Caries-preventive effect of chlorhexidine gel applications among high-risk children.
Evidence on the caries-preventive effect of chlorhexidine (CHX) among high-risk children is inconclusive, possibly because obscured by fluoride exposure. We investigated the effect of CHX among initially 3-year-old subjects whose baseline d(3)ft was = 0 and whose only regular fluoride exposure came from toothpaste. The subjects were assigned to three groups: high-risk test (HRT, n = 70), high-risk control (HRC, n = 71), and low-risk control (LRC, n = 70). Risk classification was based on salivary mutans streptococcal levels (MS, </>or=1.0 x 10(5) cfu/ml). Basic measures (oral hygiene, dietary counselling every 4 months) were given to all groups. HRT also underwent CHX gel applications for 3 consecutive days at 3-month intervals for 15 months. Eighteen months after baseline d(3)ft increments and proportions of children with d(3)ft increment >or=1 (%d(3)ft increment >or=1) among all groups were assessed. Anti-MS effect on high-risk children and caries-preventive effect on all children were statistically analysed by residual change analysis (MS), non-parametric tests and logistic regression analysis (caries). No differences were found between the groups in basic programme compliance. CHX significantly reduced MS levels. %d(3)ft increment >or=1 and mean d(3)ft increments were 34.3%, 0.56 (HRT), 32.4%, 0.54 (HRC) and 11.4%, 0.11 (LRC), with HRT/HRC values statistically significantly higher than LRC values and no significant difference between HRT and HRC. HRT children were not less likely to show new lesions than HRC children (OR = 1.09; 95% confidence interval 0.54-2.19), while high-risk children were 4 times more likely to show new lesions than low-risk children (OR = 3.71; 95% confidence interval 1.53-9.03). CHX gel applications showed moderate anti-MS effect but negligible caries-preventive effect.
Petti
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G. Sanarelli Department of Public Health Sciences, La Sapienza University, Rome, Italy. stefano.petti@uniroma1.it
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D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002327:Cariostatic Agents / Q000008:administration & dosage; D002710:Chlorhexidine / Q000627:therapeutic use*; D003731:Dental Caries / Q000517:prevention & control*; D004812:Epidemiologic Methods; D005459:Fluorides / Q000008:administration & dosage; D005782:Gels; D006801:Humans; D007223:Infant; D012463:Saliva / Q000382:microbiology*; D013295:Streptococcus mutans / Q000302:isolation & purification*; D014099:Toothbrushing; D014100:Toothpastes / Q000737:chemistry
D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D005782:Gels; D014100:Toothpastes; D005459:Fluorides; D002710:Chlorhexidine