The Microflora Associated with the Development of Initial Enamel Decalcification below Orthodontic Bands in vivo in Children Living in a Fluoridated-water Area

Abstract

Thirty-four caries-free teeth destined for orthodontic extraction were banded to provide a protected area for the accumulation of plaque. The teeth were extracted at one, two, four, eight, and 14 days after being banded, and samples of the flora below the band were analyzed for the presence of Streptococcus sanguis, Streptococcus 'mitior', 'mutans streptococci', Actinomyces viscosus, Actinomyces naeslundii, Actinomyces odontolyticus, Lactobacillus species, and Veillonella. After plaque sampling, the teeth were sent to the Royal Dental College (Copenhagen) for histological analysis. The results showed that S. mutans could colonize the area below the band after one day, but that colonization was only 100% at 14 days. Lactobacillus was only isolated from 2/8 samples at four days and from 4/8 samples at 14 days. S. sanguis and 'S. mitior' were regularly isolated at all banding times, and Veillonella was isolated from all samples. A. viscosus was the most commonly isolated Actinomyces. The numbers of Streptococcus and Veillonella were significantly higher at day 1 than at day 14 (p < 0.05). S. mutans and A. viscosus were isolated more frequently at day 14 than at day 1 (p < 0.01). Histological examination revealed that dissolution of the enamel below a band could occur after two days, but that even after 14 days dissolution could be questionable. Dissolution was detected in areas where S. mutans was not isolated (8/34), but S. mutans was also present in samples showing dissolution (12/34). There was no relationship between dissolution and the numbers of S. mutans; however, the isolation frequency of S. mutans was associated with dissolution (p < 0.05). The results also suggested that there were subject-associated factors that influenced the composition of the bacterial community, as evidenced by Lactobacillus being isolated from all samples from one subject after 14 days, while the other subject was negative for Lactobacillus.

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