{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:39:48Z","timestamp":1786649988311,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objective:<\/jats:title>\n                    <jats:p>\n                      Worldwide, dental caries is an endemic infection and a significant public health problem. Fluoride reduces caries by helping to prevent demineralisation, by remineralising early carious lesions, and by decreasing the activity and growth of\n                      <jats:italic toggle=\"yes\">Streptococcus mutans (S. mutans)<\/jats:italic>\n                      . Fluoride intake above the optimal levels leads to a condition known as dental fluorosis, which causes hypo-mineralisation of the tooth. Some studies have revealed that the severity of fluorosis is directly proportional to caries, but some showed opposite results. Hence, with these contradicting results, this study was undertaken to identify the relationship between different grades of dental fluorosis, dental caries and the most common cariogenic bacteria\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .\n                      <jats:italic toggle=\"yes\">mutans<\/jats:italic>\n                      in saliva.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 90 subjects within 14- to 16-year age range were selected and categorised depending on the severity of fluorosis into three groups: group I (mild), group II (moderate) and group III (severe) based on modified Dean\u2019s fluorosis index criteria (1942). Unstimulated whole saliva samples were collected using the oral rinse technique and processed for quantification of\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .\n                      <jats:italic toggle=\"yes\">mutans<\/jats:italic>\n                      using Mitis Salivarius Bacitracin Agar medium. The number of colony-forming units (CFUs) was determined using a colony counter and expressed as \u226510\n                      <jats:sup>2<\/jats:sup>\n                      , \u226510\n                      <jats:sup>3<\/jats:sup>\n                      , \u226510\n                      <jats:sup>4<\/jats:sup>\n                      and \u226510\n                      <jats:sup>5<\/jats:sup>\n                      CFUs per ml of the sample, in accordance with the scale recommended by the manufacturer (HiMedia Laboratories). The severity of the caries was measured using decayed, missing or filled teeth (DMFT).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Observations revealed that the overall DMFT was directly proportional to the level of\n                      <jats:italic toggle=\"yes\">S. mutans<\/jats:italic>\n                      titres. It was observed that 67 to 73% of participants showed fewer colony counts (10\n                      <jats:sup>2<\/jats:sup>\n                      and 10\n                      <jats:sup>3<\/jats:sup>\n                      ) with minimal DMFT scores and 27 to 33% showed higher counts (10\n                      <jats:sup>4<\/jats:sup>\n                      and 10\n                      <jats:sup>5<\/jats:sup>\n                      ) with higher DMFT scores in all the groups. 10\n                      <jats:sup>5<\/jats:sup>\n                      CFUs of group III showed the highest mean DMFT scores (2.9) with an increased number of involved subjects than group II (2.3) and group I (1.5). In all, male participants had higher bacterial titres and DMFT scores than females.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Fluoride in the drinking water served as anticariogenic agent regardless of the severity of fluorosis. Severe fluorosis with a higher incidence of caries and increased CFUs of S.\n                      <jats:italic toggle=\"yes\">mutans<\/jats:italic>\n                      clearly indicates the importance of preventive measures and early treatment to reduce the severity of fluorosis and prevalence of dental caries.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jomfp.jomfp_59_23","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T19:54:03Z","timestamp":1725652443000},"page":"603-604","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Relationship between dental fluorosis, dental caries and salivary levels of Streptococcus mutans"],"prefix":"10.4103","volume":"27","author":[{"given":"Neeharika","family":"Ravuru","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Pathology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. Ajay","family":"Reginald","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Pathology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basireddy Siva","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Pathology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meda","family":"Samatha","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Pathology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"R1-20240906","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1590\/S1415-790X2013000400022","article-title":"Dental caries and endemic dental fluorosis in rural communities, Minas Gerais, Brazil","volume":"16","author":"Simone","year":"2013","journal-title":"Rev Bras Epidemiol"},{"key":"R2-20240906","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1177\/00220345900690S128","article-title":"Biochemical effects of fluoride on oral bacteria","volume":"69","author":"Hamilton","year":"1990","journal-title":"J Dent Res"},{"key":"R3-20240906","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1139\/m95-133","article-title":"Antimicrobial actions of fluoride for oral bacteria \u2013Review","volume":"41","author":"Marquis","year":"1995","journal-title":"Can J Microbiol"},{"key":"R4-20240906","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1177\/00220345000790021201","article-title":"Relationship among mutans streptococci, \u201clow-pH\u201dbacteria, and lodophilic polysaccharide-producing bacteria in dental plaque and early enamel caries in humans","volume":"79","author":"van Ruyven","year":"2000","journal-title":"J Dent Res"},{"key":"R5-20240906","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1159\/000151326","article-title":"How has genomics altered our view of caries microbiology?","volume":"42","author":"Russell","year":"2008","journal-title":"Caries Res"},{"issue":"Suppl","key":"R6-20240906","doi-asserted-by":"crossref","first-page":"25S","DOI":"10.14219\/jada.archive.2008.0352","article-title":"Maintaining the integrity of the enamel surface:The role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization","volume":"139","author":"Garc\u00eda-Godoy","year":"2008","journal-title":"J Am Dent Assoc"},{"key":"R7-20240906","first-page":"1","volume":"44","year":"1995","journal-title":"MMWR"},{"key":"R8-20240906","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1752-7325.1993.tb02666.x","article-title":"A half-century of community water fluoridation in the United States:Review and commentary","volume":"53","author":"Ripa","year":"1993","journal-title":"J Public Health Dent"},{"issue":"1 Suppl","key":"R10-20240906","first-page":"10","article-title":"The cariostatic mechanism of fluoride","volume":"20","author":"Ogaard","year":"1999","journal-title":"Compend Contin Educ Dent"},{"key":"R11-20240906","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1752-7325.1997.tb02964.x","article-title":"Dental caries and dental fluorosis at varying water fluoride concentrations","volume":"57","author":"Heller","year":"1997","journal-title":"J Public Health Dent"},{"key":"R12-20240906","first-page":"37","article-title":"Dental caries and enamel fluorosis among the fluoridated and non-fluoridated populations in the Republic of Ireland in 2002","volume":"21","author":"Whelton","year":"2004","journal-title":"Community Dent Health"},{"key":"R13-20240906","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1159\/000016504","article-title":"Caries and fluorosis prevalence in communities with different concentrations of fluoride in the water","volume":"33","author":"Angelillo","year":"1999","journal-title":"Caries Res"},{"key":"R14-20240906","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1600-0722.2007.00434.x","article-title":"Dental fluorosis and dental caries among 12-yr-old children from highand low-fluoride areas in Lithuania","volume":"115","author":"Narbutaite`","year":"2007","journal-title":"Eur J Oral Sci"},{"key":"R15-20240906","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/j.1600-0528.1998.tb01920.x","article-title":"Fluorosis in relation to fluoride levels in water in Central Nigeria","volume":"26","author":"El-Nadeef","year":"1998","journal-title":"Community Dent Oral Epidemiol"},{"key":"R16-20240906","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/j.1600-0722.2008.00583.x","article-title":"Caries and dental fluorosis in a western Saharan population of refugee childre","volume":"116","author":"Almerich-Silla","year":"2008","journal-title":"Eur J Oral Sci"},{"key":"R17-20240906","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1046\/j.0960-7439.2001.00293.x","article-title":"Dental fluorosis and caries experience in relation to three different drinking water fluoride levels in South Africa","volume":"11","author":"Grobler","year":"2001","journal-title":"Int J Paediatr Dent"},{"key":"R18-20240906","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/j.1600-0528.1979.tb01185.x","article-title":"Dental findings in high fluoride areas in Ethiopia","volume":"7","author":"Olsson","year":"1979","journal-title":"Community Dent Oral Epidemiol"},{"key":"R19-20240906","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/j.1365-263X.1997.00233.x","article-title":"Caries and dental fluorosis in a 0.25 and a 2.5 ppm fluoride area in Sudan","volume":"7","author":"Ibrahim","year":"1997","journal-title":"Int J Paediatr Dent"},{"key":"R20-20240906","first-page":"244","article-title":"Relationship between dental caries experience (DMFS) and dental fluorosis in 12-year-old Puerto Ricans","volume":"23","author":"El\u00edas-Boneta","year":"2006","journal-title":"Community Dent Health"},{"key":"R21-20240906","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1159\/000066541","article-title":"Dental caries and development defects of enamel in relation to fluoride levels in drinking water in an arid area of Sri Lanka","volume":"36","author":"Ekanayake","year":"2002","journal-title":"Caries Res"}],"container-title":["Journal of Oral and Maxillofacial Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jomfp.jomfp_59_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:00:48Z","timestamp":1786647648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jomfp.jomfp_59_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jomfp.jomfp_59_23","relation":{},"ISSN":["0973-029X","1998-393X"],"issn-type":[{"value":"0973-029X","type":"print"},{"value":"1998-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"2023-02-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}