Translation, adaptation and validation process for the DINA instrument. Derdiarian Information Needs Assessment

The 5-year incidence of dental caries in a random sample of 60-, 70- and 80-year-old inhabitants of Goteborg was related to salivary and microbial conditions. Of the 208 persons examined at baseline, 148 (71%) participated in the follow-up examination; 69, 51 and 28, respectively, in the different age groups. The study revealed that 27% of the participants had not developed any carious lesions during the 5-year period and that the incidence of coronal and root caries increased with age. In the 60-year-olds, 2.5% of the susceptible coronal and root surfaces, respectively, had decayed, while the corresponding figures for the 80-year-olds were 8.8% for coronal surfaces and 9.8% for root surfaces. In all, 18% had an unstimulated saliva secretion rate of below 0.1 ml/min and 14% had a stimulated secretion rate of <0.7 ml/min, with a mean rate which decreased with increasing age from 2.0 to 1.6 and 1.3 ml/min (p = 0.02). The overall salivary counts of lactobacilli and mutans streptococci, particularly the subspecies of Streptococcus sobrinus, had increased during the period. In the respective age groups of 60, 70 and 80 years, 15, 39 and 39% had a mutans streptococci count of > or = 10(6) CFU/ml in saliva and the corresponding figures for > or = 10(5) lactobacilli counts were 22, 31 and 43%. In the stepwise regression analysis, it was found that age, salivary levels of mutans streptococci and lactobacilli and number of teeth were the best predictors of the incidence of root caries. In conclusion, these observations indicate that there is an increased risk of dental caries with age owing to unfavourable microbial and salivary conditions.     

Effect of an enzymatic rinse on salivary levels of Streptococcus mutans and lactobacilli in periodontally treated patients

Root surface caries is prevalent in patients with both treated and untreated periodontal disease. The major etiologic factor has been identified as microbial plaque. In periodontally treated patients, significantly higher root caries prevalence and incidence have been found in patients with high levels of Streptococcus mutans and Lactobacilli in saliva. Reducing the levels of S. mutans and Lactobacilli in saliva may lower the risk of root caries development. The purpose of this investigation was to determine the effect of an oral enzymatic rinse on the salivary counts of S. mutans and Lactobacilli in periodontally treated patients. Fifteen adult subjects participated in a double-blind, cross-over designed clinical trial. Each subject had previously undergone comprehensive periodontal therapy and had been maintained on a regular program of supportive periodontal therapy. Paraffin-stimulated whole saliva was collected from each participant. Each subject was then randomly given either the enzymatic rinse product or a control rinse and instructed to rinse with one tablespoonful twice a day for 2 weeks, after which saliva samples were taken. After a washout period, salivary samples were again taken, and the subjects received the alternate rinse product. Two weeks later, final salivary samples were taken. The salivary samples were serially diluted and incubated aerobically on selective culture media. S. mutans and Lactobacilli were counted on the basis of colonial morphology. Pretreatment and posttreatment salivary counts of S. mutans and Lactobacilli were analyzed using the Wilcoxon matched-pairs signed-rank test at the 5% level of significance. Analysis of data revealed that neither the test nor the control rinse significantly lowered salivary counts of either species in the sample population.     

The effect of antibody to Streptococcus mutans in saliva on caries activity and S. mutans adhering

An indirect enzyme-linked immunosorbent assay (ELISA) was used for measuring IgA antibody to whole cell of Streptococcus mutans (serotype c) in saliva. 36 parotid salivary samples of human were collected from two groups: Caries free (CF) and caries sensitive (CS). The result shows that the IgA antibody to S. mutans in CF group was higher than those in CS group (P < 0.05). The saliva antibody was gained from the rabbits by injection with S. mutans (serotype c), and the adhesion of S. mutans--3H on the surface of hydroxylapatite beads treated by rabbit's saliva was measured. The results show that the saliva with immunity could inhibit the S. mutans to adhere on the HA beads (P < 0.05). It means saliva antibody may prevent caries through inhibition of S. mutans from adhesion.     

Salivary lactobacilli explain dental caries better than salivary mutants streptococci in 4-5-year-old children

The present comparative study was undertaken to determine which of the bacteria, lactobacilli (lbc) and mutans streptococci (ms), in saliva better explains the variation of caries in 2728 South African 4-5-yr-old children. Caries was diagnosed according to WHO criteria. For lbc, the Dentocult system was used. The number of ms in stimulated saliva was counted on MSB agar plates. For correction of confounding factors, data on the frequency of intake of sweets were derived from extensive interviews. Oral hygiene was determined according to the simplified debris index of Greene & Vermillion. Simple correlation analyses between dmfs and bacterial counts were done for the total material and for three caries intervals by calculating Spearman's and Pearson's coefficients of correlation. Multivariate regression analyses were done on all intervals to correct for the confounding effects of regular intake of sweets, presence of salivary ms or lbc, and oral hygiene. Of the children, 68% had detectable lbc in the saliva, and 74% had ms. Except for children with more than 6 dmfs, the explanatory values, i.e., percentage of variation in dmfs explained, were higher for the lbc than for ms. Before correction, the values for the total material were 15 vs 6%; for children with caries, 7 vs 5%; for those with 1-6 dmfs, 5 vs 0.4%; and for those with more than 6 dmfs, 0.3 vs 2%. All r-values were reduced after correction, indicating that the confounders explain some of the correlation between dmfs and bacterial count.(ABSTRACT TRUNCATED AT 250 WORDS)     

The relationship of dental calculus to caries, gingivitis, and selected salivary factors in 11- to 13-year-old children in Chiang Mai, Thailand

Thai children have been shown to accumulate large amounts of dental calculus. The purpose of this study was to examine the relationship of calculus to caries and gingivitis, and salivary conditions which may contribute to calculus accumulation. Four-hundred and thirty-nine (439) children from 18 schools in Chiang Mai were selected for this study. The children were given oral examinations to determine calculus index (CI); decayed, missing, and filled surfaces (DMFS); decayed, missing, and filled teeth (DMFT); gingival index (GI); and plaque index (PI). Children with mean CI scores > or =1 (206) were assigned to the calculus group; the 233 children with mean CI scores of <1 to the noncalculus group. Saliva was collected from 60 randomly-selected children in each group. Unstimulated and stimulated whole saliva and stimulated parotid saliva were assessed for flow rate, pH, and buffer capacity using 2 methods. Results showed that calculus status was not significantly associated with caries, but that there was a high association between gingivitis and plaque status with calculus accumulation (P < 0.001). There were no significant differences in saliva flow rate, pH, or buffer capacity between calculus and noncalculus groups. The lack of association between calculus status and caries indicated these 2 conditions have different etiologies and suggests the importance of plaque and calculus prevention programs, in addition to caries control efforts, to maintain oral health of Thai children.     

Assessment of salivary Lactobacillus and Streptococcus mutans counts following sodium fluoride mouthrinsing in Egyptian children

The salivary Lactobacillus and Streptococcus mutans counts were assessed in 100 Egyptian children, initially before mouthrinsing with 0.05% sodium fluoride solution, 24 hours and 48 hours following rinsing. A statistically significant reduction in Lactobacillus and Streptococcus mutans counts of 49% and 44% respectively was obtained 24 hours following rinsing. This percentage decrease in both bacterial counts was reduced to 27% and 31% respectively, 48 hours following rinsing.     

Inverse correlation between the proportion of salivary bacteria inhibiting Streptococcus mutans and the percentage of untreated carious teeth

To evaluate the role of inhibitory substances produced by bacteria in the oral cavity, we estimated, by a deferred test on Todd-Hewitt agar enriched with hemin and vitamin K, the proportion of bacteria that inhibited or stimulated the growth of Streptococcus mutans and Porphyromonas gingivalis, from the saliva of 109 patients (54 males and 55 females) attending our dental clinics. The patients, aged from 8 to 75 years old (mean: 31 +/- 18 years), were randomly selected whatever the reason for their visit. The results, evaluated with the Spearman rank test, indicated that there was no statistically significant (P > 0.05) correlation between the proportion of salivary bacteria inhibiting or stimulating P. gingivalis with the Community Periodontal Index of Treatment Needs (CPITN), the number of carious, missing and filled teeth, or with the decayed, missing and filled teeth index (DMFT). Also, no statistically significant correlation was observed between the proportion of salivary bacteria stimulating the growth of S. mutans and the above mentioned health indexes. However, a statistically significant (P < 0.005) negative correlation was found between the percentage of cultivated bacteria that inhibit S. mutans and the percentage of untreated carious teeth as well as with the CPITN. The results thus indicate a possible role for inhibitory substances produced by bacteria in the maintenance of oral health.     

Effect of Cervitec varnish on the salivary Streptococcus mutans levels in the patients with fixed orthodontic appliances

The aim of the present study was to assess the efficiency of a 1% chlorhexidine-containing varnish (Cervitec, Vivadent, Liechtenstein) on the levels of Streptococcus mutans in saliva of patients with fixed orthodontic appliances using the Dentocult-SM (Vivadent, Liechtenstein) technique for the microbiological investigation. Eighty subjects participated in the study and, divided randomly into two equal groups in which one group was treated with the placebo varnish (Vivadent, Liechtenstein) for negative controls. Streptococcus mutans in saliva of the subject was sampled and enumerated by using the Dentocult-SM dip-slide technique for periods of one, two four and twelve weeks after a single varnish application. The results were evaluated statistically. After the chlorhexidine containing varnish treatment the levels of Streptococcus mutans in saliva were significantly reduced after one week (p < 0.01) and continued reduction for one month (p < 0.05). After twelve weeks Streptococcus mutans levels in saliva were given a relative increase. No significant suppression was found in the placebo group (p > 0.05). The results suggested that Cervitec varnish reduces salivary Streptococcus mutans levels and that the application should be repeated every 3 months to get antibacterial effect.     

Cariogenicity depends more on diet than the prevailing mutans streptococcal species

This review aims to compare the occurrence and distribution of mutans streptococci in Africa, Europe, and North America and in addition will try to offer explanations for existing relationships among salivary mutans streptococci counts, dietary patterns, and dental caries. The literature reveals that salivary mutans streptococci counts in child populations of the three continents are comparable. The distribution of mutans streptococci species, with a predominance of S. mutans followed by S. sobrinus, and the virtual absence of other mutans streptococci species are also comparable. Although it is widely believed that diet has an important effect on mutans streptococci counts, this review provides evidence that this does not hold true when variations in dietary patterns are moderate, as they normally are in real-life situations. Since the diets of the child populations in the three continents vary moderately, a strong dietary-induced effect on salivary mutans streptococci counts cannot be expected. The observed analogous salivary mutans streptococci counts in these child populations are thus 'not surprising' but are in accordance with the conceptual expectation. The differences in caries experience in children of the three continents cannot be explained by the prevailing mutans streptococci species but instead should be attributed to differences in the cariogenicity of the various diets. The fact that the cariogenicity of the diet determines the development of dental caries while hardly affecting the mutans streptococci counts explains the limited value of the latter as an indicator of dental caries. The reviewed literature shows that mutans streptococci are ubiquitous in children aged 7 years and older in Africa, Europe, and North America. Mutans streptococci should therefore be considered as belonging to the indigenous microflora of the human mouth.     

Influence of salivary components and extracellular polysaccharide synthesis from sucrose on the attachment of Streptococcus mutans 6715 to hydroxyapatite surfaces

The adsorption of (3)H-labeled Streptococcus mutans 6715 cells to disks of hydroxyapatite (HA) was studied. The number of streptococci that adsorbed was logarithmically related to the concentration of cells available up to at least 2 x 10(8) per ml; equilibrium occurred within 45 min. Assay reliability was verified by direct scanning electron microscopic counts. Untreated HA disks exposed to buffered saline (PBS)-suspended streptococci at a concentration of 1.1 x 10(8) per ml absorbed 3.2 x 10(6) cells per cm(2); approximately 3% of the surface area was, therefore, occupied by adsorbed organisms. The presence of adsorbed salivary components on HA reduced the number of attaching S. mutans cells by half. When S. mutans cells were suspended in saliva to mimic conditions existing in the mouth, the number of streptococci adsorbing to saliva-treated HA was reduced more than 30-fold compared to untreated HA. Approximately one-half of the streptococci adsorbed to untreated or to saliva-treated HA disks could be desorbed over a 4-h period with 0.067 M phosphate buffer. S. mutans cells exposed to sucrose to permit extracellular polysaccharide synthesis before or during adsorption attached in fewer numbers to both saliva-treated and untreated HA than PBS-treated organisms. When S. mutans cells adsorbed on untreated HA were exposed to sucrose, fewer organisms could be desorbed; thus, in situ polysaccharide synthesis promoted their more firm attachment to untreated HA. However, when saliva-suspended streptococci were adsorbed to saliva-treated HA surfaces, exposure to sucrose before or subsequent to adsorption did not promote more firm attachment. Evidently, the powerful adherence-inhibiting and desorptive effects of salivary components overshadowed any promoting effects attributable to glucan synthesis from sucrose. Similarly, no differences were noted in the desorption of S. mutans cells from human teeth after exposure to sucrose, glucose, or PBS relative to a strain of Streptococcus mitis (S. mitior). Thus, no evidence was obtained to support the hypothesis that glucan synthesis from sucrose was essential for, or promoted, the attachment of S. mutans cells to HA surfaces exposed to saliva or to the smooth surfaces of human teeth.     

Association between mother-infant salivary contacts and caries resistance in children: a cohort study

We selected 327 7-month-old infants and divided them into two groups based on the frequency of salivary close contacts between mother and infant. Five to seven years later, all first-born children (N = 55) whose dental development had been followed regularly, were examined for dental caries and prevalence of salivary mutans streptococci (MS) and lactobacilli. The children with frequent maternal close contacts (F group, N = 21) had significantly less MS in saliva than the children with rare close contacts (R group, N = 34, P = 0.02). Only 19% of the children in F group compared with 56% in R group had experienced caries in their primary molars and/or canines (P < 0.01). A significantly greater proportion of the children in F group (57%) than in R group (27%, P < 0.05) had a high intake of sugar-containing foods and drinks in a 2-day dietary history. The F and R groups did not differ significantly with respect to other children's caries risk factors, or in age, sex, stage of dental development, dental treatment, or the social aspects studied. There were no significant differences between F and R groups in maternal caries experience, salivary MS or lactobacillus counts, or in maternal background factors (age, breast feeding, or education). Frequent transfer of maternal saliva to the mouth of the baby before tooth eruption was negatively associated with oral infection by MS and to caries in the primary dentition, possibly due to protective immune mechanisms.     

Occult breast cancer causing axillary metastasis

Orthodontic bands form retention areas which create favourable conditions for growth of lactobacilli. This study deals with the numbers and specific species of lactobacilli in the oral cavity of teenage orthodontic patients. High numbers of lactobacilli were obtained (log 6.398 +/- 0.761 cfu/ml) and the buffer capacity of saliva indicated a high caries risk amongst these individuals but the actual DMFT values were relatively low. Homofermentative lactobacilli predominated in both plaque and saliva and particularly L. salivarius and L. casei. These two lactobacilli species indicated that these patients are at a high caries risk. Several other homofermentative and heterofermentative lactobacilli were isolated which indicated the complexity of the oral lactobacilli community in saliva and plaque.     

Effects of a 12-month prophylactic programme on selected oral bacterial populations on root surfaces with active and inactive carious lesions

In 15 caries-active patients, with a total of 770 exposed root surfaces, the effect of fluoride therapy and professional tooth cleaning was studied during a 1-year period. Dental plaque from 92 of the root surfaces and whole saliva samples were analysed at baseline and after 12 months for the presence of specific bacteria. The results showed that the number of active carious lesions had decreased from 99 to 46, while the inactive lesions had increased from 69 to 124. Of the active lesions which had been converted into inactive lesions, most were on the buccal and fewest were located on the distal surfaces. Lower plaque scores were found on sound and inactive root surfaces compared to active surfaces. The salivary concentrations of mutans streptococci and lactobacilli remained constant during the 12-month observation period. There was a tendency for higher levels of Streptococcus mutans in plaque from active lesions compared with sound root surfaces, whereas an inverse relationship was noted for the Streptococcus oralis group. No significant differences in the Actinomyces naeslundii counts were detected. In conclusion, the 12-month prophylactic programme had an effect on the clinical surface characteristics of root caries, but the components of the oral microflora selected for study seemed to be relatively unaffected during the observation period.     

Effective immunity to dental caries: enhancement of salivary anti-Streptococcus mutans antibody responses with oral adjuvants

In the present study, we compared the ability of the soluble adjuvants concanavalin A (ConA), muramyl dipeptide (MDP), and peptidoglycan (PG) to enhance immune responses to orally administered particulate antigens of Streptococcus mutans 6715 in gnotobiotic rats. The isotype and levels of antibody in saliva and in serum from experimental rats were determined by an enzyme-linked immunosorbent assay using S. mutans whole cells (WC) as the coating antigen. The specificities of salivary and serum immunoglobulin A (IgA) antibodies to particulate S. mutans antigens, lipoteichoic acid, S. mutans serotype g carbohydrate, and dextran were also determined. When 50 micrograms of ConA was used as the oral adjuvant with S. mutans 6715 WC immunogen, a slight enhancement of immune responses was obtained. A higher dose of ConA suppressed humoral responses to the immunogen. Enhanced immune responses, especially of the IgA isotype, in both serum and saliva were induced in gnotobiotic rats given MDP and either S. mutans 6715 WC or purified cell walls (CW) by gastric intubation. Elevated IgA antibody levels to CW, lipoteichoic acid, and carbohydrate were observed in rats given S. mutans WC and MDP by gastric intubation, whereas oral immunization with S. mutans CW and MDP resulted in higher antibody levels to CW and carbohydrate and lower levels to lipoteichoic acid when compared with the antibody levels in rats given antigen alone. Rats orally immunized with either S. mutans WC or CW and MDP and challenged with virulent S. mutans 6715 exhibited significantly (P less than or equal to 0.05) lower plaque scores, numbers of viable S. mutans in plaque, and caries scores than did rats immunized with antigen alone or in infected-only controls. In another series of experiments, a PG fraction derived from S. mutans 6715 CW was assessed for adjuvant properties. The oral administration of PG and either S. mutans WC or CW induced good salivary and serum IgA antibody responses. The specificity of the antibodies was similar to that obtained in rats given antigen and MDP. Rats receiving either S. mutans WC or CW and PG and challenged with virulent S. mutans 6715 had lower plaque scores, fewer numbers of viable S. mutans in plaque, and lower caries activity than did infected rats receiving S. mutans WC or CW immunogen alone. These results provide evidence that soluble adjuvants derived from the gram-positive bacterial CW, e.g., MDP and PG, are effective oral adjuvants and augment IgA immune responses to particulate S. mutans antigens which are protective against the mucosally associated disease, dental caries.     

Effect of three months' frequent use of sugar-free chewing gum with and without urea on calculus formation

Studies on the relationship between gum-chewing and calculus formation have produced contradictory results, and it is not clear whether frequent use of chewing gum promotes or inhibits calculus formation. Also, little is known about whether the addition of a small amount of urea to the chewing gum influences calculus formation. The aim of this investigation was to study the effect of sugar-free chewing gum--with and without urea--on calculus formation and some associated clinical variables. Three three-month periods were studied in a double-blind, crossover design, during which the subjects: (1) chewed 5 pieces/day of a sugar-free, urea-containing chewing gum (20 mg urea/piece); (2) chewed 5 pieces/day of a sugar-free, non-urea-containing gum; or (3) performed no gum-chewing. Twenty-nine persons, all calculus-formers, participated. They were scored for calculus at mesio-lingual, lingual, and disto-lingual sites on the 6 anterior mandibular teeth according to the Volpe-Manhold index. Plaque and gingival bleeding index, stimulated salivary secretion rate and buffer capacity, resting plaque pH, mutans streptococci in saliva and plaque, and lactobacilli in saliva were also determined. No differences in calculus formation were found among the 3 periods. The resting plaque pH was higher after the period with urea-containing gum than after the period with non-urea-containing gum and the no-gum period (p < 0.05). A slight increase in stimulated salivary secretion rate was found after the 2 gum periods (p < 0.05). The plaque and gingival bleeding indices decreased, while resting plaque pH and salivary buffer capacity increased throughout the entire study (p < 0.05). No significant differences in prevalence of the acidogenic micro-organisms were found among the test periods. The main conclusion from this study is that three months' frequent use of sugar-free chewing gum--with or without urea--neither promotes nor inhibits calculus formation.     

Effective immunity to dental caries: passive transfer to rats to antibodies to Streptococcus mutans elicits protection

Rat dams, given intravenous injections of heat-killed Streptococcus mutans 6715, mutant C211 demonstrated significant agglutinin activity to the homologous S. mutans in colostrum, milk, and serum. This antibody activity was associated with the immunoglobulin G (IgG) class. High titers of anti-S. mutans antibody associated with the IgG class were also exhibited in the sera and saliva of the offspring that suckled these dams. After challenge with the homologous, live S. mutans, these offspring developed significantly fewer caries on all molar surfaces than did nonimmunized infected controls. A secretory immune response (manifested by the presence of specific IgA antibody to S. mutans in colostrum and milk) was elicited (i) in rat dams locally injected, in the region of the mammary gland, with heat-killed S. mutans antigen, and (ii) in other rat dams that were provided formalin-killed S. mutans in their drinking water. Offspring suckling these dams were challenged with virulent S. mutans before weaning and developed significantly fewer caries than did their infected controls. These findings clearly suggest that passively derived IgG or IgA antibodies to S. mutans are protective against dental caries.     

What physicians should currently observe in the area of dental health

Several factors govern the development of human dental caries. The actual caries incidence in children depends greatly on fluoride consumption, reduction of fermentable sugar intake (in favour of the use of sugar substitutes), dental health habits and regular dental check-ups. A significant reduction of dental caries in children and young adults is achieved in many countries following these principles. However, there remains a group, about 25%, with a particularly high incidence of caries. Today, efforts are directed at detecting these risk subjects. Mutans streptococci and lactobacilli are the main causative bacteria of human dental caries. The initiation of dental caries is preceded by colonisation of the dentition by S. mutans, usually in early childhood. The early establishment of these bacteria in the mouth of human infants is dependent on intrafamilial--mainly maternal--transmission of saliva. The higher the level of S. mutans in the maternal saliva, the more likely is the colonisation of primary dentition by cariogenic bacteria. The earlier the colonisation, the higher the incidence of caries. Today we have new diagnostic aids: Simple microbiological tests to detect the individuals with high salivary levels of these cariogenic bacteria, so called SM-millionaires. The tests are also a good educational aid for motivating patients to individual prophylaxis. What could a paediatrician or gynaecologist do to help the dentist? He could inform the parents early enough to avoid saliva contacts. For example, the mother should not take the child's spoon or pacifier in her mouth. The dentist meets the children much later, at an age where they already have caries. The older methods, mentioned at the begin, are also still valuable.     

cDNA cloning and characterization of rat C5a anaphylatoxin receptor

lnterleukin-2 (IL-2) is known to cause xerostomia and skin manifestations similar to graft-versus-host disease (GVHD). We therefore evaluated major salivary gland function in patients with hematological malignancies treated with IL-2 and interferon-alpha (IFN-alpha) after ABSCT. Eleven patients (seven male, four female) of median age 40 (24-47) were evaluated, seven with non-Hodgkin lymphoma (NHL); one with Hodgkin's disease (HD) and three with acute myelogenous leukemia (AML). Parotid and submandibular salivary gland function was assessed before, during and after IL-2/IFN-alpha administration by evaluation of the salivary flow rate and the composition of secreted saliva. Significant reductions in both the resting and stimulated parotid and submandibular salivary flow rates were observed during IL-2/IFN-alpha immunotherapy compared with the pre- and post-therapy values (P < 0.01), while no hyposalivation was observed in the control patients who underwent ABSCT and did not received IL-2. Sialochemical evaluation revealed a significant increase in potassium concentration (24.4+/-0.6 mEq/l to 28.9+/-1.4 mEq/l) and a significant decrease in sodium concentration (6.7+/-2.1 mEq/l to 3.3+/-1.0 mEq/l) (P < 0.05) in the stimulated parotid gland saliva secreted during IL-2/IFN-alpha administration. Salivary protein concentrations were not altered by the IL-2/IFN-alpha immunotherapy. Similar changes were previously observed in mice and humans with chronic GVHD. We conclude that IL-2 immunotherapy induces major salivary gland dysfunction in humans, similar to our previous observations in patients with chronic GVHD, which may indicate similar pathophysiologic mechanisms.     

Protein binding effects of salivary excretion of phenobarbital in dogs

The salivary excretion of phenobarbital was investigated by collecting parotid saliva (Pr) and mandibular-sublingual saliva (MS) separately after intravenous administration in beagle dogs. (1) The alterations in the proportions of saliva secreted by the different glands were produced by salivation stimulants such as citric acid, ascorbic acid, sodium chloride and sodium glutamate. (2) The phenobarbital concentrations in both Pr amd MS were lower than those in plasma. The drug concentrations in MS were significantly lower than in Pr with stimulus of 10% citric acid of 15% sodium chloride (p less than 0.05). There was a significant correlation between phenobarbital concentration in each saliva and plasma specimen ( p less than 0.05). (3) The stimulation with 10% citric acid produced higher saliva /plasma drug concentration ratios (S/P ratios: 0.923 +/- 0.175 for Pr, 0.633 +/- 0.073 for MS) than that with 15% sodium chloride (S/P ratios: 0.597 +/- 0.071 for Pr, 0.509 +/- 0.067 or MS). (4) The S/P ratios were hardly influenced by salivary flow rates, at least under the experimental conditions examined in this study. (5) The increased S/P ratios were observed with higher salivary pH and then the equation of Matin et al. 3) seemed to hold for the average values of salivary pH and S/P ratio. (6) The stimulation with 10% citric acid produced higher protein concentration in saliva and higher S/P ratio than that with 15% sodium chloride following alternate stimulations in the same dog.     

Origin of esterases in human whole saliva

Whole saliva of 59 healthy persons was used for determination of esterase activity. The pattern of esterase was studied by means of isoelectrofocusing on thin-layer acrylamide gels. The esterases found in whole saliva are suggested to be derived from the cells of the tissue in the oral cavity. This origin is indicated (e.g.) by comparison between isolectrophoretic esterase patterns of whole saliva, submandibular saliva, gingival biopsy and fibroblast culture. Antisera against partially purified saliva esterases were produced in rabbits. These sera, used in immunoelectro-osmophoresis, gave esterase-active immunoprecipitate against whole saliva, the water-soluble materials of disrupted gingival biopsy and fibroblast culture, but not against the material of the bacteria, Streptococcus sanguis, Strptococcus mutans, Streptococcus mitis, Actinomyces viscosus and Lactobacillus fermentum.