Abstract
The aim of this study was to estimate the effectiveness of antimicrobial (chlorhexidine) and remineralising agents (fluoride varnish) applications for early childhood caries prevention in children with Streptococcus mutans (SM) in saliva.
Methods: The study was conducted in the Belarusian State Medical University dental school. A total of 295 children up to 3 years old (average age 15.2 months) were examined by one dentist to assess quantitative salivary levels of SM, dental caries using d1-4mft index and oral hygiene practices (index of E.Kuzmina, 2000). Children with SM CFU >103 (n=134) were randomized in group 1 (n=52) with applications of “Cervitec” varnish (chlorhexidine) 4 times a year, group 2 (n=51) with applications of “Cervitec” varnish 2 times a year and 5% fluoride varnish applications 2 times a year and control group 3 (n=31) with semi-annual dental visits. The dentist who recorded dmft was blind to the treatment groups. The results were analyzed statistically (Wilcoxon test, Mann- Whitney U test, Spearman correlation analysis). Regional Ethics Committee approval and parental informed consents were obtained.
Results: There were no statistically significant proportional differences regarding age, gender or number of erupted teeth between the groups. At baseline the dental caries prevalence was 67.3% (n=35) in group 1, 64.7% (n=33) in group 2 and 67.7% (n=21) in group 3. Index d1-4mft was 3.23 (2.90), 3.18 (2.82) and 3.32 (3.41) accordingly (p1-3=0.88; p2-3=0.86). Oral hygiene index was 0.44 (0.26), 0.39 (0.26) and 0.43 (0.27) (p1-3=0.39; p2-3=0.76). The SM salivary level was 1.69 (0.61), 1.57 (0.64) and 1.74 (0.58) accordingly (p1-3=0.67; p2-3=0.21). After 3 years the increase in dental caries in group 1 was 2.04, in group 2 – 1.35 and in group 3 – 3.30 (р1-3=0.12; р2-3=0.001). Dental caries reduction was 38.2% in group 1 and 59.1% in group 2. The correlation between dental caries prevalence and oral hygiene index in each group was (ρ=0.66, ρ=0.46 and ρ=0.45; p<0.001). There was no significant effect of 4 “Cervitec” varnish applications on dental caries increment.
Conclusion: the antimicrobial and fluoride varnish should be used together for ECC prevention in children with SM in saliva.
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