A randomised, controlled clinical trial comparing chlorhexidine gel and low-dose fluoride toothpaste to prevent early childhood caries.
OBJECTIVES.  This randomised, controlled trial compared the effectiveness of 0.12% chlorhexidine (CHX) gel and 304% fluoride toothpaste to prevent early childhood caries (ECC) in a birth cohort by 24 months. METHODS.  The participants were randomised to receive either (i) twice daily toothbrushing with toothpaste and once daily 0.12% CHX gel (n = 110) or (ii) twice daily toothbrushing with toothpaste only (study controls) (n = 89). The primary outcome measured was caries incidence and the secondary outcome was percentage of children with mutans streptococci (MS). All mothers were contacted by telephone at 6, 12, and 18 months. At 24 months, all children were examined at a community dental clinic. RESULTS.  At 24 months, the caries prevalence was 5% (3/61) in the CHX and 7% (4/58) in the controls (P = 0.7). There were no differences in percentages of MS-positive children between the CHX and control groups (54%vs 53%). Only 20% applied the CHX gel once daily and 80% less than once daily. CONCLUSIONS.  Toothbrushing using 304% fluoride toothpaste with or without the application of chlorhexidine gel (0.12%) reduces ECC from 23% found in the general community to 5-7%. The lack of effect with chlorhexidine is likely to be due to low compliance.
Logan-Beaudesert Division, Metro South Health Service District, Queensland Health, Logan, QLD, Australia.
Margaret L
ML
Pukallus
Kathryn A
KA
Plonka
Adrian G
AG
Barnett
Laurence J
LJ
Walsh
Trevor F
TF
Holcombe
W Kim
WK
Seow
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects; D002327:Cariostatic Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D003376:Counseling; D004245:DMF Index; D003731:Dental Caries / Q000382:microbiology / Q000517:prevention & control*; D004522:Educational Status; D005260:Female; D005459:Fluorides / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007778:Lactobacillus / Q000187:drug effects; D008297:Male; D009035:Mothers / Q000193:education; D009909:Oral Health / Q000193:education; D013295:Streptococcus mutans / Q000187:drug effects; D014099:Toothbrushing / Q000706:statistics & numerical data; D014100:Toothpastes / Q000627:therapeutic use*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D014100:Toothpastes; D005459:Fluorides; D002710:Chlorhexidine