VOLUME I/ISSUE

I/JUN-DEC 2013
[JOURNAL OF HEAD & NECK PHYSICIANS AND
SURGEONS]

Correspondence Swapnil Bumb , Teerthanker mahaveer dental college, Moradabad, U.P. India .
email- swapnil_bumb@yahoo.com 1

Short Communication

ROLE OF CARIES VACCINE IN PREVENTION OF
DENTAL CARIES
Swapnil Bumb
Post graduate Trainee
Department of community dentistry, Teerthanker Mahaveer Dental College, Moradabad,
U.P. , India


Abstract:
Dental caries is one of the most common infectious multifactorial disease
worldwide, characterized by the progressive demineralization of the inorganic
matter and destruction of organic matter of the tooth . The main factors
predisposing the onset of the carious process include presence of bacteria
producing acids ,inadequate oral hygiene, an inefficient immune response anti-
caries, the type of diet , structure of the teeth. Among Various bacterial species
isolated from dental plaque the most pathogenic for dental caries are:
Streptococcus mutans, Streptococcus sobrinus, Lactobacillus acidophilus,
Actinomices viscusus and Bifidobacterium dentium.
Introduction

Dental caries is a complex microbiological disease that forms through an
interaction over time between acid-producing bacteria and fermentable
carbohydrate, and many host factors including teeth and saliva leading to
dissolution of inorganic and destruction of organic matter of the tooth(1).
Vaccines are an immuno-biological substance designed to produce specific
protection against a given disease. It stimulates the production of a protective
antibody and other immune mechanisms. Vaccines are prepared from live modified
VOLUME I/ISSUE
I/JUN-DEC 2013
[JOURNAL OF HEAD & NECK PHYSICIANS AND
SURGEONS]

Correspondence Swapnil Bumb , Teerthanker mahaveer dental college, Moradabad, U.P. India .
email- swapnil_bumb@yahoo.com 2

organisms, inactivated or killed organisms, extracted cellular fractions, toxoids, or
a combination thereof. (2)

Mechanism of action of caries vaccine

In vitro studies have shown that IgG antibodies have inhibitory effect on
adherence, glucosyl-transferase, and acid production. Hence, IgG could inhibit
establishment and metabolism of S. mutans. Further parenteral immunization could
favor the establishment of noncariogenic microflora on teeth, which in turn could
prevent or delay the colonization of pathogenic S. mutans. (3)
Secretory IgA is the principle immune component of major and minor salivary
Gland and thus would be considered to be the primary mediator of adaptive
immunity in the salivary milieu apart from other immunoglobulin like IgM and
IgG which are derived from gingival sulcular fluid .in addition to this gingival
sulcus also contains various cellular components of the immune system like
lymphocytes ,macrophages and neutrophils .(4)Altering cariogenic potential can
also be used as a mode of action of the vaccine. Antibodies could affect the
cariogenicity of S. mutans by interfering with glucose uptake and acid production.
Thus lactate dehydrogenase from S. mutans has been purified in order to test the
possible effect of this enzyme in providing protection against acid producing
microorganisms. (5)
DISCUSSION:
Antigenic Components of Streptococcus Mutans
S. mutans posses various cell surface substances including adhesins, GTFs, and
glucan binding proteins (GBP). These substances can induce protective immunity
so can be used for the preparation of vaccines

Adhesins: Adhesins form the two principal human pathogens of S. mutans
(variously identified as antigens I/II, Pac, or P1 and Streptococcus sobrinus, Spa-A
VOLUME I/ISSUE
I/JUN-DEC 2013
[JOURNAL OF HEAD & NECK PHYSICIANS AND
SURGEONS]

Correspondence Swapnil Bumb , Teerthanker mahaveer dental college, Moradabad, U.P. India .
email- swapnil_bumb@yahoo.com 3

or Pag) and has been purified. Antigens I/II (Ag I/II) are found in the culture
supernatant as well as in the S. mutans cell surface. Ag I/II contains an alanine-
rich tandem-repeating region in the N-terminal third and a proline rich repeat
region in the center of the molecule. (2)These regions have been associated with
the adhesin activity of Ag I/II. in Vivo and in vitro studies indicates that antibody
with specificity for S .mutans AgI/II or S.sobrinus spaA can interfere with
specificity with bacterial adherence and subsequent dental caries (5)

Adjuvants and Delivery Systems for Dental Caries Vaccines:
Various new experiments have been tried out to strengthen the immune response
by inducing sufficient antibodies to achieve a protective effect to overcome the
existing disadvantages.

Synthetic peptides: Any antigen derived from animals or humans has the potential
for hypersensitivity reaction. The chemically synthesized peptides hold an
advantage in that this reaction can be avoided. This has been found to enhance the
immune response. In humans, synthetic peptides elicited both IgG and T-cell
proliferative responses, and the antibodies were both anti-peptide and anti-native.
The synthetic peptides give antibodies not only in the GCF but also in the saliva.
The synthetic peptide used is derived from the Glucosyltransferase enzyme. (6)(7)

Dental caries is a multifactorial disease which is present world wide.a-rapid
increase of dental caries is seen in children and adolescents .many factors can give
way for caries formation ,improper diet habits,improper oral hygiene measures etc
are some among them .low dentist to patient ratio ,lack of awareness ,negligence
can lead to progression of caries and tooth loss.traditional vaccine therapy
indicates that immunization should be done prior to infection.immunization for
dental caries can be begin early in 2nd year of life,(8,9)it can extent till the
secondary teeth begin to erupt and getting exposed to new ecological condition
VOLUME I/ISSUE
I/JUN-DEC 2013
[JOURNAL OF HEAD & NECK PHYSICIANS AND
SURGEONS]

Correspondence Swapnil Bumb , Teerthanker mahaveer dental college, Moradabad, U.P. India .
email- swapnil_bumb@yahoo.com 4

.active or passive immunization can be given which will prevent the pathology of
caries bacteria .it will be a great benefit for the high risk categories .

REFERENCES:
1. Park K. Text book of preventive and social medicine. 17 th ed.
Bhanotidas Publication; 2004.
2. The forsyt h institute : scientist and research Martin A Tauban( pubmed
search)
3. Vaccine against dental caries - an urgent need Raman deep Singh,
gambhir Singh,simar preet Singh,gurminder Singh,rina Singh ,Tarun
nanda and Heena Kakar
4. Shivakumar K M, Vidya S K, Chandu G N. Dental caries vaccine. Indian
J Dent Res 2009;20:99-106
5. Smith D J (2002)dental vaccine: prospects and concerns crit Rev oral bio
med 13:335-349
6. Lehner T. Immunology of dental caries. Immunology of oral diseases. 3
rd ed. Blackwell scientific publications; 1992.
7. Tandon S. Textbook of Pedodontics. 1 st ed. Paras Publishing; 2001.
8. Moro I, Lehner T. Symposium report: Sixth International congress of
mucosal immunology; Dental caries vaccine. J Dent Res July 23 rd 1990.
p.
9. Koga T, Oho T, Shimazaki Y , Nakano Y. Immunization against dental
caries. Vaccine 2002;20:2027-44.


Conflict of Interest- Nil
Support Nil
Acknowledgements Nil