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ORIGINAL ARTICLE
Year : 2009  |  Volume : 27  |  Issue : 1  |  Page : 17-21
 

Dermatoglyphic interpretation of dental caries and its correlation to salivary bacteria interactions: An in vivo study


Department of Pedodontics and Preventive Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Ghaziabad, India

Correspondence Address:
R Somani
Department of Pedodontics and Preventive Dentistry, Modinagar, Ghaziabad
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.50811

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   Abstract 

Background: Dental caries is defined as an infectious disease of microbial origin which is related to every specialty of dentistry in one or the other way. Genetic susceptibility to dental caries is dependent on certain factors, which if evaluated, can help in estimating disease situation prematurely. The present study was done to estimate dermatoglyphic dependence of dental caries and its relation with salivary bacteria levels, primarily Streptococcus mutans. Aims: To determine if there is any significant correlation between salivary bacteria interactions, dermatoglyphics, and dental caries. Settings and Design: In the present study, 90 subjects were evaluated for dermatoglyphics in conjunction with bacteria levels. Methods and Materials: Dermatoglyphic interpretation was done using stamp-pad method and S. mutans levels were estimated by microbial culture of salivary samples collected. Statistical Analysis : Z-test (standard normal variate, proportion) was used to analyze dermatoglyphic patterns and bacteria levels. Results and Conclusions: 1. Subject group had a decreased frequency of loops, whereas control group had an increased frequency of loops on all palmar digits. 2. Subject group had high S. mutans growth, whereas control group had low S. mutans growth. Subject group had positive correlation with loops and S. mutans growth likened to control group that had negative correlation with both.


Keywords: Dermatoglyphics, dental caries, Streptococcus mutans


How to cite this article:
Sharma A, Somani R. Dermatoglyphic interpretation of dental caries and its correlation to salivary bacteria interactions: An in vivo study. J Indian Soc Pedod Prev Dent 2009;27:17-21

How to cite this URL:
Sharma A, Somani R. Dermatoglyphic interpretation of dental caries and its correlation to salivary bacteria interactions: An in vivo study. J Indian Soc Pedod Prev Dent [serial online] 2009 [cited 2018 Nov 14];27:17-21. Available from: http://www.jisppd.com/text.asp?2009/27/1/17/50811



   Introduction Top


The present study aimed at unveiling the genetic basis of dental caries and its correlation with salivary bacteria levels.

The basis of considering dermatoglyphic patterns as genetic marker for dental caries is that the primary palate develops during 6-13 th week of intrauterine life. Epithelium of primary palate as well as finger buds develop from the same site and are of ectodermal origin. [1]

Another point which needs a mention is epithelium of finger buds as well as enamel (most susceptible dental tissue to caries) have ectodermal origin, and both develop at the same time of intrauterine life. Several studies have also shown that dermatoglyphic patterns are genetically determined. [2],[3],[4],[5],[6]

The role of microorganisms has also been much investigated previously, but was revisited in the present study so as to know the correlation between various parameters as well as to ascertain the colony count with the caries status of the individual. The present study established a unique correlation between salivary bacterial interactions and dermatoglyphic patterns, and its correlation to dental caries.


   Materials and Methods Top


Caries detection

Relevant case history was obtained from the study cohort and dental caries was recorded using 'deft' index for primary teeth and 'DMFT' index for permanent teeth, with the help of a right angle probe (no.17), sheperd probe (no. 23), and odontoscope (mouth mirror) under natural diffused light source. Sterile cotton was used during the procedure so as to clean the tooth during examination procedure.

Dermatoglyphic pattern recording and interpretation

Dermatoglyphic patterns of all 10 palmar digits were recorded using Cummins and Midlo method. [7]

The finger prints were recorded as follows:

Firstly, hands were scrubbed thoroughly with an antiseptic lotion (Savlon) and allowed to dry. After this, right hand digits were guided by the researcher to the ink stamp pad and pressed firmly against bond paper that was placed on a smooth surface board 3-4 times. This was repeated for the thumb of right hand. In this method, third recording was satisfactory and readable, so impressions were recorded 3-4 times [Figure 1].

Same procedure was repeated for the left hand. In this way, a total of 900 digital prints were obtained from 90 patients. These dermatoglyphic patterns were analyzed with the help of a magnifying glass (10x), with respect to available standards and data were tabulated.

Estimation of salivary bacteria

For bacterial estimation, S. mutans was cultured as detailed below.

Firstly, throat swabs were collected [Figure 2] with the help of sterile swabs from all patients and transferred to the microbiology lab, where blood agar plates were prepared previously. The swabs were then transferred to these blood agar plates and streaked with the help of wire-loop in a criss-cross pattern. Once streaked, the plates were incubated for 16-18 hours at 37 degrees centigrade.

Following the growth of bacterial colonies on the agar plates, they were taken out from the incubator and colony growth was appreciated [Figure 3] and [Figure 4]. Gram staining was done. Optochin test was done to differentiate between S. mutans and pneumococcus, since both show hemolysis on blood agar. Optochin test is positive for S mutans .

To reconfirm the results, antibiotic sensitivity was also done. Once this was achieved, plates were divided into four quadrants and S mutans bacterial colonies were counted with the help of a magnifying lens.

Procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional or regional) and with the Helsinki Declaration of 1975, as revised in 2000.


   Results Top


Observations for dermatoglyphics

The frequency distribution for dermatoglyphics in subjects and controls is presented in [Table 1] and [Table 2], respectively.

The comparison of mean values of loops for both groups is shown in [Table 3]. The mean value of loops in controls was observed to be 8.37 + 1.29 and that for subject group it was 5.15 + 2.38. Thus, controls had higher loops as compared to subjects at 0.01% level of significance.

While applying Z test, a highly significant difference was observed between subject and control groups for loops and salivary pH tested at 1% level of significance ( P > 0.001).

Observations for microflora

The total viable count of bacterial flora was determined and expressed as bacterial flora/ml. Because of the wide range of total numbers five classes were defined for total viable count.

The total viable count for both subject and control groups is presented in [Table 4]. Control group had a lower viable growth (11, 6, 2, 2) than subject group (6, 10, 9, 5). Z test for proportion was applied and Z cal was significantly lower (2.43, 2.09, 2, 29, 2.61) than Z tab. Hence, it was concluded that control group had low microbial growth.

Following results were drawn from the study:

  1. There was a highly significant difference for loops between subject and control groups. Since observed value ( Z cal = 7.9762, 4.0248) was more than the standard value ( Z tab = 3.79) at P < 0.001.
  2. There was significant difference between subject and control groups for microbial growth since observed value ( Z cal = 2.43, 2.09, 2.29, 2.61) was more than the standard value ( Z tab = 1.96) at P < 0.05.
  3. Finally, the resultant was that there existed a statistically significant difference between subject and control groups for dermatoglyphics, and S mutans levels.



   Discussion Top


Multifactorial etiology works as a processing unit in the causation of dental caries in mineralized portions of human teeth. These factors can be conveniently divided into various subtypes. In the present study two important parameters were considered, one being genetic component, dermatoglyphics, and other being salivary component, microflora.

In humans, the development of primary palate and the lip is completed by the seventh week of intrauterine life and that of secondary palate by twelfth week. The dermal ridges develop in relation to volar pads, which are formed by the sixth week of gestation and reach maximum size between 12-13 th week. This means that genetic message contained in the genome, normal or abnormal, is deciphered during this period and is also reflected by dermatoglyphics. Moreover, tooth enamel is an ectodermal structure same as that of palate and alveolar ridges and is most susceptible to caries. Dermal ridge differentiation takes place early in fetal development.

The resulting ridge configurations are genetically determined and are influenced or modified by environmental forces. It is known that finger and palm prints are formed during the 6-7 th week of the embryonic period and are completed after 10-20 weeks of gestation. Abnormalities in these areas are influenced by a combination of hereditary and environmental factors, but only when the combined factors exceed a certain level, can these abnormalities be expected to appear. This threshold theory advanced by studies of Carter and Matsunga is now generally accepted.

The word dermatoglyphics was coined by Cummins and Midlo in 1926 meaning dermi = skin and glyphe = curve. [8] The method of recording and evaluating dermatoglyphics used in the present study is ink-stamp pad method given by them.

Dermatoglyphic patterns are broadly classified into three major types: whorl, loops, and arches, which have been subdivided into various subtypes. These patterns are present on finger tips/buds, whereas whole of human palm show certain other features such as atd angle, H-loop, IV loop, and t-triradius.

In the present study, loops were compared between subjects and controls and correlated to salivary pH and bacteria. Individual susceptibility to dental caries varied from genetic factors and environmental influences. There were familial, pedigree, and twin studies on dental caries, but present study is unique in the way that dermatoglyphics has been linked to salivary pH and bacteria; thus, polygenic nature as well genetic susceptibilty to dental caries is revisited.

Selected children were between 3-6 years of age in this study because of following reasons. Firstly, by three years of age whole set of deciduous dentition must have erupted. Secondly, by this period window of infectivity would have been completed so that S. mutans levels can be measured much confidently. Thirdly, we know that incipient enamel lesions transform into cavitation by 2-5 years 42, in case of deciduous dentition rate being faster. So, by this time if any lesion would have developed it must have started progressing and this may add up to number of carious teeth; keeping these factors in my mind it can be well assured that it is genetically susceptibility that determines cariogenic potential of enamel at this point of time, since as the age advances other factors may also become much significant in causation of dental caries. This justifies the rationale for selection of age group for this study.

S. mutans has been referred to as the main causative agent for dental caries. [9] S. mutans has greater propensity to recolonize the tooth surfaces [10] and they have been linked to have significant effect on causation of dental caries. [11] Moreover, salivary testing has been recommended as a routine diagnosis when treating patients with high-caries risks. [12],[13] Low rate of transmission of S. mutans include its relatively weak ability to adsorb to teeth and its low salivary concentrations available for attachment. [14]

All S. mutans strains studied have been demonstrated to be homolactic fermenters converting over 90% of hexose to lactic acid. [15] They have the metabolic potential to produce a low pH and to survive in a low pH environment. The terminal pH of S. mutans grown in glucose- or sucrose-enriched media is well below pH 4.5. They are known to utilize sucrose at faster rates than other organisms such as S. mitis , S. sanguis . and A. viscosus .

In the present study, 90 patients, 45 subjects and 45 controls, were evaluated. In the first part of the study, dermatoglyphic examination and in the second part salivary testing in terms of salivary pH and S. mutans levels was done, and results were obtained after coalescing of these data.

Results showed that there is a significant role of genetic and environmental factors in causation of dental caries. Control group, that is, caries-free children, had an increased frequency of loops and a higher salivary pH toward normal, whereas subjects, that is, children with caries in ≥5 teeth, had decreased frequency of loops and a lower salivary pH toward normal. This clearly illustrates that these two parameters are interlinked. This means that if a child has carious teeth his/her salivary pH would be lowered owing to more demineralization activity caused by microorganisms. This was further supported by measuring S. mutans level in the subject and control groups. Controls (caries-free students) showed decreased S. mutans levels as compared to subject group. Our findings support the previous study [16] that caries-free students have increased loops and there is a high significant difference in controls and subjects in terms of frequency of loops. This difference in dermatoglyphic patterns indicates that it's no wonder if dermatoglyphic pattern recording of a child may be carried out as it is done in a medical examination in some nations.

Since this may be a genetic indicator for dental caries acquisition, as we have S. mutans levels for early childhood caries.

Saliva also contains glycoproteins that are known to be antibacterial, such as lysozyme and lactoperoxidase. [17] These compounds act independently of the host's immune system, and are able to destroy invasive bacteria without harming the ecological balance of the oral cavity, since indigenous bacteria have evolved resistance .

These studies are in harmony with our observations and rehones role of microflora in pathogenesis of dental caries, summing these oral factors with genetic ones opens a new epoch in the specialty. This also makes the study unique in the way that two prudent parameters of caries causation have been linked together. These data are preliminary, but are suggestive of a significant association between these two factors - dermatoglyphics and saliva - which open a new arena for quantification of dental caries. Since a longitudinal study may prove that just by taking dermatoglyphic pattern dental caries may be estimated which may be a boon in epidemiologic studies as well as a cost-efficient method.

This study may serve as a cornerstone for further studies adding to existing research work which may lead to a new horizon.


   Acknowledgments Top


Dr N.N. Singh, Department of Oral and Maxillofacial pathology.

 
   References Top

1.Mathew L, Hegde AM, Rai K Dermatoglyphic findings in oral clefts. J Indian Soc Pedod Prev Dent 2005;23:179-82.  Back to cited text no. 1    
2.Holt SB. The hypothenar radial arch-A genetically determined epidermal ridge configuration. Am J Phy Anthrop 1975;42:229-32.  Back to cited text no. 2    
3.Uchida JA, Solton HC. Evaluation of Dermatoglyphics in medical genetics. Pediatr Clin North Am 1963;10:409.  Back to cited text no. 3    
4.Mellor CS. Dermatoglyphics in Schizophrenia. Br J Psychiatry 1968;114:1387-97.   Back to cited text no. 4    
5.Pons J. Genetics of a-b ridge count on human palm. Ann Hum Genet 1964;37:273.  Back to cited text no. 5    
6.Glanville EV. Heredity and line of palmar dermatoglyphics. Am J Hum Genet 1965;17:420-4.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]
7.Cummins. Revised methods of interpretation and formulation of palmar dermatoglyphics. Am J Phy Anthr 1929;12:415-502.   Back to cited text no. 7    
8.Cummins. Study of error in interpretation and formulation of palmar dermatoglyphics. Am J Phy Anthr 1928;11:501-21.  Back to cited text no. 8    
9.Hegde SK. Estimation of salivary capable of inhibiting and stimulating streptococcus mutans, and its correlation to dental caries and untreated carious teeth. J Indian Soc Pedod Prev Dent 2005;23:126-30.  Back to cited text no. 9  [PUBMED]  Medknow Journal
10.Pereira CV, Pereira LJ. In vitro bacterial plaque suppuration and recolonization by S.mutans and S.sobrinus. Braz J Microbiol 2006;37:20-5.  Back to cited text no. 10    
11.Bolgül BS, Celenk S, Ayna BE, Atakul F, Uysal E. Evaluation of caries risk factors and effects of a fluoride-releasing adhesive material in children with insulin-dependent diabetes mellitus (IDDM): Initial first-year results. Acta Odontol Scand 2004;62:289-92.  Back to cited text no. 11    
12.Gopinath VK, Arzreanne AR. Saliva as a diagnostic tool for assessment of Dental caries. Arch Oro Sci 2006;1:57-9.  Back to cited text no. 12    
13.Stookey GK. Effect of saliva on dental caries. J Am Dent Assoc 2008;139:11s-7s.  Back to cited text no. 13  [PUBMED]  [FULLTEXT]
14.Gibbons RJ, Houte JV. Bacterial adherence in oral microbial ecology. A Rev Microbiol 1975;29:19.  Back to cited text no. 14    
15.Brown AT. Carbohydrate metabolism in caries-conductive, oral streptococci; in sipple, mcnutt, sugars and nutrition. chap.38, New York: Academic Press; 1974. p. 689.  Back to cited text no. 15    
16.Atasu M. Dermatoglyphic findings in Dental caries: A preliminary report. J Clin Pediatr Dent Winter 1998;22:147-9.  Back to cited text no. 16    
17.Loesche WJ. Role of Streptococcus mutans in human dental decay. Microbiol Rev 1986;50:353-80.  Back to cited text no. 17  [PUBMED]  [FULLTEXT]


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]


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