Type 2 diabetes mellitus is increasingly common in Thailand and elsewhere. In the present investigation, the bacteriological composition of saliva and supragingival plaque in Thai diabetics with and without active dental caries and in nondiabetics was determined by differential culture and eubacterial DNA profiling. Potential associations between fasting blood sugar and glycosylated hemoglobin (biomarkers of current and historical glucose control, respectively) with decayed, missing, and filled teeth and with salivary Streptococcus and Lactobacillus counts were also investigated. The incidence of active dental caries was greater in the Thai diabetics than in nondiabetics, and the numbers of total streptococci and lactobacilli were significantly higher in supragingival plaque from diabetics than in nondiabetics. Lactobacillus counts in the saliva and supragingival plaque of diabetics with active caries were significantly higher than those in diabetics without active caries. Oral eubacterial DNA profiles of diabetic versus nondiabetic individuals and of diabetics with active caries versus those without active caries could not be readily differentiated through cluster analysis or multidimensional scaling. The elevated caries incidence in the Thai diabetics was positively associated with numbers of bacteria of the acidogenic/acid-tolerant genera Streptococcus and Lactobacillus. Lactobacillus bacterial numbers were further elevated in diabetics with active caries, although salivary eubacterial DNA profiles were not significantly altered.
Thailand has a comparatively high prevalence of severe early childhood caries (S-ECC). S-ECC adversely affects the quality of life for children and their caregivers and represents a considerable economic burden. We have assessed the bacteriological composition of unstimulated saliva, dental plaque, and degraded dentine in a Thai cohort, including children with S-ECC and children without cavities; their siblings, and their primary caregivers. Samples were collected during a dental examination and patients were scored for plaque accumulation and their decayed, missing, and filled teeth (dmft) index. Samples were analyzed using differential bacteriological counting and gel-based eubacterial DNA profiling. Plaque Lactobacillus abundance correlated significantly with S-ECC. Whilst Lactobacillus counts were significantly higher in children with S-ECC than in their siblings and primary caregivers (five families), the opposite trend was apparent for cavity-free children. Counts of Gram-negative anaerobes were significantly lower in children with S-ECC than orally healthy children. S-ECC correlated significantly with plaque index scores, dmft, and with Lactobacillus abundance in a highly predictive manner. DNA profiles showed significant homology between families but not within non-cavity and S-ECC groups. In conclusion, salivary and plaque Lactobacillus counts were significantly associated with S-ECC in the Thai subjects. Lactobacillus counts in the children were not correlated with those of their siblings and primary caregivers. Individuals could be significantly differentiated based on family but not on caries status.
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