Streptococcus mutans and Lactobacillus detection in the assessment of dental root surface caries risk.

Forty-five subjects contributing 150 root surfaces with gingival recession were sampled seven times over a 32-month period. We calculated isolation frequencies of lactobacilli on selective Rogosa SL agar and S. mutans in a sensitive enrichment broth and on mitis salivarius agar. Both S. mutans and lactobacilli were isolated more frequently from surfaces which became carious than from those remaining caries-free. Isolation frequencies were also higher for caries-free surfaces in caries-active subjects than for caries-free surfaces in caries-inactive subjects. The presence or absence of S. mutans and lactobacilli in samples taken at baseline could discriminate between subjects who were to be root-caries-active and those who were to remain root-caries-inactive during the subsequent observation period. Moreover, if both bacteria were detected or only S. mutans was detected on a root surface at its entry into the study, that surface had a greater risk for developing a root lesion. However, the tests could not predict which root surfaces within the mouths of caries-active subjects were to become carious. Analysis of the data suggests that simple microbiological detection tests may be useful in identifying patients at high risk of root caries.