Increase in cariogenic bacteria after initial periodontal therapy.
This study examined the hypothesis of an intra-oral shift, during initial periodontal therapy, from a periopathogenic to a cariogenic flora. Seventy-one patients with periodontitis were randomly allocated to one of the following treatment strategies: (1) scaling and root planing, quadrant by quadrant, at two-week intervals (NC); (2) full-mouth scaling and root planing within 24 hrs (FRP); or (3) full-mouth disinfection within 24 hrs, including antiseptics [chlorhexidine (CHX) or amine fluoride/stannous fluoride (F) for 2 mos, or CHX for 2 mos followed by F for 6 mos (CHX+F)]. At baseline and after 2, 4, and 8 mos, bacterial samples were taken from supra- and subgingival plaque, saliva, and tongue. The detection frequencies and relative proportions of Streptococcus mutans increased in the NC and FRP groups, but decreased in the F group. In the CHX group, these species disappeared temporarily, but they disappeared for the entire 8 mos in the CHX+F group. These observations were similar for all sample locations. The periopathogens decreased in all groups. This finding confirms the abovementioned hypothesis and indicates a need for caries prophylactic regimens.
De Soete
M
M
Department of Periodontology, Faculty of Medicine, Catholic University of Leuven, Belgium.
Dekeyser
C
C
Pauwels
M
M
Teughels
W
W
van Steenberghe
D
D
Quirynen
M
M
D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000494:pharmacology* / Q000627:therapeutic use; D002710:Chlorhexidine / Q000494:pharmacology* / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003773:Dental Plaque / Q000382:microbiology*; D012534:Dental Scaling; D017753:Ecosystem; D005260:Female; D005460:Fluorides, Topical / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007778:Lactobacillus / Q000254:growth & development / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000494:pharmacology* / Q000627:therapeutic use; D010518:Periodontitis / Q000382:microbiology / Q000628:therapy*; D016966:Porphyromonas gingivalis / Q000187:drug effects*; D013295:Streptococcus mutans / Q000254:growth & development* / Q000302:isolation & purification; D014002:Tin Fluorides / Q000494:pharmacology / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D005460:Fluorides, Topical; D009067:Mouthwashes; D014002:Tin Fluorides; C094808:amine fluoride solution; D002710:Chlorhexidine