Did you know that getting cavities in your teeth is an infectious disease? Cavities are a result of bacteria in the genus Streptococcus. In this lesson, we will examine how bacteria contribute to tooth decay.
The End of Tooth Decay
Consider this hypothetical scenario.
If you could give your child a vaccine before they started sprouting teeth that would render them impervious to tooth decay and cavities for life, would you do it? Would you submit your baby to one more injection to eliminate a lifetime of potential dental problems? I know I would. Tooth decay affects more children in the U.S. than any other chronic infectious disease. For the child, it results in pain and stress. For the parent, it results in huge medical costs.
I know I would avoid all that for myself and my child if I could.In reality, there is no magic vaccine that can protect you from cavities. Not yet anyway. But many scientists throughout the world are currently working on developing one. I’m sure some of the critical thinkers in the group are saying, ‘Wait a second, vaccines protect against catching infectious diseases. You can’t catch cavities.
‘ Actually, you can. In this lesson, I will attempt to explain just what causes tooth decay and how these exciting new vaccines might someday eliminate it.
Your mouth is a thriving ecosystem full of bacteria. You have an estimated 50-100 billion bacterial cells in your mouth at any given time. These bacteria make up your normal oral micro flora.
This population of organisms is generally harmless to you and can even serve a beneficial purpose. Having a healthy and diverse population of bacteria in your mouth can prevent pathogenic organisms like the parasitic fungus Candida from overgrowing and causing the disease thrush.Your mouth is a perfect microbe habitat. The constant warm temperature, high moisture content, plentiful food particles, and sloughed off mouth cells provide a protective environment and plenty of nutrients. For most of human history, these bacteria floated freely in the saliva or attached to the soft tissues without causing any damage. The smooth, hard enamel on your teeth was too tough and slippery for bacteria to attach and colonize effectively.
This protected ancient man’s teeth from cavities. But, after the Industrial Revolution, contemporary man developed a sweet tooth, and with it came the widespread consumption of the sugar sucrose. But, sucrose didn’t come alone.
It brought with it some members of the bacterial genus Streptococcus.
Streptococcus and Tooth Colonization
Fructose is the dominant sugar in most fruits and natural products and was the only source of sugar for many humans throughout history. The white table sugar so common in foods today is sucrose and comes from the sugarcane plant. Bacteria in the genus Streptococcus are very good at fermenting sucrose but not fructose. As we have begun to eat more sucrose, the Streptococcus populations in the mouth have begun to increase.This is significant for two major reasons. First, Streptococcus sobrinus and mutans bind to proteins in saliva, and second, Streptococcus are lactic acid bacteria.
Let’s examine how these two factors lead to increased tooth decay. Streptococcus sobrinus and mutans are able to bind to the proteins naturally found in our saliva. These salivary proteins naturally adhere to our tooth surfaces. S. sobrinus and mutans binding to these proteins means that the bacteria are able to colonize the enamel surfaces previously free of attached bacteria.
It only takes one Streptococcus cell to stick to the enamel surface and start a chain reaction. Single cells divide, forming colonies of many cells. At first, only the Streptococcus bacteria can adhere, but soon, other species of bacteria begin attaching to the Streptococcus.
This forms a continually thickening layer of bacterial cells.Eventually a biofilm forms. An oral biofilm is a deposit of dense, gelatinous material composed of salivary proteins, trapped food debris, and enormous numbers of bacterial cells. You might know this biofilm by another name: plaque. The thick, mature plaque that you can feel by rubbing your teeth with your tongue was started by just one species of bacteria, but can now contain up to 300 different species.
Why is it so bad for Streptococcus to form these oral biofilms on your teeth? Well, Streptococcus are lactic acid bacteria. This means that Streptococcus is able to ferment sucrose and produce lactic acid as a byproduct.
Consuming more sucrose leads to larger populations of Streptococcus, which in turn produces larger amounts of acid.This acid is responsible for tooth decay. Dental caries, more commonly known as cavities, are areas of tooth decay caused by the acidic byproducts of microbial metabolism. The acid removes the minerals from the tooth surface.
This eventually causes holes in the enamel. The acids can continue to break down the tooth material, called dentin, that lies under the enamel. Once through the dentin, the nerves and blood supply of the tooth pulp are invaded.Interestingly, there are still isolated populations of humans that don’t have a source of sucrose in their diets.
These groups have very few to no Streptococcus bacteria in their mouths. They also are generally completely cavity-free.
Prevention of Dental Caries
Now you should be able to see why cavities are an infectious disease.
If you could prevent the Streptococcus from colonizing your teeth, no other microbes would be able to adhere to your enamel. Without this close association, any acid produced by the oral flora would simply be diluted and neutralized by your saliva.But where do the Streptococcus bacteria actually come from? Almost all adult mouths harbor Streptococcus. Without teeth or exposure to sucrose, most newborn mouths have very few to no Streptococcus. The close contact between parents and children, specifically at feeding time, passes Streptococcus from your parents’ mouths to yours. In essence, you caught your cavities from your parents.
So, if we’re talking about infectious disease, it should be possible to create a vaccine to protect us from Streptococcus. Scientists are currently working on several. One group has developed a vaccine that provides the person with antibodies specific to Streptococcus mutans.
These antibodies bind to the surface of the bacteria and prevent it from binding to the enamel, thus preventing plaque formation.Another group has developed a vaccine that blocks S. mutans from synthesizing the carbohydrate chain that binds to the salivary proteins. Again, this prevents the Streptococcus from binding to the enamel, preventing plaque formation.
These vaccines are still a ways off. Much more testing and experimentation is required before we can eliminate our risk of caries. There are some things you can do now to prevent caries that have been tested and proven to be very effective. Regular brushing and flossing prevents the biofilms from getting too thick and established, and limiting sucrose eliminates the major food source for Streptococcus. This should prevent the population from exploding and reduce the acid production. Finally, regular trips to the dentist can detect any problems before they arise.
Let’s review some of the key points.Your mouth contains a thriving population of bacteria. Most of these bacteria are harmless and can even help prevent other oral pathogens from overgrowing and causing disease. Most of these bacterial species are unable to colonize the enamel surfaces of your teeth. As people have begun eating more sucrose, bacteria in the genus Streptococcus have become more prevalent in the mouth. These bacteria are able to bind to the saliva proteins that coat the enamel surface. As more Streptococcus bind to the enamel, other bacterial species are able to bind to the Streptococcus.
This forms an increasingly thick biofilm.An oral biofilm is a deposit of dense, gelatinous material composed of salivary proteins, trapped food debris, and enormous numbers of bacterial cells. This is also known as plaque. Inside this plaque biofilm, the Streptococcus ferment sucrose, releasing lactic acid as a byproduct. Dental caries, more commonly known as cavities, are areas of tooth decay caused by the acidic byproducts of microbial metabolism.
Currently, the best way to prevent dental caries is regular brushing and flossing, limiting sucrose consumption, and making regular trips to the dentist.
Upon finishing this video lesson, students should be able to:
- Describe the benefits of having a diverse population of bacteria in the mouth
- Explain what prevented cavities in ancient humans
- Name the sugar that was widely consumed after the Industrial Revolution and the bacteria that it feeds
- Explain how oral biofilms, or plaque, forms
- Define dental caries and understand how Streptococcus and the lactic acid that it produces contribute to their formation
- Summarize the characteristics and complications of periodontal disease
- Describe two examples of vaccines that could prevent cavities
- Name some proven ways to prevent cavities