Clinical reduction of S. mutans in pre-school children using a novel liquorice root extract lollipop: a pilot study.
OBJECTIVE
To determine the clinical effect of a simple herbal caries-prevention protocol aimed at reduction of Streptococcus mutans (SM) in young children in a pre-school setting.


METHODS
Proof-of-principle pilot study.


METHODS
To prove the concept this pilot study delivered a clinical intervention using sugar-free lollipops containing liquorice root extract. Regimen: Supervised herbal lollipops, twice daily for 3 weeks. Species-specific monoclonal antibody testing of saliva provided SM counts. Children were grouped in high, medium and low caries-risk using baseline SM-levels as risk-indicator. Bacterial numbers at baseline, during intervention, and for 9 weeks post-intervention were compared.


METHODS
SM levels were analysed using GEE modelling.


RESULTS
High-risk children showed the steepest early decrease in mean log-SM (P<.001). At end of a follow-up period, the log-SM decrease moved the high-risk group down to moderate-risk level. High-risk children showed a decrease in fitted mean SM% not seen in other groups (P<.001). The decrease reached a nadir around 22-days post-intervention. Twice-daily use of herbal lollipop significantly reduced both number and relative percent of SM in high-risk children. SM numbers were reduced for 22 days after the last lollipop, stabilized and then began to rebound.


CONCLUSIONS
A potential for simple effective caries-prevention for high-risk children has been demonstrated. Encouraging results warrant randomised clinical trials (RCT) of liquorice root in herbal lollipops or alternative modes of delivery.
Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, 1100 N University, Ann Arbor, MI 48109, USA. mcpete@umich.edu
M C
MC
Peters
J A
JA
Tallman
T M
TM
Braun
J J
JJ
Jacobson
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D058491:Bacterial Load; D002182:Candy; D002675:Child, Preschool; D003733:Dental Caries Susceptibility; D018479:Early Intervention, Educational; D005260:Female; D005500:Follow-Up Studies; D006035:Glycyrrhiza; D006801:Humans; D008297:Male; D008517:Phytotherapy; D010865:Pilot Projects; D010936:Plant Extracts / Q000627:therapeutic use*; D018517:Plant Roots; D036343:Pterocarpans / Q000627:therapeutic use; D012463:Saliva / Q000382:microbiology*; D013295:Streptococcus mutans / Q000187:drug effects / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D010936:Plant Extracts; D036343:Pterocarpans; C508542:glycyrrhizol A; C508543:glycyrrhizol B