Microbiology of root surface caries in humans

Studies on the microbiology of root surface caries between 1970 and 1975 placed emphasis on Gram-positive pleomorphic filamentous rods, particularly Actinomyces viscosus and Actinomyces naeslundii. Both of these species had been shown to produce root surface caries in experimental animals. Since this time, studies have placed more emphasis on Streptococcus mutans, and S. mutans and Lactobacillus are significant in prediction of root surface caries risk in patients. Subsequent studies confirmed an association between S. mutans and 'soft' or 'initial' root lesions. Thus, it is important when determining the microflora of root surface lesions to make careful characterization of the state of the lesion. A second important aspect of the analysis of bacterial communities associated with root surface caries is better definition of the organisms. Most studies have concentrated on 'target organisms' S. mutans, S. sanguis, A. viscosus, A. naeslundii, Lactobacillus, and Veillonella. However, it has been known for 17 years that the Actinomyces associated with the lesions may be variants of A. viscosus and A. naeslundii. Such strains (intermediate strains) have been described in taxonomic studies of Actinomyces, yet little is known of the differences in physiology of these strains or their relationship to root surface caries. A similar situation exists with oral Streptococcus where new taxonomic divisions are being proposed. Recognition of the potential diversity within the 'target' genera of root surface caries could yield valuable data. Recent studies suggest that this is so, since samples from root surface lesions which contain S. mutans and Lactobacillus show a high isolation of S. mitis 1 and no isolations of A. naeslundii. Careful definition of the lesions of root surface caries and the flora will allow analysis to relate a specific bacterial community to the state fo the lesion and assist in monitoring the control of the lesion through fluoride and antibacterials.