University of Lublin. The study was financed by Statutory Activities No. DS 291, Medical University of Lublin, Poland.
Results
Clinical examination
The prevalence of caries in the examined group was 44.51%, and it increased with the children’s age (χ2 Pearson = 26.10; p = 0.0001), from 0.00% in the group of the youngest children (under 12 months) to 65.91% in the oldest group (over 48 months). The statistical analysis revealed that the frequency of caries was not gender-dependant (χ2 Pearson = 0.08; p = 0.95). In the group of girls, the prevalence of caries was 44.3%, whilst among boys it was 44.68%. Moreover, it was found that the place of living was not statistically significantly correlated with caries prevalence (χ2 = 4.59; p = 0.19). The prevalence of caries among children living in a big town with a population over 100,000 was statistically non-significantly lower at 36.59%, whereas in the group of children living in the country and small towns it equaled 42.41% and 47.68% respectively.

Powyżej zamieściliśmy fragment artykułu, do którego możesz uzyskać pełny dostęp.
Mam kod dostępu
  • Aby uzyskać płatny dostęp do pełnej treści powyższego artykułu albo wszystkich artykułów (w zależności od wybranej opcji), należy wprowadzić kod.
  • Wprowadzając kod, akceptują Państwo treść Regulaminu oraz potwierdzają zapoznanie się z nim.
  • Aby kupić kod proszę skorzystać z jednej z poniższych opcji.

Opcja #1

19

Wybieram
  • dostęp do tego artykułu
  • dostęp na 7 dni

uzyskany kod musi być wprowadzony na stronie artykułu, do którego został wykupiony

Opcja #2

49

Wybieram
  • dostęp do tego i pozostałych ponad 7000 artykułów
  • dostęp na 30 dni
  • najpopularniejsza opcja

Opcja #3

119

Wybieram
  • dostęp do tego i pozostałych ponad 7000 artykułów
  • dostęp na 90 dni
  • oszczędzasz 28 zł
Piśmiennictwo
1. Chaffee BW, Feldens CA, Rodrigues PH, Vítolo MR: Feeding practices in infancy associated with caries incidence in early childhood. Community Dent Oral Epidemiol 2015; 43: 338-348.
2. Olczak-Kowalczyk D, Boguszewska-Gutenbaum H, Janicha J, Turska-Szybka A: Selected issues of baby teething. Nowa Stomatol 2011; 16: 73-76.
3. American Academy of Pediatric Dentistry: Clinical Affairs Committee – Infant Oral Health Subcommittee. Guideline on infant oral health care. Pediatr Dent 2012; 34: e148-152.
4. Szczepańska J, Szydłowska-Walendowska B, Pawłowska E, Lubowiedzka-Gontarek B: Salivary levels of Streptococcus mutans and Lactobacillus sp. in 3-year-old children born by Caesarian section. J Stomatol 2009; 62: 711-721.
5. Yoon RK, Smaldone AM, Edelstein BL: Early childhood caries screening tools: A comparison of four approaches. J Am Dent Assoc 2012; 143: 756-763.
6. Palmer CA, Kent R Jr, Loo CY et al.: Diet and Caries-associated Bacteria in Severe Early Childhood Caries. J Dent Res 2010; 89: 1224-1229.
7. Kaczmarek U, Grzesiak I, Kowalczyk-Zając M: Early childhood caries – analysis of selected biological factors. Dent Med Prob 2008; 45: 260-270.
8. Turska-Szybka A, Grudziąż-Sękowska J, Olczak-Kowalczyk D: Early childhood caries risk factors and individual assessment of risk level according to CAMBRA. Nowa Stomatol 2011; 16: 119-127.
9. Smith CA, Higham SM, Smith PW, Verran J: The Effect of Chewing Urea-Containing Gum on Plaque Acidogenic and Alkaligenic and Alkaligenic Parameters. Caries Res 2004; 38: 124-129.
10. Caufield PW, Cutter GR, Dasanayake AP: Initial acquisition of mutans streptococci by infants: evidence for a discrete window of infectivity. J Dent Res 1993; 72: 37-45.
11. Sołtan EA, Herman K, Kaczmarek U: Salivary levels of Streptococcus mutans and Lactobacillus acidophilus with regard to caries intensity in children. Dent Med Probl 2016; 53: 203-209.
12. Milgrom P, Riedy CA, Weinstein P et al.: Dental caries and its relationship to bacterial infection, hypoplasia, diet, and oral hygiene in 6- to 36-month-old children. Community Dent Oral Epidemiol 2000; 28: 295-306.
13. Hallett KB, O’Rourke PK: Social and behavioural determinants of early childhood caries. Aust Dent J 2003; 48: 27-33.
14. Zhou Y, Yang JY, Zhi QH et al.: Factors associated with colonization of Streptococcus mutans in 8- to 32-month-old children: a cohort study. Aust Dent J 2013; 58: 507-513.
15. Proc P, Filipińska-Skąpska R, Wochna-Sobańska M: Is a bacterial factor crucial in caries development of the youngest children? Nowa Stomatol 2004; 2: 51-55.
16. Parisotto TM, Steiner-Oliveira C, Duque C et al.: Relation among microbiological composition and presence of dental plaque, sugar exposure, social factors and different stages of early childhood caries. Arch Oral Biol 2010; 55: 365-373.
17. Law V, Seow WK, Townsend G: Factors influencing oral colonization of mutans streptococci in young children. Aust Dent J 2007; 52: 93-100.
18. Ge Y, Caufield PW, Fisch GS, Li Y: Streptococcus mutans and Streptococcus sanguinis Colonization Correlated with Caries Experience in Children. Caries Res 2008; 42: 444-448.
19. Tanner ACR, Kent RL Jr, Lif Holgerson P et al.: Microbiota of Severe Early Childhood Caries before and after Therapy. J Dent Res 2011; 90: 1298-1305.
20. Begzati A, Berisha M, Meqa K: Early childhood caries in preschool children of Kosovo – a serious public health problem. BMC Public Health 2010; 10: 1-8.
otrzymano: 2017-07-14
zaakceptowano do druku: 2017-08-04

Adres do korespondencji:
*Elżbieta Pels
Zakład Stomatologii Wieku Rozwojowego Uniwersytet Medyczny w Lublinie
ul. Karmelicka 7, 20-081 Lublin
tel. +48 (81) 532-06-19
elzbieta.pels@umlub.pl

Nowa Stomatologia 3/2017
Strona internetowa czasopisma Nowa Stomatologia