title: Effect of different chlorhexidine varnish regimens on mutans streptococci levels in interdental plaque and saliva.
abstract: The aim of the present study was to evaluate and compare the effects of an intensive and a monthly mode of antibacterial varnish application on the levels of mutans streptococci (MS) in interdental plaque and whole saliva. Eighty-eight healthy schoolchildren (11-13 years) with high scores of salivary MS were selected by a screening procedure and randomised into two groups, MS were enumerated at all mesial interdental sites of the first permanent molars with the aid of a modified chair-side technique, disclosing a total of 161 sites with moderate or high colonisation levels. The subjects were treated with a 1% chlorhexidine-thymol-containing varnish (Cervitec) either in an intensive mode (IM) with 3 applications within a 2-week period or in a monthly mode (MM) during a 3-month period. The varnish was applied with a miniball burnisher after the teeth had been cleaned interdentally with dental floss and dried with air. Follow-up samples of saliva and plaque from the interdental areas were collected after 1, 3 and 6 months. Both groups exhibited a statistically significant (p > 0.05) reduction of interdental MS after 1 month when compared with baseline. An eliminated MS growth appeared more frequently following the IM compared with the MM. After 3 months, a significant reduction compared with baseline was still found in the IM group but not in the MM group. No reduction was found in either group after 6 months. MS levels in saliva were mainly unaffected at the follow-up samplings, with the exception of a slight reduction in the IM group after 1 month. In conclusion, the results suggest that an intensive mode of chlorhexidine-thymol varnish application is more effective against interdental MS than the monthly mode of application. Bacterial growth should be monitored in a site-specific way, since interdental reductions were not adequately reflected in whole saliva samples.
authors.affiliation: Department of Paediatric Dentistry, Medical and Dental Health Centre, Halmstad, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Twetman
authors.forename: L G
authors.initials: LG
authors.lastname: Petersson
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000382:microbiology*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D008963:Molar / Q000382:microbiology; D010150:Paint; D012463:Saliva / Q000382:microbiology*; D013295:Streptococcus mutans / Q000187:drug effects* / Q000254:growth & development; D013943:Thymol / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; C079161:chlorhexidine, thymol drug combination; D013943:Thymol; D002710:Chlorhexidine