C L IN IC A L
REPORT
Asymmetrical dental caries and Streptococcus mutans infection
Mona Svanberg, LDS Bo Krasse, LDS, O do n t Dr, G o te b o rg , S weden
A 27-year-old w om an chew ed u n ila te ra lly and had re s to ra tio n s and caries o n ly on th e rig h t side o f the d e n titio n . The le ft side had a g re a te r a m o u n t of so ft
Silicate restorations were recorded in the m axil lary right incisors and canines. A t the radiographic and clinical exam ination, one carious lesion on an unrestored surface and ten lesions on previously restored surfaces were recorded. T hirty-seven D M F S w ere recorded, all on the right side o f the dentition. V olum inous soft deposits on the occlusal surfaces and subgingival calculus w ere found on the teeth o f the left side. On the right side, only small am ounts of plaque on
and hard d e p o sits and m ore severe p e rio d o n ta l disease. P laque sam ples fro m o c clu sa l and interpro xim a l to o th surfa ce s w ere co lle cte d and c u l tu re d . The p ro p o rtio n o f S tre p to c o c c u s m u ta n s of th e to ta l a n a e ro b ic c o u n t in th e p la q ue sam ples fro m th e rig h t side was 1,000 to 10,000 tim e s as high as fro m th e le ft side. The p ro p o rtio n o f S m u ta n s of the to ta l s tre p to c o c c u s was 6% to 20% on th e rig h t and less than 1% on th e le ft side.
A 27-year-old wom an was referred to the dental school for crepitations and occasional pain in the right tem porom andibular joint. T he sym ptom s seem ed to be m uscular in origin, and no patholog ical changes of the joints w ere observed. T he patient avoided chewing on left side of the m outh, although a functional analysis showed that bilat eral occlusal contacts existed. D uring the p a tien t’s yearly visits to the dentist, restorations were placed on the right side only. A t recent vis its, subgingival calculus was rem oved only from the left side.
Report of case Amalgam restorations w ere found in all canines, prem olars, and m olars on the right side (Fig 1, 2).
Fig 1 ■ M axillary (top) and m andibular (bottom ) teeth showing restorations on rig h t side only. JADA, Vol. 96, June 1978 ■ 1025
C L IN IC A L
REPORT
Table 1 ■ Clinical observations on each side of the dentition. Function T e m porom andibular jo in t Caries Restorations DMFS Plaque Subgingival calculus, inte rpro xim ally Pocket depth, inte rpro xim ally
Right side
Left side
Chewing Pain and crepitations Present Present 37 Small am ounts only on cervi cal third Absent < 4 mm
No chewing No sym ptom s Absent Absent 0 V olum inous depo sits on all too th surfaces Present 4-6 mm
Table 2 ■ Proportional distribution of Streptococcus mutans in occlusal and approximal plaque from different parts of dentition. S mutans,% of total streptococci* P la q u e M axilla Occlusal Interproxim al M andible Occlusal Interproxim al
S. mutans,t % of total anaerobic counts
Left side
Right side
Left side
Right side
REPORT
Asymmetrical dental caries and Streptococcus mutans infection
Mona Svanberg, LDS Bo Krasse, LDS, O do n t Dr, G o te b o rg , S weden
A 27-year-old w om an chew ed u n ila te ra lly and had re s to ra tio n s and caries o n ly on th e rig h t side o f the d e n titio n . The le ft side had a g re a te r a m o u n t of so ft
Silicate restorations were recorded in the m axil lary right incisors and canines. A t the radiographic and clinical exam ination, one carious lesion on an unrestored surface and ten lesions on previously restored surfaces were recorded. T hirty-seven D M F S w ere recorded, all on the right side o f the dentition. V olum inous soft deposits on the occlusal surfaces and subgingival calculus w ere found on the teeth o f the left side. On the right side, only small am ounts of plaque on
and hard d e p o sits and m ore severe p e rio d o n ta l disease. P laque sam ples fro m o c clu sa l and interpro xim a l to o th surfa ce s w ere co lle cte d and c u l tu re d . The p ro p o rtio n o f S tre p to c o c c u s m u ta n s of th e to ta l a n a e ro b ic c o u n t in th e p la q ue sam ples fro m th e rig h t side was 1,000 to 10,000 tim e s as high as fro m th e le ft side. The p ro p o rtio n o f S m u ta n s of the to ta l s tre p to c o c c u s was 6% to 20% on th e rig h t and less than 1% on th e le ft side.
A 27-year-old wom an was referred to the dental school for crepitations and occasional pain in the right tem porom andibular joint. T he sym ptom s seem ed to be m uscular in origin, and no patholog ical changes of the joints w ere observed. T he patient avoided chewing on left side of the m outh, although a functional analysis showed that bilat eral occlusal contacts existed. D uring the p a tien t’s yearly visits to the dentist, restorations were placed on the right side only. A t recent vis its, subgingival calculus was rem oved only from the left side.
Report of case Amalgam restorations w ere found in all canines, prem olars, and m olars on the right side (Fig 1, 2).
Fig 1 ■ M axillary (top) and m andibular (bottom ) teeth showing restorations on rig h t side only. JADA, Vol. 96, June 1978 ■ 1025
C L IN IC A L
REPORT
Table 1 ■ Clinical observations on each side of the dentition. Function T e m porom andibular jo in t Caries Restorations DMFS Plaque Subgingival calculus, inte rpro xim ally Pocket depth, inte rpro xim ally
Right side
Left side
Chewing Pain and crepitations Present Present 37 Small am ounts only on cervi cal third Absent < 4 mm
No chewing No sym ptom s Absent Absent 0 V olum inous depo sits on all too th surfaces Present 4-6 mm
Table 2 ■ Proportional distribution of Streptococcus mutans in occlusal and approximal plaque from different parts of dentition. S mutans,% of total streptococci* P la q u e M axilla Occlusal Interproxim al M andible Occlusal Interproxim al
S. mutans,t % of total anaerobic counts
Left side
Right side
Left side
Right side
