Article Data

  • Views 814
  • Dowloads 184

Original Research

Open Access

Effect of Infant Formula on Streptococcus Mutans Biofilm Formation

  • Laura M Hinds1,*,
  • Elizabeth A S Moser2
  • George Eckert2
  • Richard L Gregory3,*,

1Indiana University School of Dentistry, Riley Hospital for Children at IU Health

2Department of Biostatistics, Indiana University School of Medicine

3Department of Oral Biology, Indiana University School of Dentistry

DOI: 10.17796/1053-4628-40.3.178 Vol.40,Issue 3,May 2016 pp.178-185

Published: 01 May 2016

*Corresponding Author(s): Laura M Hinds E-mail:
*Corresponding Author(s): Richard L Gregory E-mail:


Objective: This study investigated the effect that infant formula had on biofilm growth of Streptococcus mutans. Specifically, it compared biofilm growth in media containing lactose-based and sucrose-based formulas. It also analyzed biofilm formation with formulas of varying iron content. Biofilm growth was tested with the specific infant formula components sucrose, lactose, and ferric chloride. The study was designed to determine if these types of infant formulas and components affected S. mutans biofilm formation differently. Study design: A 24-hour culture of S. mutans was treated with various concentrations of infant formula diluted in bacteriological media. To test for biofilm formation, S. mutans was cultured with and without the infant formula and formula components. The biofilms were washed, fixed, and stained with crystal violet. The absorbance was measured to evaluate biofilm growth and total absorbance. Results: Sucrose-based formulas provided significant increases in biofilm growth when compared to lactose-based formulas at two dilutions (1:5, 1:20). Similac Sensitive RS (sucrose-based) at most dilutions provided the most significant increase in biofilm growth when compared to the control. Sucrose tested as an individual component provided more of a significant increase on biofilm growth than lactose or iron when compared to the control. A low iron formula provided a significant increase in biofilm growth at one dilution (1:5) when compared to formula containing a normal iron content. There was no significant difference in biofilm growth when comparing high iron formula to normal iron formula or low iron formula. There was no significant difference when comparing Similac PM 60/40 (low iron formula) to Similac PM 60/40 with additional ferric chloride. Conclusion :The results of this study demonstrated that sucrose-based formula provided more of a significant increase in biofilm growth compared to lactose-based formula. Sucrose alone provided a significant increase of biofilm growth at more dilutions when compared to the control than lactose and iron. The amount of iron in formula had a significant effect on biofilm formation only when comparing low iron formula to normal iron formula at the highest concentration (1:5). There was no significant difference in biofilm growth when iron was added to the low iron formula. The information obtained expands current knowledge regarding the influence of infant formula on the primary dentition and reinforces the importance of oral hygiene habits once the first tooth erupts. infant formula, sucrose, lactose, ferric chloride, early childhood caries (ECC), S. mutans


infant formula, sucrose, lactose, ferric chloride, early childhood caries (ECC), S. mutans

Cite and Share

Laura M Hinds,Elizabeth A S Moser,George Eckert,Richard L Gregory. Effect of Infant Formula on Streptococcus Mutans Biofilm Formation. Journal of Clinical Pediatric Dentistry. 2016. 40(3);178-185.


1. Shelov SP and Hannemann RE, eds. American Academy of Pediatrics. Caring for your baby and young child: birth to age 5. New York, NY: Bantam; 2004.

2. Grummer-Strawn LM, Scanlon KS, and Fein SB. Infant feeding and feeding transitions during the first year of life. Pediatrics; 122: S36-S42. 2008.

3. Centers for Disease Control and Prevention. Breastfeeding report card. United States: 2007.

4. World Health Organization. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. Geneva: World Health Organization; 2009.

5. Marshall TA, Levy SM, Warren JJ, Broffitt B, Eichenberger-Gilmore JM, Stumbo PJ. Associations between intakes of fluoride from beverages during infancy and dental fluorosis of primary teeth. J AM Coll Nutr; 23: 108- 116. 2004.

6. Holgerson PL et al. Oral microbial profile discriminates breast-fed from formula-fed infants. J Pediatr Gastroenterol Nutr; 56: 127-136. 2013.

7. US Department of Health and Human Services. Oral health in America: a report of the surgeon general. Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institute of Health; 2000.

8. Drury TF, Horowitz AM, Ismail AI, et al. Diagnosing and reporting early childhood caries for research purposes. J Public Health Dent; 59: 192- 197. 1999.

9. Kaste LM, Gift HC. Inappropriate infant bottle feeding – status of the healthy people 2000 objective. Arch Pediatr Adolesc Med; 149: 786-791. 1995.

10. Van Houte J, Gibbs G, Butera C. Oral flora of children with nursing bottle caries. J Dent Res; 61: 382-385. 1982.

11. Bowen WH, Pearson SK, Rosalen PL, Miguel JC, Shih AY. Assessing the cariogenic potential of some infant formulas, milk, and sugar solutions. J Am Dent Assoc; 42: 37-43. 1997.

12. Loesche WJ. Role of Streptococcus mutans in human dental decay. Microbiol Rev; 50: 353-380. 1986.

13. Hung R, Mingyun Li, Gregory RL. Bacterial interactions in dental biofilms. Virulence; 2.5: 435-444. 2011

14. Leme, AF, Koo H, Bellato CM, Bedi G, Cury JA. The role of sucrose in cariogenic dental biofilm formation – new insight. J Dent Res; 85.10: 878- 887. 2006.

15. Zeng L, Das S, Burned RA. Utilization of lactose and galactose by Strep-tococcus mutans: transport, toxicity, and carbon catabolite repression. J Bacteriol; 192: 2434-2444. 2010.

16. Campbell RG, Zinner DD. Effect of certain dietary sugars on hamster caries. J Nutr 1969; 100: 11-20.

17. Peres RC, Coppi LC, Volpato MC, Groppo FC, Cury JA, Rosalen PL. Cariogenic potential of cows’, human and infant formulas and effect of fluoride supplementation. Br J Nutr. 2009; 101: 376-382.

18. Bowen WH, Lawrence RA. Comparison of cariogenicity of cola, honey, cow milk, human milk, and sucrose. Pediatrics; 80: S199-210. 2005.

19. Prabhakar AR, Kurthukoti AJ, Gupta P. Cariogenicity and acidogenicity of human milk, plain and sweetened bovine milk: an in vitro study. J Clin Pediatr Dent;3: 239-247. 2010.

20. Hopkins D, Emmett P, Steer C, Rogers I, Noble S, Edmond A. Infant feeding in the second 6 months of life related to iron status: an observa-tional study. Arch Dis Child; 92: 850-854. 2007.

21. Messenger AJM and Barclay R. Bacteria, iron and pathogenicity. Biochemical Education; 11: 54-63. 1983.

22. Ribeiro CCC, Ccahuana-Vasquez RA, Carmo CDS, Alves CMC, Leitao TJ, Vidotti LR, Cury JA. The effect of iron on Streptococcus mutans biofilm and on enamel demineralization. Brazilian Oral Research; 26: 300- 305. 2012.

23. Martinhon CCR et al. Effect of iron on bovine enamel and on the compo-sition of the dental biofilm formed “in situ”. Arch Oral Biol; 51: 471-475. 2006.

24. Huang R, Li M, Gregory RL. Effect of nicotine on growth and metabo-lism of Streptococcus mutans. Eur J Oral Sci; 120: 319-325. 2012.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time