DENTAL CARIES: A DENT ON DOGMA.

PART 1

By

Dr John Gabrovsek

Received: January 1997

 

Dental Caries Part 2 Dental Caries Part 3 Dental Caries Part 4

This scope note on dental caries can be found on Medline and reads as follows:

"Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked,the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disease are that acid produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification."

I would like to ask the one responsible for the above statment: "Is it indeed so that only bacterial enzymes are causing lysis of organic structures leading to cavity formation?"

Those with an interest in the field will know that the oral cavity with mucosa and gingival sulcus is the place with numerous PMNs or neutrophils or oral granulocytes (synonyms) which are loaded with lysosomal enzymes (Jassinowsky 1925) (Chauncey 1961) (Klinkhamer 1963) (Schiott et al,1970)

Researchers from the University of Pennsylvania (Baehni et al,1977) demonstrated in vitro that Streptococcus mutans grown in brain-heart infusion broth did not induce significant lysosome release or demonstrable phagocytic activity by neutrophil leucocytes (PMNs). In contrast however, Streptococcus mutans grown in brain-heart infusion containing sucrose or pre-incubated with anti-Streptococcus mutans antibodies acted as potent triggers of lysosome release and PMN phagocytosis.

Streptococcus mutans together with the sucrose in the oral cavity is the most potent caries inducing infectious agent known, we all agree. We must also agree to the fact that the host derived enzymes are present in the oral cavity and that they may play a role in pathophysiology of dental caries.

And now I would like to ask again: "Can we be absolutely assured that only bacterial enzymes are involved in lysis of organic stucture of the tooth leading to cavity formation in the oral cavity?"The answer is no.

References

Baehni,P,Listgarten,MA,Taichman,NS,McArthur,WP.(1977) Electron microscopic study of the interaction of oral microorganisms with polymorphonuclear leucocytes.Arch.Oral.Biol. 22, 685-692.

Chauncey,HH.(1961) Salivary enzymes. J.Am.Dent.Assos.63,360-367.

Jassinowsky,MA.(1925) Uber die Herkunft der Speichelkorperchen. Frnkf.Zschr.f.Path.31,411-439.

Klinkhamer,JM.(1963) Human oral leucocytes. Periodont.1,109-117.

Schiott,CR,Loe,H.(1970) The origin and variation in number of leucocytes in the human saliva.J.Periodont. Res. 5,36-41.

 


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