The role of antimicrobials in the future

A better understanding of bacterial communities found in biofilms, such as its diversity and interactions among cells, provides opportunities for new methods to control biofilm formation (Wade, 2010). It has been shown that blocking communication mechanisms between cells in biofilms (quorum-sensing) can partially restore their susceptibility to antimicrobial agents (Bjarnsholt et al., 2005). Other benefits may include reduction of pathogenic microorganisms due to reduction in the virulence mechanism in the microorganism of interest. In the particular case of dental caries, blocking or reducing the activity of glycosyltransferase in S. mutans would be interesting, since these enzymes are implicated in the ability of this cariogenic bacterium.

In addition, probiotic approaches for oral use are being developed: such as the development of s Lactobacillus paracasei trains which maintain its co-aggregation activity with S. mutans even when dead (Lang et al., 2010), or Lactobacillus reuteri strains that are able to reduce the number of S. mutans in the mouth (Caglar et al., 2008) in order to decrease the incidence of tooth decay. Other bacterium normally found in the mouth, and important in this sense, is Streptococcus salivarius, which produces a bacteriocin that inhibits anaerobic Gram-negative bacteria and that in vivo was shown also to reduce the level of halitosis (Burton et al., 2006).

In conclusion, microbiota analysis methods independent of culture have allowed to understanding the diversity of the oral microbiota. So far, most studies have focused on the microbiota composition in the disease, but a better understanding of this microflora in health is required and also as probiotic organisms are capable of restoring and maintaining health in such environment. Thus, future studies are still needed, especially for analyzing the interactions between species and how to use this knowledge to develop new products for prevention and treatment of oral diseases.

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