Effectiveness of 2-year application of school-based chlorhexidine varnish, sodium fluoride gel, and dental health education programs in high-risk adolescents.
OBJECTIVE
To compare the caries preventive effects of 2-year application of school-based chlorhexidine varnish, sodium fluoride gel, and dental health education programs among a high-risk group of 11- to 13-year-olds with low caries activity.


METHODS
A total of 149 subjects who had previous caries experience in the primary dentition and Streptococcus mutans levels higher than 10(5) at baseline with 0 DMFS index were selected for this randomized clinical trial. Subjects were allocated to one of 3 groups for treatment with chlorhexidine varnish (n = 50), sodium fluoride gel (n = 50), or a dental health education program (n = 49), which were repeated throughout the 2-year study. The outcomes examined at the end of the study were the caries increment (DMFS index), dental plaque scores, and salivary S mutans counts.


RESULTS
The subjects in the education group showed a significant increase in the salivary levels of S mutans in comparison with the other groups (P = .004), but there was no significant difference among the groups in the caries increment after 2 years, with mean DMFS +/- SD as 0.95 +/- 1.33, 0.88 +/- 1.47, and 1.05 +/- 2.01 in the chlorhexidine varnish, sodium fluoride gel, and education groups, respectively. There were also no significant differences in the pre- and posttreatment plaque scores between the groups.


CONCLUSIONS
Although all 3 preventive programs in this high-caries-risk group of children with low caries activity resulted in similar plaque and caries values after 2 years, longer follow-up studies are needed to clarify the effect of reduction in S mutans growth by chemotherapeutic agents in caries incidence.
Ersin
Nazan Kocatas
NK
Department of Pedodontics, Ege University, Izmir, Turkey. nazan.ersin@ege.edu.tr
Eden
Ece
E
Eronat
Nesrin
N
Totu
Fusun Irem
FI
Ates
Mustafa
M
D000287:Administration, Topical; D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D004245:DMF Index; D003731:Dental Caries / Q000517:prevention & control*; D003733:Dental Caries Susceptibility; D003774:Dental Plaque Index; D004338:Drug Combinations; D005460:Fluorides, Topical / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005782:Gels; D006267:Health Education, Dental; D006801:Humans; D018570:Risk Assessment; D012463:Saliva / Q000382:microbiology; D012571:School Dentistry; D012923:Social Class; D012969:Sodium Fluoride / Q000008:administration & dosage / Q000627:therapeutic use*; D013295:Streptococcus mutans / Q000254:growth & development; D013943:Thymol / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D004338:Drug Combinations; D005460:Fluorides, Topical; D005782:Gels; C079161:chlorhexidine, thymol drug combination; D013943:Thymol; D012969:Sodium Fluoride; D002710:Chlorhexidine