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Effect of a chlorhexidine/thymol and a fluoride varnish on caries development in erupting permanent molars: a comparative study

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Abstract

Aim

To compare the caries preventive effect of a chlorhexidine/thymol-containing antibacterial varnish with a fluoride varnish when topically applied during the eruption of permanent molars.

Methods

The study group consisted of 189 patients, 5–14 years of age, with one 1st or 2nd permanent molar in the process of eruption. After stratification for type of molar and stage of eruption, the patients were randomised to either quarterly topical applications with an antibacterial varnish (Cervitec® Plus; CV group) or biannual applications with a fluoride varnish plus biannual treatments with placebo varnish (Fluor Protector; FV group). The duration of the study was 2 years. The primary endpoint was caries incidence (initial and cavitated) in the erupting molars and the secondary outcome was salivary mutans streptococci (MS) counts.

Results

The groups were balanced with respect to socio-economy, oral hygiene, dietary habits and caries experience at baseline. The dropout rate was 11.6 %. The caries incidence was low (<10 %) in both groups and there was no significant difference between the CV and FV groups with respect to occlusal caries development in the erupting molars (relative risk 1.08, 95 % CI 0.94–1.25). Significantly lower levels of salivary MS were disclosed in the CV group at the end of the study (p < 0.05).

Conclusions

No difference in occlusal caries development in young permanent molars was displayed after topical applications of either a chlorhexidine/thymol varnish or a fluoride varnish during tooth eruption.

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References

  • Araujo AMPG, Naspitz GMCC, Chelotti A, Cai S. Effect of Cervitec® on Mutans Streptococci in plaque and on caries formation on occlusal fissures of erupting permanent molars. Caries Res. 2002;36:373–6.

    Article  PubMed  Google Scholar 

  • Beauchamp J, Caufield PW, Crall JJ, et al. Evidence-based clinical recommendations for the use of pit-and-fissure sealants: a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2008;139:257–68.

    Article  PubMed  Google Scholar 

  • Carvalho JC, Ekstrand KR, Thylstrup A. Results after 1 year of non-operative occlusal caries treatment of erupting permanent first molars. Community Dent Oral Epidemiol. 1991;19:23–8.

    Article  PubMed  Google Scholar 

  • Driessens FC, Heijligers HJ, Borggreven JM, Woltgens JH. Posteruptive maturation of tooth enamel studied with the electron microprobe. Caries Res. 1985;19:390–5.

    Article  PubMed  Google Scholar 

  • Hiiri A, Ahovuo-Saloranta A, Nordblad A, Mäkelä M. Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents. Cochrane Database Syst Rev. 2010;17(3):CD003067.

    Google Scholar 

  • James P, Parnell C, Whelton H. The caries-preventive effect of chlorhexidine varnish in children and adolescents: a systematic review. Caries Res. 2010;44:333–40.

    Article  PubMed  Google Scholar 

  • Korhonen M, Käkilehto T, Larmas M. Tooth-by-tooth survival analysis of the first caries attack in different age cohorts and health centers in Finland. Acta Odontol Scand. 2003;61:1–5.

    Article  PubMed  Google Scholar 

  • Maltz M, Beighton D. Multidisciplinary research agenda for novel antimicrobial agents for caries prevention and treatment. Adv Dent Res. 2012;24:133–6.

    Article  PubMed  Google Scholar 

  • Marinho VC, Worthington HV, Walsh T, Clarkson JE. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2013;11(7):CD002279.

    Google Scholar 

  • Mejàre I, Axelsson S, Dahlén G, et al. Caries risk assessment. A systematic review. Acta Odontol Scand. 2014;72(2):81–91.

    Article  PubMed  Google Scholar 

  • Paul S, Baranya Shrikrishna S, Suman E, Shenoy R, Rao A. Effect of fluoride varnish and chlorhexidine-thymol varnish on mutans streptococci levels in human dental plaque: a double-blinded randomized controlled trial. Int J Paediatr Dent. 2014;24(6):399–408.

    Article  PubMed  Google Scholar 

  • Petersson LG, Magnusson K, Andersson H, Almquist B, Twetman S. Effect of quarterly treatments with a chlorhexidine and a fluoride varnish on approximal caries in caries-susceptible teenagers: a 3-year clinical study. Caries Res. 2000;34:140–3.

    Article  PubMed  Google Scholar 

  • Piaggio G, Elbourne DR, Pocock SJ, Evans SJ, Altman DG, CONSORT Group. Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement. JAMA. 2012;308:2594–604.

    Article  PubMed  Google Scholar 

  • Ribeiro LG, Hashizume LN, Maltz M. The effect of different formulations of chlorhexidine in reducing levels of mutans streptococci in the oral cavity: a systematic review of the literature. J Dent. 2007;35:359–70.

    Article  PubMed  Google Scholar 

  • Sajjan PG, Nagesh L, Sajjanar M, Reddy SK, Venktesh UG. Comparative evaluation of chlorhexidine varnish and fluoride varnish on plaque Streptococcus mutans count—an in vivo study. Int J Dent Hyg. 2013;11:191–7.

    Article  PubMed  Google Scholar 

  • Schwendicke F, Jäger AM, Paris S, Hsu LY, Tu YK. Treating pit-and-fissure caries: a systematic review and network meta-analysis. J Dent Res. 2015;94(4):522–33.

    Article  PubMed  Google Scholar 

  • ten Cate JM, Zaura E. The numerous microbial species in oral biofilms: how could antibacterial therapy be effective? Adv Dent Res. 2012;24:108–11.

    Article  PubMed  Google Scholar 

  • Tut OK, Milgrom PM. Topical iodine and fluoride varnish combined is more effective than fluoride varnish alone for protecting erupting first permanent molars: a retrospective cohort study. J Public Health Dent. 2010;70:249–52.

    Article  PubMed Central  PubMed  Google Scholar 

  • Twetman S. Antimicrobials in future caries control? A review with special reference to chlorhexidine treatment. Caries Res. 2004;38:223–9.

    Article  PubMed  Google Scholar 

  • Twetman S, Axelsson S, Dahlén G, et al. Adjunct methods for caries detection: a systematic review of literature. Acta Odontol Scand. 2013;71:388–97.

    Article  PubMed  Google Scholar 

  • Unkel JH, Fenton SJ, Hobbs G Jr, Frere CL. Toothbrushing ability is related to age in children. ASDC J Dent Child. 1995;62:346–8.

    PubMed  Google Scholar 

  • Wade WG. The oral microbiome in health and disease. Pharmacol Res. 2013;69:137–43.

    Article  PubMed  Google Scholar 

  • Weyant RJ, Tracy SL, Anselmo TT, et al. Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review. J Am Dent Assoc. 2013;144:1279–91.

    Article  PubMed Central  PubMed  Google Scholar 

  • World Health Organisation. Oral health surveys. Basic methods. 3rd ed. World Health Organisation: Geneva, 1997.

  • Zhang Q, Mulder J, Truin GJ, van Palestein Helderman WH. Effect of 40 % chlorhexidine varnish on mutans streptococci in pits and fissures of permanent first molars. J Dent. 2007;35:588–92.

    Article  PubMed  Google Scholar 

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Acknowledgments

The varnishes (chlorhexidine/thymol––Cervitec® and fluoride––Fluor Protector®) and the chair-side tests (CRT bacteria) were generously supplied by Ivoclar Vivadent AG, Schaan, Liechtenstein.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in the study participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Correspondence to S. Gizani.

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Flamee, S., Gizani, S., Caroni, C. et al. Effect of a chlorhexidine/thymol and a fluoride varnish on caries development in erupting permanent molars: a comparative study. Eur Arch Paediatr Dent 16, 449–454 (2015). https://doi.org/10.1007/s40368-015-0192-x

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  • DOI: https://doi.org/10.1007/s40368-015-0192-x

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