Prevora Blog

A family dentist recently asked if caries originates when the mother cross-infects her young infant with Streptococci mutans, would adults cross infect others who had been treated with Prevora, and thereby negate the prevention of this treatment? Here is what the studies indicate:

1. Two studies have shown that cross-infection can occur after the early childhood. A Finnish study found that 2 of 4 married couples shared the same sero- and ribotypes of S. mutans.[1] A Dutch study found that 2 out of 12 families (father, mother, child over 5 years of age) harbored strains of mutans streptococci with a similar profile.[2]

2. On the other hand, two Swedish reports show that cross-infection between adults is difficult. On study found that none of the individuals in 13 pairs of couples had identical genotypes of mutans streptococci.[3] A similar study found that few spouses amongst a group of 25 Swedish pairs and 11 Chinese pairs acquired mutans streptococci from each other over a period of 2 to 5 years.[4]

3. The literature does show that the composition of dental plaques over several years remain remarkably stable despite the fact that new species are continually being introduced into the oral cavity and indigenous microbes are repeatedly being removed by oral hygiene procedures.[5] This stability is attributed to the characteristics of the biofilm, a complex web of many different microorganisms which serves to prolong vitality and mortality. It has been shown that the biofilm on the tooth surface re-emerges rapidly after brushing and flossing; this is partly due to the difficulty of cleaning the tooth surface – even after careful oral hygiene technique, there are still approximately 10⁶ bacteria per mm² adhering to the enamel.[6] At the root surface, the residual biofilm after cleaning is also substantial; for example, a professional debridement of the root surface can remove about 99% of viable bacteria, but about 10⁵ cfu remain the tubules, surface indentations or adjacent soft tissue. Recolonization of the root surface then occurs and viable counts can reach pre-treatment values within 3 to 7 days.[7]

So what does this evidence mean for Prevora and the opportunity for re-infection within a couple or a family after treatment? It would appear that while cross-infection is possible, it is unlikely between adults. Cross-infection may happen, moreover, immediately following a dental cleaning, not just Prevora. Without Prevora, the patient’s risks are clearly heightened for (more) root caries. Withholding Prevora treatment because of some unlikely event of cross-infection, seems to raise the risks un-necessarily. Perhaps another strategy could be considered: have both spouses treated.

Ross Perry

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