Effect of Photodynamic Therapy on Multispecies Biofilms, Including Streptococcus mutans, Lactobacillus casei, and Candida albicans

Objective: The aim of this study was to evaluate the effect of photodynamic therapy (PDT) on multispecies oral caries biofilms composed of Streptococcus mutans, Lactobacillus casei, and Candida albicans. Background: The abovementioned microorganisms largely cause dental caries, especially early childhood caries (ECC), by synthesizing of acids in the presence of sugar. PDT is considered an effective process to remove oral biofilms, and erythrosine, an oral bacterial disclosing agent, is an ideal dye that can be used as a photosensitizer in PDT. However, until now, there are no studies that have reported the effect of erythrosine-mediated PDT on biofilms, including the three microorganisms. Methods: The biofilms were formed on hydroxyapatite discs, and erythrosine was used as the photosensitizer, diluted to a concentration of 40 mu M for 3 min. Light was irradiated for 10 and 20 sec using a blue light-emitting diode dental curing light. After the experiment, the colony-forming units of each microbial group cultured on blood agar plates were counted, and a confocal laser-scanning microscope was used to evaluate the effect of PDT. Results: The counts of all three microorganisms significantly decreased in the PDT group compared with those in the control group. For S. mutans and L. casei, there was a larger decrease proportional to the amount of energy irradiated. Conclusions: Overall, PDT showed a significant antimicrobial effect against oral biofilms composed of the three microorganisms, suggesting its potential clinical application for infants with ECC.