Microbial Populations Growing in the Presence of Fluoride at Low pH Isolated from Dental Plaque of Children Living in an Area with Fluoridated Water

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Abstract
Longitudinal microbiological examinations have been made of dental plaque from a site approximal to the upper central incisors of 10 8-year-old children living in an area with water fluoridation. Differential counts of viable bacteria, made using a selective medium containing various levels of fluoride (0 to 100 μg/ml) at pH levels of 7.0 to 5.5, demonstrated an effect of both pH and fluoride on the numbers and types of bacteria isolated. Strains of Streptococcus and Neisseria grew after only 16 h of incubation at pH levels as low as 6.0 with fluoride levels up to 50 μg/ml. The most commonly isolated streptococci were Streptococcus mitior and S. salivarius. S. mutans was isolated less frequently and was inhibited by 20 and 50 μg of fluoride per ml at pH 6.0 and 6.5, respectively. Veillonella strains were the most resistant isolates, being isolated after 16 h of incubation on media at pH 6.0 with 100 μg of fluoride per ml. Despite their known fluoride resistance, Actinomyces spp. were often only detected on the selective media after 72 h of incubation. The pH of the medium had a definite selective effect, as the number of colonies growing on the fluoride-free basal media at pH 6.0 was only 30% of that at pH 7.0. Representative strains of S. mutans, S. mitior, S. sanguis, and S. milleri were tested for their ability to utilize glucose at the pH and fluoride levels of the medium on which they were initially isolated. Fluoride reduced the initial glycolytic rate of the cells, but in 5 of the 13 strains tested the final amount of glucose used after 2 h of incubation was the same in the presence or absence of fluoride. The isolation of bacteria capable of growth in the presence of fluoride over a significant portion of the pH range that occurs in plaque in vivo could explain in part the finding that fluoride does not have a dramatic effect on the plaque community. Fluoride in plaque may reduce the ecological advantage afforded to aciduric S. mutans strains by carbohydrate substances. In the in vivo situation this could mean that, even with high carbohydrate intake, fluoride may permit S. mitior to compete with S. mutans within the plaque ecosystem.