Granath L, Cleaton-Jones P, Fatti L P, Grossman E S
Department of Pedodontics, School of Dentistry, Lund University, Malmö, Sweden.
J Clin Microbiol. 1993 Jan;31(1):66-70. doi: 10.1128/jcm.31.1.66-70.1993.
The correlation between dental caries and the number of oral mutans group streptococci (ms) present has been shown to be weak. The aim of this investigation was to study associations between caries experience (decayed, missing, and filled surfaces [dmfs]) and the number of ms in stimulated saliva, with emphasis on the level of disease and the confounding effect of regular intake of sweets, the presence of salivary lactobacilli, and oral hygiene. In some 2,700 4- to 5-year-old South African children of different ethnic origins, caries was diagnosed on the basis of World Health Organization criteria and saliva samples were analyzed for ms after cultivation on mitis salivarius-bacitracin agar and for lactobacilli by using the Dentocult kit. Oral hygiene was scored on the basis of the Greene and Vermillion simplified debris index, while data on intake of sweets were derived from extensive interviews. Pearson's coefficient of correlation was computed, and multiple regression analysis was performed to correct for confounding factors. The distribution of the children in the eight caries classes was strongly associated with the ms class (P < 0.001), with those in the lower ms classes generally having low dmfs scores and those in the higher ms classes having dmfs scores distributed over the whole range. The r value for the two variables was 0.25 for the total material; this was reduced to 0.18 by correction for confounding factors. The corresponding values for children with caries were 0.21 and 0.17, for those in the 1 to 6 dmfs interval they were 0.07 and 0.03, and for those in the 7 to 81 dmfs interval they were 0.16 and 0.14. The data imply that the explanatory values for ms, those for the lower caries interval not counted, ranged from 6 to 2%. The unexpected results for children with caries might be due to their distribution pattern. It is concluded that there is a need for reevaluation of ms as a risk factor in dental caries.
龋齿与口腔变形链球菌（ms）数量之间的相关性已被证明较弱。本研究的目的是探讨龋病经历（龋、失、补牙面数[dmfs]）与刺激唾液中ms数量之间的关联，重点关注疾病程度以及经常摄入甜食、唾液中乳酸菌的存在和口腔卫生的混杂效应。在约2700名不同种族的4至5岁南非儿童中，根据世界卫生组织标准诊断龋齿，并在唾液链球菌-杆菌肽琼脂上培养后分析唾液样本中的ms，使用Dentocult试剂盒分析乳酸菌。根据格林和弗米利恩简化牙菌斑指数对口腔卫生进行评分，而甜食摄入数据来自广泛的访谈。计算皮尔逊相关系数，并进行多元回归分析以校正混杂因素。八个龋病等级中儿童的分布与ms等级密切相关（P < 0.001），ms等级较低的儿童dmfs评分通常较低，而ms等级较高的儿童dmfs评分分布在整个范围内。整个样本中两个变量的r值为0.25；校正混杂因素后降至0.18。患龋儿童的相应值分别为0.21和0.17，dmfs在1至6区间的儿童为0.07和0.03，dmfs在7至81区间的儿童为0.16和0.14。数据表明，不计算低龋区间的ms的解释值范围为6%至2%。患龋儿童的意外结果可能归因于他们的分布模式。结论是有必要重新评估ms作为龋齿风险因素的作用。
