Further Studies on the Association Between the Products of Protein Putrefaction and Dental Caries Activity

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Abstract
In a previous publication a hypothesis was advanced that the low incidence of dental caries, particularly of the smooth surface type in endemic pellagrins and persons with chronic nutritional deficiency diseases, could in part be attributed to the products of protein putrefaction since the prevalence of chronic periodontal disease in these patients was exceedingly high. In vitro studies which demonstrated the inhibition of acid production in saliva and the adverse effect on the growth and acid production of a strain of oral Lactobacillus acidophilus of dilute solns. of indole and indole-3-acetic acid were extended in this expt. to include skatole, phenol, cresol, and a salt of putrescine, all products of the bacterial decomposition of proteins. Relatively dilute solns. of skatole, phenol, cresol, and a salt of putrescine partially or completely inhibited acid production in vitro in 81 of the 83 saliva samples. Dilute solns. of some mixtures of these compounds together with indole and indole-3-acedic acid significantly inhibited acid production in vitro in all but one of the 34 saliva samples. The action of these compounds appeared to be additive since they were more effective as inhibitors of acid production in saliva when used in combination than when used alone. In addition, when added in relatively small amts., skatole, phenol, and cresol, singly and in various combinations with indole, indole-3-acetic acid, and a dihydrochloride salt of putrescine, significantly inhibited the growth and acid production of a culture of Lactobacillus acidophilus (Hadley) recovered from a carious lesion. It would appear that the products of protein putrefaction may play a significant role in lessening susceptibility to dental caries.