Beyond Streptococcus mutans: dental caries onset linked to multiple species by 16S rRNA community analysis
Erin L Gross, Clifford J Beall, Stacey R Kutsch, Noah D Firestone, Eugene J Leys, Ann L Griffen, Erin L Gross, Clifford J Beall, Stacey R Kutsch, Noah D Firestone, Eugene J Leys, Ann L Griffen
Abstract
Dental caries in very young children may be severe, result in serious infection, and require general anesthesia for treatment. Dental caries results from a shift within the biofilm community specific to the tooth surface, and acidogenic species are responsible for caries. Streptococcus mutans, the most common acid producer in caries, is not always present and occurs as part of a complex microbial community. Understanding the degree to which multiple acidogenic species provide functional redundancy and resilience to caries-associated communities will be important for developing biologic interventions. In addition, microbial community interactions in health and caries pathogenesis are not well understood. The purpose of this study was to investigate bacterial community profiles associated with the onset of caries in the primary dentition. In a combination cross-sectional and longitudinal design, bacterial community profiles at progressive stages of caries and over time were examined and compared to those of health. 16S rRNA gene sequencing was used for bacterial community analysis. Streptococcus mutans was the dominant species in many, but not all, subjects with caries. Elevated levels of S. salivarius, S. sobrinus, and S. parasanguinis were also associated with caries, especially in subjects with no or low levels of S. mutans, suggesting these species are alternative pathogens, and that multiple species may need to be targeted for interventions. Veillonella, which metabolizes lactate, was associated with caries and was highly correlated with total acid producing species. Among children without previous history of caries, Veillonella, but not S. mutans or other acid-producing species, predicted future caries. Bacterial community diversity was reduced in caries as compared to health, as many species appeared to occur at lower levels or be lost as caries advanced, including the Streptococcus mitis group, Neisseria, and Streptococcus sanguinis. This may have implications for bacterial community resilience and the restoration of oral health.
Conflict of interest statement
Competing Interests: The authors have declared that no competing interests exist.
Figures
References
- US Department of Health and Human Services (2000) Oral Health in America: A Report of the Surgeon General– Executive Summary National Institute of Dental and Craniofacial Research, National Institutes of Health.
- Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E (2009) Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc 140: 650–657.
- Kanellis MJ, Damiano PC, Momany ET (2000) Medicaid costs associated with the hospitalization of young children for restorative dental treatment under general anesthesia. J Public Health Dent 60: 28–32.
- al-Shalan TA, Erickson PR, Hardie NA (1997) Primary incisor decay before age 4 as a risk factor for future dental caries. Pediatr Dent 19: 37–41.
- Alm A, Wendt LK, Koch G, Birkhed D (2007) Prevalence of approximal caries in posterior teeth in 15-year-old Swedish teenagers in relation to their caries experience at 3 years of age. Caries research 41: 392–398.
- Mattila ML, Rautava P, Aromaa M, Ojanlatva A, Paunio P, et al. (2005) Behavioural and demographic factors during early childhood and poor dental health at 10 years of age. Caries research 39: 85–91.
- Peretz B, Ram D, Azo E, Efrat Y (2003) Preschool caries as an indicator of future caries: a longitudinal study. Pediatr Dent 25: 114–118.
- Burne RA (1998) Oral streptococci… products of their environment. J Dent Res 77: 445–452.
- Marsh PD (2003) Are dental diseases examples of ecological catastrophes? Microbiology 149: 279–294.
- van Houte J (1994) Role of micro-organisms in caries etiology. J Dent Res 73: 672–681.
- Aas JA, Griffen AL, Dardis SR, Lee AM, Olsen I, et al. (2008) Bacteria of dental caries in primary and permanent teeth in children and young adults. Journal of clinical microbiology 46: 1407–1417.
- Gross EL, Leys EJ, Gasparovich SR, Firestone ND, Schwartzbaum JA, et al. (2010) Bacterial 16S sequence analysis of severe caries in young permanent teeth. Journal of clinical microbiology 48: 4121–4128.
- Hirose H, Hirose K, Isogai E, Miura H, Ueda I (1993) Close association between Streptococcus sobrinus in the saliva of young children and smooth-surface caries increment. Caries research 27: 292–297.
- Kleinberg I (2002) A mixed-bacteria ecological approach to understanding the role of the oral bacteria in dental caries causation: an alternative to Streptococcus mutans and the specific-plaque hypothesis. Crit Rev Oral Biol Med 13: 108–125.
- Tanner AC, Mathney JM, Kent RL, Chalmers NI, Hughes CV, et al. (2011) Cultivable anaerobic microbiota of severe early childhood caries. Journal of clinical microbiology 49: 1464–1474.
- Burne RA, Marquis RE (2000) Alkali production by oral bacteria and protection against dental caries. FEMS microbiology letters 193: 1–6.
- Griffen AL, Beall CJ, Firestone ND, Gross EL, DiFranco JM, et al. (2011) CORE: A Phylogenetically-Curated 16S rDNA Database of the Core Oral Microbiome. PLoS One 6: e19051.
- Preza D, Olsen I, Aas JA, Willumsen T, Grinde B, et al. (2008) Bacterial profiles of root caries in elderly patients. Journal of clinical microbiology 46: 2015–2021.
- Beighton D (2005) The complex oral microflora of high-risk individuals and groups and its role in the caries process. Community Dent Oral Epidemiol 33: 248–255.
- Kawamura Y, Hou XG, Sultana F, Miura H, Ezaki T (1995) Determination of 16S rRNA sequences of Streptococcus mitis and Streptococcus gordonii and phylogenetic relationships among members of the genus Streptococcus. International journal of systematic bacteriology 45: 406–408.
- Tanzer JM, Livingston J, Thompson AM (2001) The microbiology of primary dental caries in humans. J Dent Educ 65: 1028–1037.
- Loesche WJ (1986) Role of Streptococcus mutans in human dental decay. Microbiological Reviews 50: 353–380.
- Tanzer JM, Kurasz AB, Clive J (1985) Inhibition of ecological emergence of mutans streptococci naturally transmitted between rats and consequent caries inhibition by Streptococcus salivarius TOVE-R infection. Infect Immun 49: 76–83.
- Hughes CV, Dahlan M, Papadopolou E, Loo CY, Pradhan NS, et al. (2012) Aciduric microbiota and mutans streptococci in severe and recurrent severe early childhood caries. Pediatr Dent 34: 16–23.
- Okada M, Soda Y, Hayashi F, Doi T, Suzuki J, et al. (2005) Longitudinal study of dental caries incidence associated with Streptococcus mutans and Streptococcus sobrinus in pre-school children. Journal of medical microbiology 54: 661–665.
- Seki M, Yamashita Y, Shibata Y, Torigoe H, Tsuda H, et al. (2006) Effect of mixed mutans streptococci colonization on caries development. Oral Microbiol Immunol 21: 47–52.
- Loyola-Rodriguez JP, Martinez-Martinez RE, Flores-Ferreyra BI, Patino-Marin N, Alpuche-Solis AG, et al. (2008) Distribution of Streptococcus mutans and Streptococcus sobrinus in saliva of Mexican preschool caries-free and caries-active children by microbial and molecular (PCR) assays. J Clin Pediatr Dent 32: 121–126.
- Choi EJ, Lee SH, Kim YJ (2009) Quantitative real-time polymerase chain reaction for Streptococcus mutans and Streptococcus sobrinus in dental plaque samples and its association with early childhood caries. Int J Paediatr Dent 19: 141–147.
- Kanasi E, Johansson I, Lu SC, Kressin NR, Nunn ME, et al. (2010) Microbial risk markers for childhood caries in pediatricians’ offices. J Dent Res 89: 378–383.
- Palmer CA, Kent R Jr, Loo CY, Hughes CV, Stutius E, et al. (2010) Diet and caries-associated bacteria in severe early childhood caries. J Dent Res 89: 1224–1229.
- Kawamura Y, Hou XG, Todome Y, Sultana F, Hirose K, et al. (1998) Streptococcus peroris sp. nov. and Streptococcus infantis sp. nov., new members of the Streptococcus mitis group, isolated from human clinical specimens. International journal of systematic bacteriology 48 Pt 3: 921–927.
- Drucker DB, Shakespeare AP, Green RM (1984) The production of dental plaque and caries by the bacterium Streptococcus salivarius in gnotobiotic WAG/RIJ rats. Arch Oral Biol 29: 437–443.
- Horton WA, Jacob AE, Green RM, Hillier VF, Drucker DB (1985) The cariogenicity of sucrose, glucose and maize starch in gnotobiotic rats mono-infected with strains of the bacteria Streptococcus mutans, Streptococcus salivarius and Streptococcus milleri. Arch Oral Biol 30: 777–780.
- Willcox MD, Drucker DB, Hillier VF (1988) In-vitro adherence of oral streptococci in the presence of sucrose and its relationship to cariogenicity in the rat. Arch Oral Biol 33: 109–113.
- Willcox MD, Knox KW, Green RM, Drucker DB (1991) An examination of strains of the bacterium Streptococcus vestibularis for relative cariogenicity in gnotobiotic rats and adhesion in vitro. Arch Oral Biol 36: 327–333.
- Chestnutt IG, MacFarlane TW, Stephen KW (1994) An in vitro investigation of the cariogenic potential of oral streptococci. Arch Oral Biol 39: 589–593.
- Becker MR, Paster BJ, Leys EJ, Moeschberger ML, Kenyon SG, et al. (2002) Molecular analysis of bacterial species associated with childhood caries. Journal of clinical microbiology 40: 1001–1009.
- Chen YY, Burne RA (1996) Analysis of Streptococcus salivarius urease expression using continuous chemostat culture. FEMS microbiology letters 135: 223–229.
- Tanzer JM, Kurasz AB, Clive J (1985) Competitive displacement of mutans streptococci and inhibition of tooth decay by Streptococcus salivarius TOVE-R. Infect Immun 48: 44–50.
- Toro E, Nascimento MM, Suarez-Perez E, Burne RA, Elias-Boneta A, et al. (2010) The effect of sucrose on plaque and saliva urease levels in vivo. Arch Oral Biol 55: 249–254.
- Corby PM, Bretz WA, Hart TC, Schork NJ, Wessel J, et al. (2007) Heritability of oral microbial species in caries-active and caries-free twins. Twin Res Hum Genet 10: 821–828.
- Whiley RA, Fraser HY, Douglas CW, Hardie JM, Williams AM, et al. (1990) Streptococcus parasanguis sp. nov., an atypical viridans Streptococcus from human clinical specimens. FEMS microbiology letters 56: 115–121.
- Kikuchi K, Enari T, Totsuka K, Shimizu K (1995) Comparison of phenotypic characteristics, DNA-DNA hybridization results, and results with a commercial rapid biochemical and enzymatic reaction system for identification of viridans group streptococci. Journal of clinical microbiology 33: 1215–1222.
- Paddick JS, Brailsford SR, Kidd EA, Beighton D (2005) Phenotypic and genotypic selection of microbiota surviving under dental restorations. Applied and environmental microbiology 71: 2467–2472.
- Byun R, Nadkarni MA, Chhour KL, Martin FE, Jacques NA, et al. (2004) Quantitative analysis of diverse Lactobacillus species present in advanced dental caries. Journal of clinical microbiology 42: 3128–3136.
- Chhour KL, Nadkarni MA, Byun R, Martin FE, Jacques NA, et al. (2005) Molecular analysis of microbial diversity in advanced caries. Journal of clinical microbiology 43: 843–849.
- Loesche WJ, Syed SA (1973) The predominant cultivable flora of carious plaque and carious dentine. Caries research 7: 201–216.
- Marchandin H, Teyssier C, Simeon De Buochberg M, Jean-Pierre H, Carriere C, et al. (2003) Intra-chromosomal heterogeneity between the four 16S rRNA gene copies in the genus Veillonella: implications for phylogeny and taxonomy. Microbiology 149: 1493–1501.
- Rogosa M (1964) The Genus Veillonella. I. General Cultural, Ecological, and Biochemical Considerations. J Bacteriol 87: 162–170.
- Lima KC, Coelho LT, Pinheiro IV, Rocas IN, Siqueira JF Jr (2011) Microbiota of dentinal caries as assessed by reverse-capture checkerboard analysis. Caries research 45: 21–30.
- Noorda WD, Purdell-Lewis DJ, van Montfort AM, Weerkamp AH (1988) Monobacterial and mixed bacterial plaques of Streptococcus mutans and Veillonella alcalescens in an artificial mouth: development, metabolism, and effect on human dental enamel. Caries research 22: 342–347.
- Mikx FH, Van der Hoeven JS (1975) Symbiosis of Streptococcus mutans and Veillonella alcalescens in mixed continuous cultures. Arch Oral Biol 20: 407–410.
- Bradshaw DJ, Marsh PD (1998) Analysis of pH-driven disruption of oral microbial communities in vitro. Caries Res 32: 456–462.
- Bradshaw DJ, Marsh PD, Schilling KM, Cummins D (1996) A modified chemostat system to study the ecology of oral biofilms. J Appl Bacteriol 80: 124–130.
- Bradshaw DJ, McKee AS, Marsh PD (1989) Effects of carbohydrate pulses and pH on population shifts within oral microbial communities in vitro. J Dent Res 68: 1298–1302.
- McDermid AS, McKee AS, Ellwood DC, Marsh PD (1986) The effect of lowering the pH on the composition and metabolism of a community of nine oral bacteria grown in a chemostat. J Gen Microbiol 132: 1205–1214.
- Marsh PD (1994) Microbial ecology of dental plaque and its significance in health and disease. Adv Dent Res 8: 263–271.
- Liu J, Wu C, Huang IH, Merritt J, Qi F (2011) Differential response of Streptococcus mutans towards friend and foe in mixed-species cultures. Microbiology 157: 2433–2444.
- Marchant S, Brailsford SR, Twomey AC, Roberts GJ, Beighton D (2001) The predominant microflora of nursing caries lesions. Caries research 35: 397–406.
- Crielaard W, Zaura E, Schuller AA, Huse SM, Montijn RC, et al. (2011) Exploring the oral microbiota of children at various developmental stages of their dentition in the relation to their oral health. BMC Med Genomics 4: 22.
- Boone DR, Castenholz RW, Garrity GM (2001) Bergey’s manual of systematic bacteriology/George M. Garrity, editor-in-chief. New York: Springer. v. <v. 1–2 in 4>p.
- Lin X, Lamont RJ, Wu J, Xie H (2008) Role of differential expression of streptococcal arginine deiminase in inhibition of fimA expression in Porphyromonas gingivalis. J Bacteriol 190: 4367–4371.
- Dong Y, Chen YY, Snyder JA, Burne RA (2002) Isolation and molecular analysis of the gene cluster for the arginine deiminase system from Streptococcus gordonii DL1. Applied and environmental microbiology 68: 5549–5553.
- Kuramitsu HK, Wang BY (2006) Virulence properties of cariogenic bacteria. BMC Oral Health 6 Suppl 1S11.
- Wang BY, Kuramitsu HK (2005) Interactions between oral bacteria: inhibition of Streptococcus mutans bacteriocin production by Streptococcus gordonii. Applied and environmental microbiology 71: 354–362.
- Howell A Jr, Pine L (1961) The classification of organisms termed Leptotrichia (Leptothrix) buccalis. IV. Physiological and biochemical characteristics of Bacterionema matruchotii. Bacteriol Rev 25: 162–171.
- Moore LVH, Johnson JL, Moore WEC (1987) Selenomonas noxia sp. nov., Selenomonas flueggei sp. nov., Selenomonas infelix sp. nov., Selenomonas dianae sp. nov., and Selenomonas artemidis sp. nov., from the Human Gingival Crevice. International journal of systematic bacteriology 37: 271–280.
- Margolis HC, Moreno EC, Murphy BJ (1985) Importance of high pKA acids in cariogenic potential of plaque. J Dent Res 64: 786–792.
- Margolis HC, Zhang YP, Lee CY, Kent RL Jr, Moreno EC (1999) Kinetics of enamel demineralization in vitro. J Dent Res 78: 1326–1335.
- Arif N, Sheehy EC, Do T, Beighton D (2008) Diversity of Veillonella spp. from sound and carious sites in children. J Dent Res 87: 278–282.
- Jiang W, Jiang Y, Li C, Liang J (2011) Investigation of supragingival plaque microbiota in different caries status of Chinese preschool children by denaturing gradient gel electrophoresis. Microbial ecology 61: 342–352.
- Li Y, Ge Y, Saxena D, Caufield PW (2007) Genetic profiling of the oral microbiota associated with severe early-childhood caries. Journal of clinical microbiology 45: 81–87.
- Leys EJ, Griffen AL, Strong SJ, Fuerst PA (1994) Detection and strain identification of Actinobacillus actinomycetemcomitans by nested PCR. Journal of clinical microbiology 32: 1288–1294.
- Kumar PS, Griffen AL, Moeschberger ML, Leys EJ (2005) Identification of candidate periodontal pathogens and beneficial species by quantitative 16S clonal analysis. J Clin Microbiology 43: 3944–3955.
- Altschul SF, Gish W, Miller W, Myers EW, Lipman DJ (1990) Basic local alignment search tool. J Mol Biol 215: 403–410.
- Oksanen J, Blanchet FG, Kindt R, Legendre P, Minchin PR, et al.. (2011) vegan: Community Ecology Package.
- R Development Core Team (2011) R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.
Source: PubMed