Cario-Analyse® : biological analysis accessible to practitioners

Dental caries has been an important public health problem worldwide. Information about an individual’s caries risk and state of carious lesions should be used in making a personalised treatment plan. The origin of caries disease is the formation of bacterial biofilm with specific pathogenic bacteria on the teeth occlusal surface.The colonization of the mouth by caries bacteria can take place at an early age of the patient but can also take place after dental prosthetic installation or orthodontic treatment for patients with poor oral hygiene and non-adapted diet.

A microbiological risk !

Recent studies have successfully identified patients with a high or low risk of primary caries by using Classification and Regression Trees (CART) according to the number of specific cariogenic bacteria, as well as those at risk of secondary caries according to the number of particular bacteria and previous caries experience. The growth of certain bacteria strains (Lactobacillus spp. and Streptococcus mutans) at a certain level during reduced period (approximately 3 months) is a significant biological signal of increased risk of caries.
Abnormal salivary function (limited saliva buffer capacity, Sjoreen syndrome, hyposialia following head and neck irradiation, genetic diseases) will increase the risk by increasing the pathogenic bacteria plaque quantity.

Cariogenic microorganisms have a significant increase at 6 months following placement of orthodontic devices due to the irregular nature of their surfaces, which promote the growth of these aciduric and acidogenic bacteria that prefer hard surfaces to grow on.

The objectives of Cario-Analyse®

In order to decrease caries risk, it is encouraged for people to have less than 10,000 Streptococcus mutans per ml of saliva in their mouth.

Class 0-3 is referring to how many Streptococcus mutans reside in the mouth with class 0-1 acting as best case with good oral hygiene, while class 3 acts as the worst case.
class 0-1 <100,000/ml

class 2 >100,000/ml <1,000,000/ml

class 3 >1,000,000 /ml

Saliva buffer capacity analysis
Real Time PCR

Microbial DNA extraction from saliva.

DNA amplification with DNA probes and primers for Streptococcus mutans and Lactobacillus spp.

Pathogenic bacteria strains associated with caries risks

Streptococcus mutans is a cariogenic microorganism that breaks down sugar for energy and produces an acidic environment, which demineralizes the superficial structure of the tooth. Transmission of S. mutans can be found in people of all ages although it is more common in infants and children. There is transmission of S. mutans from mothers to their children. The genus Lactobacillus currently contains over 180 species. They are a major part of the lactic acid bacteria group (i.e. they convert sugars to lactic acid ). In humans, they constitute a significant component of the microbiota of saliva and are responsible for acid production and low pH situation.

Situations to carry out Cario-Analyse®

  • first visit
  • patient with primary or secondary caries
  • patient with poor oral hygiene and/or poor diet
  • patient with orthodontic prosthesis
  • rapid progressive caries patients