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Background  The majority of caries lesions in adults occur on the proximal tooth surfaces of the posterior teeth. A comprehensive study of the composition of the oral microbiota is fundamental for a better understanding of the etiology of interdental caries.    Methods  Twenty-five caries-free subjects (20–35 years old) were enrolled in the study. The interdental biofilm of four interdental sites were collected. The real-time polymerase chain reaction (PCR) methodology were used to quantify (i) the following bacteria:  Streptococcus spp .,  Streptococcus mutans ,  Lactobacillus spp .,  Enterococcus spp ., and  Enterococcus faecalis;  (ii) the fungus  Candida albicans;  and (iii)  total bacteria .    Results   Streptococcus  spp. was the most abundant species, followed by  Lactobacillus  spp. and  Enterococcus  spp.  Streptococcus  spp. and  Lactobacillus  spp. were detected at all tested sites and  Enterococcus  spp. at 99% of sites.  S .  mutans  was detected at only 28% of the tested sites and  C .  albicans  was detected at 11% of sites.  E .  faecalis  was never detected. In 54.5% of the biofilm inhabited by  C .  albicans ,  S .  mutans  was present. Moreover, 28% of the ID sites co-expressed  S .  mutans  and  Lactobacillus  spp. The studied pathogens were organized into two correlated groups of species. Strikingly, the fungus  C .  albicans  and the bacteria  Enterococcus  spp. cluster together, whereas  Streptococcus  spp.,  S .  mutans  and  Lactobacillus  spp. form one distinct cluster.    Conclusion  The interdental biofilm of young caries-free adults is comprised of pathogens that are able to induce interproximal caries. That several of these pathogens are implicated in heart disease or other systemic diseases is an argument for the disruption of interdental biofilms using daily oral hygiene.

Quantification of carious pathogens in the interdental microbiota of young caries-free adults