The aim of this study was to compare the levels of fluoride and mutans streptococci in plaque grown on glass ionomer (Ketac-Fil) and composite (Silar) restorations in vivo. From tunnels left under the brackets bonded either with glass ionomer or composite, 14-day-old plaque samples were collected 14, 28, and 42 days after bonding. For glass ionomer the mean counts of mutans streptococci in plaque were 0.5 × 10³, 6.7 × 10³, and 8.8 × 10³ CFU at the first, second, and third collection, respectively, whereas for composite restorations the corresponding values were 32.1 × 10³, 14.6 × 10³, and 120.6 × 10³ CFU. For glass ionomer the mean concentrations of fluoride were 19,985, 5,788, and 5,019 ppm at first, second, and third collections of 14-day-old plaque samples, respectively, whereas for composite restorations the mean concentrations of fluoride were about 200 ppm throughout the study. The results show that the fluoride level in plaque growing on glass ionomer is much higher than that on composite restorations which seems to affect the level of mutans streptococci in dental plaque.

A total of 164 schoolchildren, aged 11–15 years with high DMF scores was divided into 4 groups. Subjects of the CXF group brushed their teeth after school lunch and rinsed their mouths with a solution containing 0.05% chlorhexidine gluconate + 0.044% NaF in succinic acid/NaOH buffer, pH 5.9. The F group had 0.044% NaF in the buffer. The PI group used a placebo solution and the C group served as the basic control. Respective nonabrasive toothpaste preparations were used in the evenings and twice a day during weekends and the holidays. After 2 years, the mean DMFS increments in the C, Pl, F and CXF groups were 6.3, 5.1, 4.3 and 2.9, respectively. The percentage of subjects with bleeding vestibular gingival units examined in different groups had changed from initial to final value as follows: C, 40–63; PI, 50–49; F, 71–47 and CXF, 63–14.

The susceptibilities of 379 clinical mutans streptococcal isolates to chlorhexidine (CHX) were tested by agar dilution according to the standards of the National Committee for Clinical Laboratory Standards. Isolates were obtained from saliva samples of 34 young mothers who had high or moderate salivary levels of mutans streptococci at baseline. Samples were collected on three occasions, before childbirth, when each child was 6 months old, and 1 year later. Of these isolates, 50% were inhibited at 1 microgram of CHX per ml, 90% were inhibited at 2.0 micrograms/ml, and all were inhibited at 4.0 micrograms/ml. The MICs for Streptococcus mutans isolates (serotypes c, e, and f) were lower than those for Streptococcus sobrinus isolates (serotypes d and g). In some subjects, the MICs for isolates of the same serotype were different. This phenomenon was studied by ribotyping isolates (n = 45) from selected subjects (n = 7). It was found that if there were intraindividual differences in the MICs for isolates of the same serotype, then the ribotypes of these isolates were different. In order to decrease the mutans streptococcal infection risk for children, 24 mothers (test group) brushed their teeth periodically with a gel that contained 0.3% CHX digluconate and 0.2% NaF, pH 5.8, between the second and third sampling occasions. The gel was used twice a day for the first 10 days of each month. Development of resistant strains during CHX-NaF gel use was not detected. The serotype distribution of isolates from the test group after 1 year of periodic CHX-NaF gel use did not differ from that at baseline. Periodic CHX-NaF gel brushing did not lead to lower salivary mutans streptococcal counts.

In order to study the effects of different glass ionomers on the metabolism of Streptococcus mutans, test slabs of freshly mixed conventional glass ionomer (Fuji), silver glass ionomer (Ketac-Silver), composite (Silux), and 2-week-old Fuji were fitted into the bottom of a test tube. A plaque-like layer of S. mutans strain Ingbritt was centrifuged onto the test slabs, and the samples were incubated for 20 h in 1.7% (w/v) sucrose solution. For freshly mixed Fuji and Ketac-Silver, the pH fall was significantly smaller than for old Fuji and composite. These materials also released the largest amount of fluoride into the fluid phase. Incubation with glass ionomer materials led to an increase in the cellular concentration of fluoride in bacteria, but intracellular fluoride did not correlate with the fall in pH. The lowest pH was associated with the lowest cellular magnesium content. Ketac-Silver released large amounts of calcium in the fluid phase, and the cellular calcium content was doubled in this group. The results show that freshly mixed glass ionomers affect acid production and electrolyte metabolism of S. mutans in vitro. The effect of conventional glass ionomer, however, seems to disappear after a few weeks. The effects of calcium and silver released by cermet glass ionomer deserve further study.