The aim of this in vitro study was to evaluate the surface properties of moderately to severely fluorotic enamel and the adhesion of Streptococcus mutans and Streptococcus sanguinis to enamel, exploring the relationship between dental fluorosis and dental caries from a microbiology perspective.
We examined the basic surface properties of moderately to severely fluorotic enamel by surface microhardness test, scanning electron microscopy (SEM) and atomic force microscopy. Then S. mutans single-species biofilms and S. mutans – S. sanguinis dual-species biofilms were cultured on fluorotic enamel surface. The morphology of biofilms, the volume of bacteria and expolysaccharides (EPS) and the number of bacteria were respectively tested by SEM, confocal laser scanning microscopy and colony-forming units (CFU) counting.
Fluorotic enamel displayed lower average microhardness and greater surface roughness than sound enamel, and it also showed structure defects like pores or pits. The biofilm thickness, volume of bacteria and EPS, and CFU counts of bacteria in both single-species and dual-species biofilms on fluorotic enamel were all significantly higher than those on sound enamel. The volume of bacteria and EPS in dual-species biofilms are both less than those of single-species biofilms.
The higher surface roughness and the structure defects of teeth with moderate to severe dental fluorosis contributed to the adhesion of S. mutans and S. sanguinis, and the increased adhesion of S. mutans may increase the susceptibility of dental caries. However, S. sanguinis would play a role as a “designer bacteria” which reduce the cariogenicity of the biofilms on fluorotic enamel surface.

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