 Hello everyone welcome back to another session in dentistry and more today we have an interesting topic carries vaccine. So we have been learning and listening about vaccine from our very younger classes from school time we have been listening from our teachers and from faculty members about vaccine and the diseases which can be prevented by vaccine and we know many diseases which are completely eradicated from earth like smallpox or polio and now we are into a rush of creating a vaccine for coronalysis. So vaccine it's not a newer term but carries vaccine it is not very popular because there is no proper carries vaccine which can prevent dental carries unlike other diseases which can be prevented by vaccine carries cannot be prevented by a vaccine because of a crucial thing that is carries is caused by a multifactorial causes. So let's learn about carries vaccine and its concept why it is not very popular and why it cannot be used as a method to prevent dental carries or a sol method to prevent dental carries. So we know dental carries is a microbial infectious disease of teeth which results in local dissolution and destruction of calcified tissue it is one of the most common disease in human and it is also a major public health problem and vaccine it is an immunological substance which is designed to produce a specific protection against a given disease that is this gives protection against dental carries. So we need to learn about immunity so immunity we know the various types of immunity innate immunity, acquired immunity so I have explained in my previous video in detail about the types of immunity so hope you remember the concept of immunity you don't need to learn everything about immunity to understand carries vaccine just the concept of immunity how immunity works how the innate immunity works and how the acquired immunity works and passive so all those immunity types okay so immunity is nothing but a resistance exhibited by the host against any foreign antigen including microorganisms okay now we have carries vaccine so why we need vaccination because dental carries as I said it is a major public health problem which has a severe impact on oral health related quality of life because when we get this carries it might affect our personal life it might create a loss of working hours we might need to skip our school day or work working hours so it is a public health problem definitely so vaccination is very much required since it is a public health problem because almost public health concerns almost 70 to 80 percent of the population will be having at least one dental carries often his mouth before moving to vaccine we need to understand the concept of multifactorial causation so we know polio is caused by a virus right and we know smallpox is caused by again microorganisms so if we find a vaccine if we create a vaccine which can destroy that particular virus or particular microorganisms we can prevent that disease so we know that carries is caused by caused by stuctococcus mutants lactobacillus or actinomysus so here itself we have many bacteria so we need to find out vaccines for each bacteria or each strain of the bacteria because initiation of carries by mutants progression by lactobacillus then by actinomysus so there are n number of bacteria which is involved in dental carries so we need to find a vaccine against this bacteria or a particular strain and if we can kill the bacteria if we can prevent the bacteria its localization in any way if you are removing the bacteria we can prevent dental carries if we are thinking about the same concept of polio and smallpox but the dental carries is not just caused by bacteria it is a multifactorial disease not just bacteria there is involvement of host factors that is tooth its position the flow of saliva the maloculation status its personal oral hygiene status and the food he consumes the kerosene food the sticky food the frequency of food and the time the more time the food substance which is retained in the mouth also cause dental carries so when all these factors that is bacteria tooth food time altogether works to create dental carries because all people will have bacteria everyone will have this particular strain of bacteria mutants lactobacillus actinomysus because it is a normal oral flora it will increase when there is carries but not just bacteria can create carries because not every person who is having bacteria can dental carries is not there okay but people with dental carries will be having this bacteria just like tuberculosis every person or who is infected with the tuberculum bacteria is not getting tuberculosis there are many factors which involve like poor immunological response or the nourishment status and its hygiene so everything involves in creation of or the resulting the output of that disease so like I said it is a multifactorial disease so not just bacteria prevention or its killing of bacteria by vaccine will not prevent the formation of carries because of its multifactorial concept okay and we know how this carries happens when there is dental plague formation so over the plague this bacteria will get deposited and this plague will act on the substrate which the person consume like sucrose or any other kerosene food and will create lactic acid which will deminulize the teeth and finally carries happens this is a process okay how the carries happens so we have antigenic determinants of streptococcus mutants so now we are focusing on streptococcus mutants so we have antigenic anyway streptococcus mutants is a gram positive facultative anaerobic and its antigenic determinants okay so hope you know antigen is something which comes from outside and antibodies immune complex which is created within the body when responds to antigen so antigenic determinants are adhesin which is a wall associated protein which form the two principle human pathogens of streptococcus mutants and next one is glucosyl transferase which is streptococcus mutants has three forms of glucosyl transferase and the third one is glucan binding protein or GBP okay so the mutants against has three distinct proteins and the dextranase so it is an important constant of early dental plague okay so these antigenic determinants so our vaccine is aimed at these antigenic determinants like adhesin glucosyl transferase GBP and dextranase in the plague so how do we apply this vaccine or how do we use or administer this vaccine that is root of administration we have the common mucosal immune pathway that is the first one it has various root like rectal oral intranasal tonsillar and minor salivary gland roots then we have systemic root then we have active gingiva salivary root okay these are the roots of administration so the common mucosal immune pathway where the mucosal application of dental carries vaccine are generally preferred for the induction of secretary IgA antibodies so mostly this through the IgA antibodies okay so it is acting against these antigens and creation is IgA antibodies so the oral root so the first one is oral root which is relied on the oral induction of immunity in the GALT okay it's nothing but the gut associated lymphoid tissue so antigen was applied by oral feeding gastric intubation or in vaccine containing capsules or liposomes next is the intranasal root so intranasal installation of antigen which has been used to induce immunity to bacterial antigens including those associated with streptococcus mutants colonization and accumulation whereas a tonsillar root where the tonsillar tissues containing contain the required elements of induction of IgA and IgG so palatine tonsils especially nasopharyngeal tonsils have been suggested to this mucosal effectosite such as salivary glands so in minor salivary gland they have been suggested as the potential roots for mucosal induction given the short broad secretory ducts that facilitate retrograde access of bacteria and their products and give the lymphatic tissue aggregates whereas rectal root so we have rectal root this is a region as an inductive location for immune responses in humans as this site has the highest concentration of lymphoid follicles in the lower intestinal tract and the second root is systemic root this is successfully elicited because it has IgG, IgM and IgA antibodies can be elicited through this systemic root and the last one is active gingio salivary root so in order to limit the potential side effects and to localize the immune response the gingioval crevicular fluid has been used as a root of administration okay so these are active immunization active immunization means we are injecting the or we are giving the antigens okay so these are the antigens which can be used to create the antibodies okay so that is active immunity so the immunity active immunity is induction of antigens whereas a passive immunity passive immunity is like creation of antibodies from outside and giving antibodies to the person that is like monoclonal antibodies or bovine milk so all these are passive immunization where transferring just the antibodies so active immunity body itself creates antibodies when there is a presence of antigens so we are inoculating antigens which are part of the streptococcus mutants so that the body creates immunity so the advantages of this vaccine is it prevents the disease in children it can be incorporated to universal immunization program which is cost effective in long run and it provides lifelong immunity but the main problem is it is a multifactorial its effectiveness is very questionable and there is risk of hypersensitivity and there could be cross reactivity of certain antigening components of streptococcus mutants with heart tissue and there is microbial resistance so that is all about kerry's vaccine so kerry's vaccine is nothing but creation of antigens which are the antigening components of bacteria and induction via various routes and creating antibodies against kerry's vaccine but it's practically not very effective because still this time there is no much well accepted kerry's vaccine available because of the multifactorial causation so i'll come up with a new topic in dentistry and more thank you