Elevated antibody to D-alanyl lipoteichoic acid indicates caries experience associated with fluoride and gingival health

Abstract

Background: Acidogenic, acid-tolerant bacteria induce dental caries and require D-alanyl glycerol lipoteichoic acid (D-alanyl LTA) on their cell surface. Because fluoride inhibits acid-mediated enamel demineralization, an elevated antibody response to D-alanyl LTA may indicate subjects with more acidogenic bacteria and, therefore, an association of DMFT with fluoride exposure and gingival health not apparent in low responders. Methods:Cluster analysis was used to identify low antibody content. Within low and high responders (control and test subjects), the number of teeth that were decayed missing and filled (DMFT), or decayed only (DT) were regressed against fluoride exposure in the water supply and from dentrifice use. The latter was determined from gingival health: prevalences of plaque (PL) and bleeding on probing (BOP), and mean pocket depth (PD). Age was measured as a possible confounding cofactor. Results:In 35 high responders, DMFT associated with length of exposure to fluoridated water (F score), PL and BOP (R 2 = 0.51, p < 0.001), whereas in 67 low D-ala-IgG responders, DMFT associated with PL, age, and PD (R 2 = 0.26, p < 0.001). BOP correlated strongly with number of 7 7 decayed teeth (DT) in 54 high responders (R 2 = 0.57, p < 0.001), but poorly in 97 low responders (R 2 = 0.12, p < 0.001). The strength of the PD association with DMFT, or of BOP with DT, in high responders significantly differed from that in low responders (p < 0.05). Conclusion:Caries associates with gingival health and fluoridated water exposure in high D-alanyl LTA antibody responders.

Antibody Response to Actinomyces Antigen and Dental Caries Experience: Implications for Caries Susceptibility

“…The findings permitted the incidence of A-Ab in Oklahoma dental students and patients and in out-of-state volunteers to be determined. They also permitted an elevated antibody response to be defined and age and sex associations to be examined as in a study of S-Ab response described previously (24). Nineteen dental students provided a second sample of blood for determining the variation in A-Ab content after 6 months.…”

“…Examinations were performed during the early to mid-afternoon by experienced clinicians who were calibrated as reported previously (24). Caries experience was measured as the number of decayed, missing, and filled teeth (DMFT), teeth surfaces (DMFS), and decayed teeth (DT).…”

“…Fluoride exposure was estimated from a subject's date of birth over each of five periods (birth to 2, 3 to 5, 6 to 8, 9 to 11, and 12 to 14 years). A subject's address at these times was scored as listed (1) or not listed (0) in the 1980 Fluoridation Census (24). Flu was the sum of these scores and had a value of 0 (address not listed for any period) through 5 (listed for all periods).…”

“…It eluted with 0.4 M NaCl and was identified as poly(glycerophosphate) containing fatty acids and D-alanine (22,24,26,27). Precipitation is due to large amounts of IgG reacting with esterified D-alanine (24,25).…”

“…Human serum immunoglobulin G (IgG) antibodies precipitate with D-alanine esterified to poly(glycerophosphate) from biofilms (27). An elevated IgG antibody response to this epitope from S. mutans (S-Ab response) indicates caries experience that associates strongly with gingival health and exposure to fluoridated water (24).…”