title: Removal of Dental Biofilms with an Ultrasonically Activated Water Stream.
abstract: Acidogenic bacteria within dental plaque biofilms are the causative agents of caries. Consequently, maintenance of a healthy oral environment with efficient biofilm removal strategies is important to limit caries, as well as halt progression to gingivitis and periodontitis. Recently, a novel cleaning device has been described using an ultrasonically activated stream (UAS) to generate a cavitation cloud of bubbles in a freely flowing water stream that has demonstrated the capacity to be effective at biofilm removal. In this study, UAS was evaluated for its ability to remove biofilms of the cariogenic pathogen Streptococcus mutans UA159, as well as Actinomyces naeslundii ATCC 12104 and Streptococcus oralis ATCC 9811, grown on machine-etched glass slides to generate a reproducible complex surface and artificial teeth from a typodont training model. Biofilm removal was assessed both visually and microscopically using high-speed videography, confocal scanning laser microscopy (CSLM), and scanning electron microscopy (SEM). Analysis by CSLM demonstrated a statistically significant 99.9% removal of S. mutans biofilms exposed to the UAS for 10 s, relative to both untreated control biofilms and biofilms exposed to the water stream alone without ultrasonic activation (P < 0.05). The water stream alone showed no statistically significant difference in removal compared with the untreated control (P = 0.24). High-speed videography demonstrated a rapid rate (151 mm(2) in 1 s) of biofilm removal. The UAS was also highly effective at S. mutans, A. naeslundii, and S. oralis biofilm removal from machine-etched glass and S. mutans from typodont surfaces with complex topography. Consequently, UAS technology represents a potentially effective method for biofilm removal and improved oral hygiene.
authors.affiliation: National Institute for Health Research Southampton Respiratory Biomedical Research Unit, Southampton Centre for Biomedical Research, University Hospital Southampton NHS Foundation Trust, Southampton, UK Centre for Biological Sciences, Faculty of Natural and Environmental Sciences and Institute for Life Sciences, University of Southampton, Southampton, UK.
authors.forename: R P
authors.initials: RP
authors.lastname: Howlin
authors.affiliation: National Centre for Advanced Tribology, Faculty of Engineering and Institute for Life Sciences, University of Southampton, Southampton, UK.
authors.forename: S
authors.initials: S
authors.lastname: Fabbri
authors.affiliation: Chemistry, University of Southampton, Southampton, UK.
authors.forename: D G
authors.initials: DG
authors.lastname: Offin
authors.affiliation: National Centre for Advanced Tribology, Faculty of Engineering and Institute for Life Sciences, University of Southampton, Southampton, UK.
authors.forename: N
authors.initials: N
authors.lastname: Symonds
authors.affiliation: Southampton Nanofabrication Centre Electronics & Computer Science, University of Southampton, Southampton, UK.
authors.forename: K S
authors.initials: KS
authors.lastname: Kiang
authors.affiliation: Centre for Biological Sciences, Faculty of Natural and Environmental Sciences and Institute for Life Sciences, University of Southampton, Southampton, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Knee
authors.affiliation: Centre for Biological Sciences, Faculty of Natural and Environmental Sciences and Institute for Life Sciences, University of Southampton, Southampton, UK.
authors.forename: D C
authors.initials: DC
authors.lastname: Yoganantham
authors.affiliation: National Institute for Health Research Southampton Respiratory Biomedical Research Unit, Southampton Centre for Biomedical Research, University Hospital Southampton NHS Foundation Trust, Southampton, UK Centre for Biological Sciences, Faculty of Natural and Environmental Sciences and Institute for Life Sciences, University of Southampton, Southampton, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: Webb
authors.affiliation: Chemistry, University of Southampton, Southampton, UK.
authors.forename: P R
authors.initials: PR
authors.lastname: Birkin
authors.affiliation: Faculty of Engineering and the Environment, University of Southampton, Southampton, UK Institute of Sound and Vibration Research, University of Southampton, Southampton, UK.
authors.forename: T G
authors.initials: TG
authors.lastname: Leighton
authors.affiliation: National Centre for Advanced Tribology, Faculty of Engineering and Institute for Life Sciences, University of Southampton, Southampton, UK Departments of Microbial Infection and Immunity and Orthopaedics, Center for Microbial Interface Biology, The Ohio State University, Columbus, OH, USA pstoodley@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Stoodley
mesh_terms: D018441:Biofilms; D003773:Dental Plaque / Q000382:microbiology; D006801:Humans; D008855:Microscopy, Electron, Scanning; D013295:Streptococcus mutans / Q000302:isolation & purification; D014465:Ultrasonics; D014867:Water
chemical_list: D014867:Water
keywords: Streptococcus mutans; bacteria; caries; dental hygiene; infection control; microbiology