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Clinical Oral Investigations

, Volume 11, Issue 4, pp 415–423 | Cite as

Supra-gingival microbiota in Sjögren’s syndrome

  • K. C. M. Leung
  • W. K. Leung
  • A. S. McMillan
Original Article

Abstract

The aim of this study was to investigate the microbiota of noncaries associated supra-gingival plaque (SGP) microbiology in Sjögren’s syndrome (SS). Stimulated whole saliva (SWS) and full-mouth SGP on intact tooth surfaces were collected from 26 primary (p) SS, 27 secondary (s) SS, and 29 control subjects for selective culture of lactobacilli, mutans streptococci, and aerobic and facultatively anaerobic gram-negative rods (AGNR). Predominant cultivable anaerobes from SGP of 11 randomly selected subjects from each group were investigated. Clinical and sialometric data were also collected. SS sufferers had significantly lower SWS flow rate and higher mean DMFT (decayed, missing, filled teeth), while pSS subjects also had lower SWS pH and fewer standing teeth. Lactobacillus acidophilus levels in SWS (P = 0.012) and SGP (P < 0.0001) were significantly elevated in pSS sufferers compared with sSS individuals and controls. AGNR isolation was uncommon. SS sufferers had significantly lower proportion of gram-negative species (P = 0.047). Non-oral species were isolated in greater proportions from pSS SGP (P = 0.007). Subjects with pSS harbored increased levels of L. acidophilus and non-oral species, while SS sufferers generally had lower proportions of gram-negative species. The microbial composition of noncaries associated SGP indicates a potential source of increased caries risk in SS.

Keywords

Saliva Sjögren’s syndrome Dental plaque Xerostomia Microorganism 

Notes

Acknowledgment

This study was funded by Committee on Research and Conference Grants 10202569 (WKL) and 10203765 (KCML) from the University of Hong Kong.

References

  1. 1.
    Abraham CM, al-Hashimi I, Haghighat N (1998) Evaluation of the levels of oral Candida in patients with Sjögren’s syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endo 86:65–68CrossRefGoogle Scholar
  2. 2.
    Almståhl A, Wikström M, Kroneld U (2001) Microflora in oral ecosystems in primary Sjögren’s syndrome. J Rheumatol 28:1007–1013PubMedGoogle Scholar
  3. 3.
    Almståhl A, Wikström M, Stenberg I, Jakobsson A, Fagerberg-Mohlin B (2003) Oral microbiota associated with hyposalivation of different origins. Oral Microbiol Immunol 18:1–8CrossRefGoogle Scholar
  4. 4.
    Baudet-Pommel M, Albuisson E, Kemeny JL, Falvard F, Ristori JM, Fraysse MP, Sauvezie B (1994) Early dental loss in Sjögren’s syndrome. Histologic correlates. European Community Study Group on Diagnostic Criteria for Sjögren’s syndrome (EEC COMAC). Oral Surg Oral Med Oral Pathol 78:181–186PubMedCrossRefGoogle Scholar
  5. 5.
    Bratthall D, Hänsel Petersson G (2005) Cariogram- a multifactorial risk assessment model for a multifactorial disease. Community Dent Oral Epidemiol 33:256–264PubMedCrossRefGoogle Scholar
  6. 6.
    Carlsson P, Olsson B, Bratthall D (1985) The relationship between the bacterium Streptococcus mutans in the saliva and dental caries in children in Mozambique. Arch Oral Biol 30:265–268PubMedCrossRefGoogle Scholar
  7. 7.
    Crossner C (1981) Salivary lactobacillus counts in the prediction of caries activity. Community Dent Oral Epidemiol 9:182–190PubMedCrossRefGoogle Scholar
  8. 8.
    Çelenligil H, Eratalay K, Kansu E, Ebersole J (1998) Periodontal status and serum antibody responses to oral micro-organisms in Sjögren’s syndrome. J Periodontol 69:571–577PubMedGoogle Scholar
  9. 9.
    Featherstone JD, Adair SM, Anderson MH, Berkowitz RJ, Bird WF, Crall JJ, Den Besten PK, Donly KJ, Glassman P, Milgrom P et al (2003) Caries management by risk assessment: consensus statement, April 2002. J Calif Dent Assoc 31:257–269PubMedGoogle Scholar
  10. 10.
    Gold OG, Jordan HV, van Houte J (1973) A selective medium for Streptococcus mutans. Arch Oral Biol 18:1357–1364PubMedCrossRefGoogle Scholar
  11. 11.
    Gomes BP, Lilley JD, Drucker DB (1996) Associations of endodontic symptoms and signs with particular combinations of specific bacteria. Int Endod J 29:69–75PubMedCrossRefGoogle Scholar
  12. 12.
    Greene J, Vermillion JR (1960) Oral hygiene index. J Am Dent Assoc 61:172–179Google Scholar
  13. 13.
    Kindelan SA, Yeoman CM, Douglas CWI, Franklin C (1998) A comparison of intraoral Candida carriage in Sjögren’s syndrome patients with healthy xerostomic controls. Oral Surg Oral Med Oral Pathol Oral Radiol Endo 85:162–167CrossRefGoogle Scholar
  14. 14.
    Kolavic SA, Gibson G, Al-Hashimi I, Guo IY (1997) The level of cariogenic micro-organisms in patients with Sjögren’s syndrome. Spec Care Dent 17:65–69Google Scholar
  15. 15.
    Kuru B, McCullough MJ, Yilmaz S, Porter SR (2002) Clinical and microbiological studies of periodontal disease in Sjögren’s syndrome patients. J Clin Periodontol 29:92–102PubMedCrossRefGoogle Scholar
  16. 16.
    Lana M, Ribeiro-Sobrinho A, Stehling R, Garcia GD, Silva BKC, Hamdan JS, Nicoli JR, Carvalho MAR, Farias Lde M (2001) Microorganisms isolated from root canals presenting necrotic pulp and their drug susceptibility in vitro. Oral Microbiol Immunol 16:100–105PubMedCrossRefGoogle Scholar
  17. 17.
    Leung KCM, McMillan AS, Leung WK, Wong MCM, Lau CS, Mok TMY (2004) Oral health condition and saliva flow in southern Chinese with Sjögren’s syndrome. Int Dent J 54:159–165PubMedGoogle Scholar
  18. 18.
    Leung KCM, McMillan AS, Cheung BPK, Leung WK (2007). Sjögren’s syndrome sufferers have increased oral yeast levels despite regular dental care. Oral Dis published online (DOI  10.1111/j.1601-0825.2007.01368.x)
  19. 19.
    Leung WK, Jin LJ, Samaranayake LP, Chiu GKC (1998) Subgingival microbiota of shallow periodontal pockets in individuals after head and neck irradiation. Oral Microbiol Immunol 13:1–10PubMedCrossRefGoogle Scholar
  20. 20.
    Leung WK, Jin LJ, Yam WC, Samaranayake LP (2001) Oral colonization of aerobic and facultatively anaerobic gram-negative rods and cocci in irradiated, dentate, xerostomic individuals. Oral Microbiol Immunol 16:1–9PubMedCrossRefGoogle Scholar
  21. 21.
    Leung WK, Yau JY, Cheung BP Jin LJ, Zee KY, Lo EC, Samaranayake LP, Corbet EF (2003) Oral colonization of aerobic and facultatively anaerobic gram-negative rods and yeasts in Tibetans living in Lhasa. Arch Oral Biol 48:117–123PubMedCrossRefGoogle Scholar
  22. 22.
    Leung WK, Jin L, Yau JYY, Sun Q, Corbet EF (2005) Microflora cultivable from minocycline strips placed in persisting periodontal pockets. Arch Oral Biol 50:39–48PubMedCrossRefGoogle Scholar
  23. 23.
    Loesche W, Schork A, Terpenning M, Chen Y, Stoll J (1995) Factors which influence levels of selected organisms in saliva of older individuals. J Clin Microbiol 33:2550–2557PubMedGoogle Scholar
  24. 24.
    Lundström IMC, Lindström FD (1995) Subjective and clinical oral symptoms in patients with primary Sjögren’s syndrome. Clin Exp Rheumatol 13:725–731PubMedGoogle Scholar
  25. 25.
    MacFarlane TW, Mason DK (1974) Changes in the oral flora in Sjögren’s syndrome. J Clin Path 27:416–419PubMedCrossRefGoogle Scholar
  26. 26.
    MacFarlane TW (1984) The oral ecology of patients with severe Sjögren’s syndrome. Microbios 41:99–106PubMedGoogle Scholar
  27. 27.
    Marsh PD (1994) Microbial ecology of dental plaque and its significance in health and disease. Adv Dent Res 8:263–271PubMedGoogle Scholar
  28. 28.
    Mavragani CP, Moutsopoulos NM, Moutsopoulos HM (2006) The management of Sjögren’s syndrome. Nat Clin Pract Rheumatol 2:252–261PubMedCrossRefGoogle Scholar
  29. 29.
    McMillan AS, Leung KCM, Leung WK, Wong MCM, Lau CS, Mok TMY (2004) Impact of Sjögren’s syndrome on oral health-related quality of life in southern Chinese. J Oral Rehabil 31:653–659PubMedCrossRefGoogle Scholar
  30. 30.
    Ng SKS, Leung WK (2006) A community study on the relationship between stress, coping, affective dispositions and periodontal attachment loss. Community Dent Oral Epidemiol 34:252–266PubMedCrossRefGoogle Scholar
  31. 31.
    Pedersen AM, Reibel J, Nordgarden H, Bergem HO, Jensen JL, Nauntofte B (1999) Primary Sjögren’s syndrome: salivary gland function and clinical oral findings. Oral Dis 5:128–138PubMedCrossRefGoogle Scholar
  32. 32.
    Rogosa M, Mitchell JA, Wiseman RF (1951) A selective medium for the isolation and enumeration of oral lactobacilli. J Dent Res 30:682–689PubMedGoogle Scholar
  33. 33.
    Silness J, Löe H (1964) Periodontal disease in pregnancy: II correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135PubMedCrossRefGoogle Scholar
  34. 34.
    Syed SA, Loesche WJ (1972) Survival of human dental plaque flora in various transport media. Appl Microbiol 24:638–644PubMedGoogle Scholar
  35. 35.
    Thomas E, Hay E, Hajeer A, Silman A (1998) Sjögren’s syndrome: a community-based study of prevalence and impact. Br J Rheumatol 37:1069–1076PubMedCrossRefGoogle Scholar
  36. 36.
    Tsang CSP, Samaranayake LP (2001) Predominant cultivable subgingival microbiota of healthy and HIV-infected ethnic Chinese. APMIS 109:117–126PubMedCrossRefGoogle Scholar
  37. 37.
    van Houte J (1994) Role of micro-organisms in caries etiology. J Dent Res 73:672–681PubMedGoogle Scholar
  38. 38.
    Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS et al (2002) Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61:554–558PubMedCrossRefGoogle Scholar
  39. 39.
    World Health Organization (1997) Oral health surveys. Basic methods, 4th edn. WHO, GenevaGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • K. C. M. Leung
    • 1
  • W. K. Leung
    • 2
  • A. S. McMillan
    • 1
  1. 1.Oral Rehabilitation, Faculty of DentistryThe University of Hong KongHong Kong SARChina
  2. 2.Periodontology, Faculty of DentistryThe University of Hong KongHong Kong SARChina

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