Arginine: A Weapon against Cariogenic Biofilm?

Untreated dental caries is the most prevalent disease worldwide. Development of caries is associated with the intake of sugar. The microorganisms utilize the sugar and create an acidic environment, which results in mineral loss. The appropriate use of fluoride is associated with a decline of caries. Another approach in preventing caries might be the increase of pH in dental plaque. During recent years, arginine has increasingly become the focus of interest. This is based on the fact that certain streptococci possess an arginine deiminase system (ADS) which metabolizes free arginine. In vivo, the incidence of caries was inversely correlated with ADS activity in saliva and dental plaque. ADS is highly active in Streptococcus gordonii and S. sanguinis, but is absent in S. sobrinus and S. mutans. In the presence of 1.5% L-arginine, S. gordonii and S. sanguinis, but not S. mutans and S. sobrinus, synthesize the metabolite citrulline and increase the pH of the environment.In defined multispecies biofilms consisting of ADS-positive and ADS-negative streptococci, supplementation with 1.5% arginine suppressed the growth of ADS-negative by favoring ADS-positive streptococci together with an increase in the pH of the environment. Evaluating the influence of daily manual removal of the biofilm in vitro by brushing with a commercial toothpaste containing fluoride and arginine resulted in less surface microhardness even when compared with a toothpaste with fluoride only. Recent studies clinically investigated the effect of using an arginine-containing dentifrice and reported a decrease of DMFS by about 10-20%.