The Microflora Associated with the Progression of Incipient Carious Lesions in Teeth of Children Living in a Water-Fluoridated Area

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Abstract
Radiographically diagnosed incipient approximal carious lesions in deciduous molar teeth and control sites were sampled microbiologically at 6- or 12-week intervals for at least 12 months. Microbiological findings were related to radiographically diagnosed progression or non-progression of the lesions. Lactobacillus appeared at the site of 85% of progressive lesions before clinical diagnosis of progression was made and was never isolated from non-progressive lesions or control sites. Significant positive associations were detected between Streptococcus mutans, Lactobacillus, Veillonella and Actinomyces odontolyticus and progressive lesions. Singificant negative associations were detected with Streptococcus mitior, Actinomyces naeslundii and Actinomyces viscosus. Comparison of the data from control surfaces in subjects with and without progressive lesions suggested that the former were more highly colonized with S. mutans. The data emphasizes the significance of S. mutans and Lactobacillus in lesion progression and draws attention to a role of A. odontolyticus. The negative association suggests a shift in the flora with a reduction in S. mitior and A. viscosus and A. naeslundii in progressive lesions.