Effects of Extracellular Plaque Components on the Chlorhexidine Sensitivity of Strains of Streptococcus mutans and Human Dental Plaque

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Abstract
An in vitro study was undertaken to determine the effects of sucrose-derived extracellular plaque components on the sensitivity of selected oral bacteria to chlorhexidine (CX). Cultures of Streptococcus mutans HS-6, OMZ-176, Ingbritt C, 6715-wtl3, and pooled human plaque were grown in trypticase soy media with or without 1 % sucrose. The sensitivity to CX of bacteria grown in each medium was determined by fixed-time exposure to CX and subsequent measurement of 3H-thymidine uptake. One-hour exposure to CX at concentrations of 10-4 M (0.01% w/v) or greater substantially inhibited subsequent cellular division among all the S. mutans strains and human plaque samples tested. An IC50 (the CX concentration which depressed 3H-thymidine incorporation to 50% of control level) of close to 10-4 M was noted for S. mutans strains HS- 6, OMZ-176, and 6715-wt13 when grown in the presence of sucrose. The same strains grown in cultures without added sucrose showed about a ten-fold greater sensitivity to CX (IC50 close to 10 -5 M). A three-fold difference was noted for S. mutans Ingbritt C. Only a slight increase in the IC50 was noted for the plaque samples cultured in sucrose-containing media, but their threshold for depression of 3H-thymidine uptake by CX was lower than that for the sucrose-free plaque samples. The study showed that extracellular products confer some protection against CX to the bacteria examined, and provided an explanation for the disparity between clinically-recommended concentrations for plaque suppression and data on in vitro susceptibility. Also, when compared with similarly-derived indices of susceptibility of mammalian cells to CX, the data obtained give rise to new possibilities for therapeutic use of CX or other bisguanides in dentistry.

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