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Background: Non-mutans low pH oral streptococci are postulated to contribute to caries etiology.
Objective: This study was undertaken to investigate whether the acidogenicity and acid tolerance of clinical strains of Streptococcus oralis and Streptococcus mitis correlate with health or early-stage enamel caries.
Design: S. oralis and S. mitis were isolated from plaque samples taken from the occlusal surfaces of second molars sampled at two different visits 4 years apart. All sites were sound at Visit 1; subjects were segregated into one of three groups based on the status of the site at Visit 2 and caries elsewhere in the dentition. Strains of S. oralis and S. mitis were evaluated for acidogenicity and acid tolerance, and the results correlated with the clinical status of the sites from which they were isolated. Mutans streptococci (MS) isolated from the plaque samples were also quantified, and the presence or absence of growth on pH 5.5 media or on media selective for bifidobacteria was recorded.
Results: No significant positive correlations were found between the acidogenicity properties of the S. oralis and S. mitis clones and caries at either visit. Similar results were obtained for acid tolerance of S. oralis clones but were inconclusive for S. mitis clones. A statistically significant positive correlation between MS levels and caries (or future caries) was evident at both visits, but there were no statistical correlations with the growth on pH 5.5 media or media selective for bifidobacteria.
Conclusions: The low pH potential likely varies considerably among oral streptococcal species and is least likely to be found among strains of S. mitis. Accordingly, the concept and constitution of 'low pH streptococci' may need to be re-evaluated.
Keywords: dental plaque; mutans streptococci; cariogenicity; oral microbiota; acidogenicity; acid tolerance
The microbial etiology of dental caries remains a subject of debate. The role of the mutans streptococci (MS), in particular Streptococcus mutans, has drawn the greatest share of attention, though some argue that this focus is to the detriment of understanding how overall plaque ecology drives caries risk (1-4). What seems clear is that on a population level the link between S. mutans and caries is strong. But at the individual level, there may be alternative pathways to caries, even in a severe form. While it is...