Recolonization of human tooth surfaces by Streptococcus mutans after suppression by chlorhexidine treatment

In eight subjects who were initially highly colonized with Streptococcus mutans and who used a 1% chlorhexidine gel, the numbers of this organism were suppressed in both plaque and saliva. Bacterial plaque samples were obtained from all tooth surfaces, and the recolonization pattern of S. mutans was studied over a 26-week period. At baseline, 83% of all surfaces harbored S. mutans with buccal surfaces colonized in higher frequency than the others. After chlorhexidine treatment, the proportion of tooth surfaces colonized by S. mutans was reduced to a low level. Re-appearance was slow. S. mutans was first recovered from the most posterior teeth in the mouth, the molar surfaces were recolonized earlier than were those of pre-molars and anterior teeth, and the buccal surfaces were recolonized more readily than were the other tooth surfaces. The data show that there is a specific recolonization pattern of S. mutans after chlorhexidine treatment, and that the re-emergence of S. mutans is most probably due to regrowth of bacteria which have not been eradicated.