CARIES VACCINE – S H ORT NOTES

 2011 R V SUBRAMANYAM

Various methods have been tried to prevent dental caries. A successful vaccination directed
against S.mutans could be a valuable adjunct to other caries preventive measures. Vaccination
which may be active or passive.

ACTIVE
Antigens are introduced into the individual which induce production of antibodies against
cariogenic organisms – especially strep mutans.
Immunity is for a long duration.
Methods:
Mucosal Immunization
 Antigen alone
 low adsorption, degradation, poor immunogenicity
 Antigen conjugation
 Cholera toxin B subunit
 Antigen packaging
 Microencapsulation (starch, polyacrylamide, co-polymers lactate-glycolate)
 Liposomes
 Adjuvants
 Monophosphoryl lipid A, cholera, muramyl dipeptide
 Mechanisms
 Antigen protection from acidic and enzymatic degradation in intestines
(oral vaccines).
 Particulate antigen is taken up more effectively than soluble antigen by
Memory cells.
 Antigen depots (maintain antigen at local sites - minimizes systemic
absorption)
 Antigen expression in colonizing bacteria (E. coli, Salmonella) or viruses (polio)

Potential Caries Vaccine Strategies

 Topical application of vaccines
 Intranasal
 Strep. mutans antigens or their functional domains have been used and
protection against caries was observed.
 Cannot be used for children with respiratory problems.
 Palatine tonsil
 topical application of formalin-killed Strep. sobrinus was able to induce
salivary immune response against cariogenic Strep.sobrinus.
 Salivary glands
 labial application of GTF was shown to decrease levels of Strep. mutans
 Rectum
 administered along with Heliobacter pylori or Strep. pneumonia –
production of Salivary IgA antibodies against cariogenic organisms
 Gingiva
 Injecting or brushing antigens into the gingiva – antibodies against
cariogenic organisms form in the crevicular fluid
 Systemic route

1
  Subcutaneous injection
 Serum IgG, IgM, IgA antibodies against cariogenic organisms were seen
in saliva and crevicular fluid.
 Adjuvants – using antigens with
 cholera toxin subunits
 avirulent strains of salmonella
 monophosphoryl lipid A
 recombinant vaccines
 cloned antigens
 recombinant vector

PASSIVE
Antibodies against cariogenic organisms are provided.
Immunity is only for a short period.
 Monoclonal antibodies
 Against Strep.mutans cell surface antigens
 Bovine milk and whey
 Cows are immunized and the cow’s milk that contains antibodies against
cariogenic organisms is included in the diet
 Egg-yolk antibodies
 Hens injected with antigens and antibodies against GTF formed– introduced by
Hamada and found to be effective.
 Transgenic plants
 Genetically modified tobacco plant with antibodies against cariogenic bacteria is
painted onto the teeth.

RISKS OF USING CARIES VACCINE

 Cross-reactivity with heart tissue antigens (humans and animals like rabbit)
 Cross-reactivity with muscle myosin (rabbit)

CONCLUSION
Though various experimental studies in animals have established the effect of these vaccines,
clinical trials in humans are still inconclusive and permission for their usage is still pending.
The risks seem to outweigh the benefits at present.