Xylitol과 불소의 병용이 Streptococcus sobrinus와 Streptococcus mutans의 성장 및 부착능에 미치는 영향

Abstract

[한글]

불소는 치아우식증을 예방하기 위하여 오랜 동안 이용되어 왔으나, 불소의 부적절한 사용으로 인하여 치아 불소증이 증가되고 있다. 이러한 이유에서 불소 농도에 대한논란이 계속되게 되었고, 최근 불소 이외에 xylitol은 물론, 불소와 xylitol을 함께 사용하여 얻어지는 항우식 효과에 대해서도 관심이 높아지고 있다. 불소와 xylitol을 치약에 함께 첨가하여 사용하는 경우 항우식 효과가 증가한다고 하며, 불소와 xylitol에 의하여 법랑질 용해도가 낮아진다고 하고 있다. 한편, 불소와 xylitol의 병용시 구강내 세균의 성장 억제 여부에 대해서는 아직 명확하게 규명되지 않았으며, 더욱이 치아면에 부착하는 구강내 세균의 수를 줄이는 효과에 대해서는 연구되어진 바가 없다. 따라서 본 연구에서는 치아우식증의 원인균으로 알려져 있는 Streptococcus sobrinus와 Streptococcus mutans의 성장 및 대사, 그리고 부착능에 대한 불소와 xylitol의 효과를 분석하고자, 0.1% 자당 또는 0.1% 포도당 존재하에서 두 균의 흡광도와 배지내 pH를 측정하여 다음과 같은 결과를 얻었다.

1. 0.1% 자당 존재하에서 불소는 S. sobrinus와 S. mutans의 성장과 산 생성을 감소 시켰으나 (p<0.05), xylitol은 이들 균주의 성장과 산 생성에 영향을 주지 않았다.

2. 0.1% 포도당이 있는 조건에서 불소와 xylitol은 각각 S. sobrinus와 S. mutans의 성장과 산 생성을 감소시켰으나 (p<0.05), xylitol과 불소를 함께 첨가한 경우, S. mutans의 성장과 산 생성이 더욱 억제되었다 (p<0.05).

3. 불소는 0.1% 자당 존재하에서 S. sobrinus의 유리면 부착능을 억제시켰으며(p<0.05), xylitol을 불소와 함께 첨가한 경우, 부착능 감소효과가 증대되었다(p<0.05).

4. 0.1% 자당 존재하에서 xylitol과 불소를 각각 또는 함께 첨가한 경우 S. mutans는 유리면에 부착능이 감소되지 않았다.

이상의 결과로 보아 균의 종류와 대사물질에 따라 차이를 나타내지만, 불소만을 사용하는 것보다는 xylitol과 불소를 함께 사용하는 경우 구강내 세균의 성장과 부착능이 더욱 억제되는 것으로 생각된다.

Combined effect of xylitol and fluoride on the growth metabolism, and adhesiveness

of Streptococcus sobrinus and Streptococcus mutans

Hyung-Gyoo Kim, D.D.S.

Department of Dental Science, The Graduate School, Yonsei University

(Directed by Assoc. Prof. Syng-Ill Lee, D.D.S., Ph.D.)

Fluoride, in various compounds and f77ms, has been the most successful agent in

preventing dental caries. Recent studies indicate, however, that the prevalence

and, to a lesser extent, the intensity of dental fluorosis have increased in

school-aged children in both fluoridated and non-fluoridated areas. Although the

dose-response relationship of fluoridation still remains controversial, the

suggestion that the F content in a toothpaste should be lowered seems to be

reasonable based upon long-term considerations of ingestion toxicity and

unnecessary mottling of teeth.

Recently, xylitol has attracted attention as a sugar substitute because it may

have anticariogenic properties. Since the anticarioeenic mechanism of xylitol may

be quite different from that of fluoride, we expected that the effects of xylitol

and fluoride would be addictive. Very few papers deal with the combined action of

fluoride and xylitol. The aim of this study has been to investigate the combined

effect of xylitol and fluoride on in vitro sucrose- or glucose-dependent growth,

metabolism and adhesiveness of Streptococcus sobrinus and Streptococcus mutans.

We could not observe tony inhibiter effect of xylitol on the growth and

fermentation of both strains in presence of sucrose. The growth and fermentation of

Streptococcus mutanss using g1ucose were reduced by xylitol and fluoride separately

and the effect was additive when they were combined. Xylitol and fluoride

separately decreased the adhesiveness of Streptococcus sobrinus, and the effects of

the combine alien of fluoride and xylitol are dramatically additive.

In conclusion although it seems to be somewhat different due to the serotype of

mutans streptococci, the combined use of xylitol and fluoride may enhance the

ability of inhibition on the bacterial growth, metabolism and adhesiveness.

[영문]

Fluoride, in various compounds and f77ms, has been the most successful agent in preventing dental caries. Recent studies indicate, however, that the prevalence and, to a lesser extent, the intensity of dental fluorosis have increased in school-aged children in both fluoridated and non-fluoridated areas. Although the dose-response relationship of fluoridation still remains controversial, the suggestion that the F content in a toothpaste should be lowered seems to be reasonable based upon long-term considerations of ingestion toxicity and unnecessary mottling of teeth.

Recently, xylitol has attracted attention as a sugar substitute because it may have anticariogenic properties. Since the anticarioeenic mechanism of xylitol may be quite different from that of fluoride, we expected that the effects of xylitol

and fluoride would be addictive. Very few papers deal with the combined action of fluoride and xylitol. The aim of this study has been to investigate the combined effect of xylitol and fluoride on in vitro sucrose- or glucose-dependent growth,

metabolism and adhesiveness of Streptococcus sobrinus and Streptococcus mutans.

We could not observe tony inhibiter effect of xylitol on the growth and fermentation of both strains in presence of sucrose. The growth and fermentation of Streptococcus mutanss using g1ucose were reduced by xylitol and fluoride separately

and the effect was additive when they were combined. Xylitol and fluoride separately decreased the adhesiveness of Streptococcus sobrinus, and the effects of the combine alien of fluoride and xylitol are dramatically additive.

In conclusion although it seems to be somewhat different due to the serotype of mutans streptococci, the combined use of xylitol and fluoride may enhance the ability of inhibition on the bacterial growth, metabolism and adhesiveness.