title: A randomized controlled trial of a 10 percent CPP-ACP cream to reduce mutans streptococci colonization.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effectiveness of a 10 percent casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) cream to reduce mutans streptococci (MS) colonization and prevent early childhood caries.
  
  
  METHODS
  The cohort was randomized at mean age of 11 days old to receive once-daily CPP-ACP cream (n=102) or no product (comparison group; n=89) from the time of first tooth eruption. All mothers were contacted by telephone at six, 12, and 18 months and advised to brush their children's teeth twice daily with low-dose fluoride toothpaste. At 24 months, all children were examined at a community clinic.
  
  
  RESULTS
  At 24 months old, one out of 65 (2 percent) children in the CPP-ACP group had caries vs. four out of 58 (seven percent) in the comparison group (difference not statistically significant). There were fewer MS-positive children in the CPP-ACP group (26 percent) vs. the comparison group (47 percent; P=.02). A dose-response effect of CPP-ACP usage on MS was observed, where MS was present in eight percent of regular CPP-ACP users, 28 percent of irregular users, and 47 percent of non-users (P<.02).
  
  
  CONCLUSIONS
  CPP-ACP reduced the percentages of mutans streptococci-positive 24-month-old children, although it did not reduce caries prevalence.
authors.affiliation: Metro South Health Service District, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Pukallus
authors.affiliation: Metro South Health Service District, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Plonka
authors.affiliation: Oral Health Program (Logan-Beaudesert Division), Metro South Health Service District, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Trevor F
authors.initials: TF
authors.lastname: Holcombe
authors.affiliation: School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane.
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Barnett
authors.affiliation: Center for Pediatric Dentistry, The University of Queensland, Brisbane, Australia.
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Walsh
authors.affiliation: School of Dentistry, The University of Queensland, Brisbane, Australia. k.seow@uq.edu.au.
authors.forename: W Kim
authors.initials: WK
authors.lastname: Seow
mesh_terms: D058491:Bacterial Load / Q000187:drug effects; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002364:Caseins / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D003731:Dental Caries / Q000382:microbiology* / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D005247:Feeding Behavior; D005260:Female; D005459:Fluorides / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006267:Health Education, Dental; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007778:Lactobacillus / Q000302:isolation & purification; D008297:Male; D012923:Social Class; D013295:Streptococcus mutans / Q000187:drug effects*; D014099:Toothbrushing / Q000379:methods; D014100:Toothpastes / Q000627:therapeutic use
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; D014100:Toothpastes; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D005459:Fluorides