Probiotic bacteria have been suggested to inhibit Streptococcus mutans (SM) and thus prevent dental caries. However, supporting evidence is weak and probiotic species might be cariogenic themselves. Thus, we compared and combined the probiotic Lactobacillus rhamnosus GG (LGG) with SM and analysed the resulting mineral loss (ΔZ) in dental tissues. We simulated three biofilm compositions (SM, LGG, SM × LGG), two lesion sites (smooth enamel, dentin cavity) and two nutrition supply frequencies (twice/day, 6 times/day) in a multi-station, continuous-culture biofilm model. A total of 240 bovine enamel and dentin samples were cut, polished and embedded. All experimental procedures were performed in independent duplicates, with 10 samples being allocated to each group for each experiment (final sample size n = 20/group). Biofilms were cultured on the specimens and supplied with 2% sucrose medium and artificial saliva in consecutive pulses. After 10 days, ΔZ and bacterial numbers were assessed. SM × LGG biofilms caused significantly increased ΔZ compared with SM or LGG biofilms (p < 0.01, Mann-Whitney test), and ΔZ was significantly increased in dentin cavities compared with smooth enamel lesions (p < 0.01). Bacterial numbers did not significantly differ between biofilms of different species (p > 0.05, ANOVA). Frequent nutrition supply significantly increased bacterial numbers (p < 0.01). Biofilms in dentin cavities compared to smooth enamel harboured significantly more bacteria (p < 0.05). LGG induced mineral loss especially in dentin cavities and under highly cariogenic conditions. LGG did not have inhibitory effects on SM, but rather contributed to the caries process in vitro.

1.
Aas JA, Griffen AL, Dardis SR, Lee AM, Olsen I, Dewhirst FE, Leys EJ, Paster BJ: Bacteria of dental caries in primary and permanent teeth in children and young adults. J Clin Microbiol 2008;46:1407-1417.
2.
Azevedo MS, van de Sande FH, Romano AR, Cenci MS: Microcosm biofilms originating from children with different caries experience have similar cariogenicity under successive sucrose challenges. Caries Res 2011;45:510-517.
3.
Badet C, Thebaud NB: Ecology of lactobacilli in the oral cavity: a review of literature. Open Microbiol J 2008;2:38-48.
4.
Beighton DB, Brailsford S, Samaranayake LP, Brown JP, Ping FX, Grant-Mills D, Harris R, Lo EC, Naidoo S, Ramos-Gomez F, Soo TC, Burnside G, Pine CM: A multi-country comparison of caries-associated microflora in demographically diverse children. Community Dent Health 2004;21:96-101.
5.
Bjørndal L, Larsen T: Changes in the cultivable flora in deep carious lesions following a stepwise excavation procedure. Caries Res 2000;34:502-508.
6.
Bönecker M, Grossman E, Cleaton-Jones PE, Parak R: Clinical, histological and microbiological study of hand-excavated carious dentine in extracted permanent teeth. SADJ 2003;58:273-278.
7.
Bowden GH, Hamilton IR: Competition between Streptococcus mutans and Lactobacillus casei in mixed continuous culture. Oral Microbiol Immunol 1989;4:57-64.
8.
Boyar RM, Bowden GH: The microflora associated with the progression of incipient carious lesions of children living in a water-fluoridated area. Caries Res 1985;19:298-306.
9.
Dibdin GH, Shellis RP, Wilson CM: An apparatus for the continuous culture of micro-organisms on solid surfaces with special reference to dental plaque. J Appl Bacteriol 1976;40:261-268.
10.
Dierksen KP, Moore CJ, Inglis M, Wescombe PA, Tagg JR: The effect of ingestion of milk supplemented with salivaricin A-producing Streptococcus salivarius on the bacteriocin-like inhibitory activity of streptococcal populations on the tongue. FEMS Microbiol Ecol 2007;59:584-591.
11.
Gold OG, Jordan HV, van Houte J: A selective medium for Streptococcus mutans. Arch Oral Biol 1973;18:1356-1364.
12.
Haukioja A, Söderling E, Tenovuo J: Acid production from sugars and sugar alcohols by probiotic lactobacilli and bifidobacteria in vitro. Caries Res 2008;42:449-453.
13.
Hedberg M, Hasslöf P, Sjöström I, Twetman S, Stecksén-Blicks C: Sugar fermentation in probiotic bacteria - an in vitro study. Oral Microbiol Immunol 2008;23:482-485.
14.
Kaufman HW, Pollock JJ, Gwinnett AJ: Microbial caries induction in the roots of human teeth in vitro. Arch Oral Biol 1988;33:499-503.
15.
Kneist S, Schmidt F, Callaway A, Willershausen B, Rupf S, Wicht M, Thiede B: Diversity of lactobacillus species in deep carious lesions of primary molars. Eur Arch Paediatr Dent 2010;11:181-186.
16.
Kõll-Klais P, Mändar R, Leibur E, Marcotte H, Hammarström L, Mikelsaar M: Oral lactobacilli in chronic periodontitis and periodontal health: species composition and antimicrobial activity. Oral Microbiol Immunol 2005;20:354-361.
17.
Marttinen A, Haukioja A, Karjalainen S, Nylund L, Satokari R, Öhman C, Holgerson P, Twetman S, Söderling E: Short-term consumption of probiotic lactobacilli has no effect on acid production of supragingival plaque. Clin Oral Invest 2012;16:797-803.
18.
Meurman JH: Probiotics: do they have a role in oral medicine and dentistry? Eur J Oral Sci 2005;113:188-196.
19.
Meurman JH, Antila H, Korhonen A, Salminen S: Effect of Lactobacillus rhamnosus strain GG (ATCC 53103) on the growth of Streptococcus sobrinus in vitro. Eur J Oral Sci 1995;103:253-258.
20.
Michalek SM, Hirasawa M, Kiyono H, Ochiai K, McGhee JR: Oral ecology and virulence of Lactobacillus casei and Streptococcus mutans in gnotobiotic rats. Infect Immun 1981;33:690-696.
21.
Näse L, Hatakka K, Savilahti E, Saxelin M, Pönkä A, Poussa T, Korpela R, Meurman JH: Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Res 2001;35:412-420.
22.
Noorda WD, Purdell-Lewis DJ, van Montfort AM, Weerkamp AH: Monobacterial and mixed bacterial plaques of Streptococcus mutans and Veillonella alcalescens in an artificial mouth: development, metabolism, and effect on human dental enamel. Caries Res 1988;22:342-347.
23.
Schlundt J: Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. http://www.who.int/foodsafety/publications/fs_management/en/probiotics.pdf, 2001.
24.
Shu M, Wong L, Miller JH, Sissons CH: Development of multi-species consortia biofilms of oral bacteria as an enamel and root caries model system. Arch Oral Biol 2000;45:27-40.
25.
Simark-Mattsson C, Emilson C-G, Håkansson EG, Jacobsson C, Roos K, Holm S: Lactobacillus-mediated interference of mutans streptococci in caries-free vs. caries-active subjects. Eur J Oral Sci 2007;115:308-314.
26.
Sissons CH, Cutress TW, Hoffman MP, Wakefield JSJ: A multi-station dental plaque microcosm (artificial mouth) for the study of plaque growth, metabolism, pH, and mineralization. J Dent Res 1991;70:1409-1416.
27.
Stecksén-Blicks C, Sjöström I, Twetman S: Effect of long-term consumption of milk supplemented with probiotic lactobacilli and fluoride on dental caries and general health in preschool children: a cluster-randomized study. Caries Res 2009;43:374-381.
28.
Takahashi N, Nyvad B: The role of bacteria in the caries process: ecological perspectives. J Dent Res 2011;90:294-303.
29.
Tanzer JM, Thompson A, Lang C, Cooper B, Hareng L, Gamer A, Reindl A, Pompejus M: Caries inhibition by and safety of Lactobacillus paracasei DSMZ16671. J Dent Res 2010;89:921-926.
30.
Twetman S, Keller MK: Probiotics for caries prevention and control. Adv Dent Res 2012;24:98-102.
31.
Wong L, Sissons CH: A comparison of human dental plaque microcosm biofilms grown in an undefined medium and a chemically defined artificial saliva. Arch Oral Biol 2001;46:477-486.
32.
Yli-Knuuttila H, Snäll J, Kari K, Meurman JH: Colonization of Lactobacillus rhamnosus GG in the oral cavity. Oral Microbiol Immunol 2006;21:129-131.
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