Bioluminescence and applications in dentistry

Dental caries is a very common infectious disease primarily transferred to children during early childhood from maternal and other close-contact sources. The principal cariogenic microorganisms are highly acidogenic and acid-tolerant bacteria and include members of the mutans streptococci group and lactobacilli. Numerous assessment tools for oral hygiene and caries risk are available to identify patients at risk for dental caries, but better quantitative methods are needed to allow appropriate targeting of aggressive, caries-protective treatments. Rapid adenosine triphosphate-driven (ATP-driven) bioluminescence assays have long been used to quantitatively measure microbial numbers in a variety of situations, including clean room monitoring and in the sanitation and food-processing industries. More recently, ATP-driven bioluminescence has been used to quantitate bacterial load in both medical and dental settings. For example, dental plaque mass and bacterial numbers in both humans and animals correlate well with ATPdriven bioluminescence values. The purpose of this review is to illustrate the use of ATPdriven bioluminescence in the rapid chair-side enumeration of total oral bacteria, including cariogenic plaque streptococci. Our studies using oral clinical specimens from pediatric patients demonstrate that ATP-driven bioluminescence can be used in the direct determination of bacterial numbers, and can serve as a general assessment indicator for oral hygiene. ATP-driven bioluminescence may potentially serve as a component of dental caries risk assessment.