Developing a System for Antibacterial Treatment of Dental Caries using Culture Based Approach

Problem statement: Dental caries is a chronic disease worldwide, caused mainly by microbes. The orthograde approaches still remain the only option of treatment. Lack of rapid antibiotic sensitivity determination of the dental pathogen is a rate limiting step in the field of Dental Microbiology. Approach: The culture dependent analysis was used for the study of oral microflora from five healthy individuals as well as three caries infected buccal cavity (one with pit and fissure caries and two with smooth surface caries). Results: The study revealed 10¹-10⁶ times higher bacterial count in healthy buccal cavity. The molecular community analysis mostly revealed Klebsiella sp, Staphylococcus sp, Bacillius sp., Streptococcus sp. and Granulicatella sp in caries infected samples. Microbial isolates from surface caries of one of the subjects (DS5 and DS6) showed resistance to most of the drugs except Polymyxin B, while Ampicillin resistance was common for all. Most of the consortia from both the healthy and infected individuals’ revealed presence of plasmids. Two step cultivation based antibiotic sensitivity detection gave consistent result within 18-20 h as opposed to the conventional 48-72 h. A model for oral application of antibiotic to tooth surface was worked out to inhibit demineralization. Conclusion/Recommendation: This study reports a rapid antibiotic sensitivity detection system for selection of treatment regime. It also proposes a model antibiotic applicator for treatment of surface caries. Detection of antibiotic sensitivity before administration of antibiotic can prevent misuse of antibiotic therapy leading to enhancement of multi drug resistance. The therapy conducted on the basis of the sensitivity data can prevent the demineralization and escaping of the isolates into the blood stream during tooth extraction.