Effect of Herbal and Fluoride Mouth Rinses on Streptococcus mutans and Dental Caries among 12-15-Year-Old School Children: A Randomized Controlled Trial

Herbal Mouthrinses for Prevention of Dental Caries in Children and Adolescents: A Systematic Review

The primary aim of this study was to evaluate the effectiveness of herbal mouthrinses (HMR) on caries prevention in children and adolescents. In addition, this systematic review assessed its effectiveness in remineralization of white spot lesions, reduction of halitosis, and improving gingival and periodontal health in orthodontic patients and patients with special healthcare needs (SHCN). A comprehensive bibliographic search was conducted in PubMed, Cochrane Central, EMBASE, AMED, ProQuest, CINAHL, AYUSH, Digital Helpline for Ayurveda Research Articles (DHARA), and Clinical Trial Gov databases. A total of 3,918 titles were identified during the initial search. Of these, 32 studies were selected for quality assessment. A total of 5,038 participants from 10 countries were thus included in this review, with 22 (66.7%) studies conducted in India. All included studies were published between 2004 and 2021. Included studies investigated the effect of HMR on caries increments, which record decayed, missing, filled (DMF) [International Caries Detection and Assessment System (ICDAS)], decayed, missing, filled teeth/surfaces (DMFT/S), and incipient caries. Changes in bacterial count (Streptococcus mutans and Lactobacillus) and alterations in levels of Candida albicans from saliva or plaque samples were also reported. The effect of HMR on gingival and plaque indices among adolescents undergoing orthodontic treatment and children with SHCN was reported in two studies. The variance in the HMR formula across studies, short follow-up period, and limiting grade of evidence do not allow for conclusive evidence of the efficacy of HMR. This warrants high-quality randomized controlled trials (RCTs) with longer intervention periods involving children under 6 years to yield more conclusive results.

How to cite this article

Saikia AM, Sivasubramanian A, MS M, et al. Herbal Mouthrinses for Prevention of Dental Caries in Children and Adolescents: A Systematic Review. Int J Clin Pediatr Dent 2024;17(S-1):S100-S111.

Comparison of the Effect of Diode Laser Irradiation and Fluoride Varnish on Salivary Streptococcus mutans Bacterial Colonies Counts: A Randomized Controlled Clinical Trial

Aim

The aim of this study was to assess antibacterial effects of diode laser irradiation and fluoride varnish on Streptococcus (S) mutans bacterial colonies counts in saliva.

Materials and Methods

This was a randomized controlled clinical trial research, in which 36 healthy caries-free schoolchildren aged 7-10 years referred to Birjand University dental school were selected randomly. None of the subjects had used any fluoride products before sampling. They divided into three groups: Group A: Diode laser irradiation, Group B: Fluoride varnish (FV) + diode laser irradiation, and Group C: FV. From each child, the baseline unstimulated saliva samples were obtained, transferred to the mitis salivarius agar (MSA) culture media and assessed for S. mutans colonies counts. The follow-up unstimulated saliva samples were collected one day after the treatments. Then the number of colony-forming units per milliliter were counted and analyzed statistically using Wilcoxon, Mann Whitney U and Kruskal-Wallis tests (p ≤ 0.05).

Results

No adverse events were reported. Salivary count of S. mutans significantly decreased in all groups. The highest and lowest number of the colonies of S. mutans in treated groups was observed in group I and group II, respectively. S. mutans was not completely eliminated by any of the treatments.

Conclusion

Considering the limitations of this study, antimicrobial efficacy of fluoride varnish + diode laser was higher than that of FV or diode laser alone. So this laser in combination with fluoride varnish may be useful in prevention of dental caries and antimicrobial treatment protocols.

Clinical trial registry

IRCTID: IRCT 201,706 181,7756N20

How to cite this article

Darmiani S, Yousefi M, Rad MS. Comparison of the Effect of Diode Laser Irradiation and Fluoride Varnish on Salivary Streptococcus mutans Bacterial Colonies Counts: A Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent 2022;15(S-2):S239-S241.

Exome array identifies functional exonic biomarkers for pediatric dental caries

BACKGROUND

Pediatric dental caries is common among Arab children, however we are still searching for possible genes and molecular mechanisms that influence caries development.

AIM

To identity genetic predispositions of dental caries among Saudi children with high DMFT (Decayed, Missing, and Filled Teeth).

DESIGN

This case-control study analysed putative functional exonic-variants (n = 243,345) to study the molecular genetics of pediatric caries with high dmft index, 8.75 ± 4.16 on Arab-ancestry subjects with primary dentition (n = 111; 76 cases, dmft>5 and 35 controls, dmft = 0).

RESULTS

Pediatric caries is significantly associated with single nucleotide polymorphisms (SNP) in the GRIN2B-rs4764039C (p-value = 2.03 × 10^-08) and CFH-rs1065489G (p-value = 8.26 × 10^-08) genes, even after Bonferroni correction. Irregular tooth brushing habits (p = 0.0404) and irregular dental visits (p = 0.0050) are significantly associated with caries. Functional enrichment analysis of significant genes is associated with calcium-activated chloride channel, Staphylococcus aureus infection, and N-linked glycosylation.

CONCLUSION

Genetic predispositions are found to be significantly associated with the high prevalence of pediatric caries, which is a disorder of multigene-environment interaction. The significant functional exonic variants identified can be biomarkers for the early diagnosis of pediatric dental caries in Arabs.

Analysis of an Herbal Ayurdantham Medicated Tooth liquid on Dentinal Tubule Occlusion using Scanning Electron Microscopy

BACKGROUND

Dentin hypersensitivity is described as "short sharp pain arising from exposed dentin in response to various stimuli typically thermal, evaporative, tactile, osmotic or chemical and cannot be ascribed to any other form of dental defect or disease." Dentine hypersensitivity can be treated with various desensitizing agents ,where oral rinse has a promising effect in delivering the therapeutic effect all over the tooth surface including interproximal areas, as they can flow and reach areas where toothpastes are not much effective, hence the occlusion of dentinal tubules using Ayurdhantam medicated an herbal mouthwash was evaluated.

METHODOLOGY

Twenty such dentinal blocks were obtained; the surfaces of each dentin block were polished using a silicon carbide disc for 30 s to create a basic smear layer. The smear layer is finally detached by applying 17% EDTA solution onto the dentin blocks for 5 min to ensure the patency of the dentinal tubules, following which they were rinsed with distilled water. The specimens were placed into the Ayurdhantam solution (medicated) for 2 min every day for 7 days. The specimens were stored in artificial saliva during the study. The specimens were analyzed under scanning electron microscope (SEM) for the occlusion of dentinal tubules.

RESULTS

SEM images showed the partial occlusion of the tubules and a large amount of smear layer.

CONCLUSIONS

Based on this in vitro experiment carried out, it is shown that Ayurdhantam-medicated mouthwash can be used for treating dentine hypersensitivity effectively.

R, C. M. Estimation of Fluoride and Sirtuin1 in Patients with Diabetic Nephropathy in Kolar District of Karnataka, India

Objective  Prevalence of type-2 diabetes mellitus (DM) and diabetic nephropathy is growing rapidly in Asian countries, affecting low- and middle-income groups. One of the epidemiological issues of Kolar district is fluorosis; advanced glycation end product, carboxymethyl lysine (CML), and a molecule of interest Sirtuin1 are employed in the present study. In the correlation of fluoride with sirtuin1and CML with sirtuin1 of cases lies the important rationale of the study to assess the extent of kidney damage.

Materials and Methods  This is a comparative cross-sectional study with three groups, each with 70 patients, as follows: G1, control; G2, diabetes with diabetic nephropathy; and G3, type-2 DM without any complications. Informed written consent was obtained from all study patients. All the routine investigations were performed by fully automated Vitro 5, 1 Fs, Vitros. Fasting insulin was analyzed by Vitro eCI and glycated hemoglobin was estimated by BioRad D10. Sirtuin1, CML, and fructosamine were estimated by double antibody sandwich technique.

Statistical Analysis  The statistical analysis was performed by SPSS 20 (IBM) software. Means of normally distributed data were compared using analysis of variance (ANOVA), and not normally distributed data were compared by Kruskal–Wallis test. A p -value of less than 0.05 was considered statistically significant.

Results  A decrease in sirtuin1, serum, and urine fluoride of group 2 (34.74 [25.08–53.2], 0.24 [0.2–0.5], and 0.24 [0.16–0.41]) was observed compared with other groups. Increased CML and fluoride act as prooxidant, restricting the effect of sirtuin1 on cellular damage, causing further complications such as increased insulin resistance and decreased insulin sensitivity.

Conclusion  The alterations in serum sirtuin1 levels indicate the severity of damage due to stress during hyperglycemia and fluoride toxicity; hence, sirtuin1 can be considered as biomarker of aging. Subsequently, the correlation of CML, estimated glomerular filtration rate (eGFR), and fluoride with sirtuin1 indicates that increasing sirtuin1 may defend the forthcoming damage and could be considered in therapeutics.

An in-vitro evaluation of fluoride content and enamel remineralization potential of two toothpastes containing different bioactive glasses

BACKGROUND

Many novel biomaterials have been incorporated in toothpastes to promote remineralization of tooth structure.

OBJECTIVES

This study was carried out to compare the discrepancies between declared and actual total fluoride (TF) or total soluble fluoride (TSF) concentration of two modern toothpastes containing bioactive glasses; these were also assessed for their remineralization potential.

MATERIALS AND METHODS

The TF and TSF concentration were assessed using a fluoride ion selective electrode. Enamel remineralization was evaluated through micro-hardness analysis. Eighteen enamel blocks were divided into three groups: 1 (n = 6; control), 2 (n = 6; Novamin® toothpaste), and 3 (n = 6; BiominF® toothpaste). The specimens were demineralized by 6 wt% citric acid (pH = 2.2). Subsequently, the specimens in group 1 were kept in artificial saliva (AS), while the specimens in groups 2 and 3 were stored in AS + Novamin® and AS + Biomin®, respectively.

RESULTS

Both Novamin® or BiominF® showed less TF concentration than their label claims. BiominF® had more TF and TSF compared to Novamin® (p < 0.05). The BiominF® toothpaste presented higher micro-hardness values on remineralization.

CONCLUSION

BiominF® toothpaste demonstrated more fluoride content and greater potential to promote remineralization of demineralized human enamel compared to Novamin®.

Clinical Trials with Herbal Products for the Prevention of Dental Caries and Their Quality: A Scoping Study

It is currently recognized that an injudicious strategy about caries in the last decades has been not only focusing of research mostly in children, but also the narrow focusing on fluoride, because despite sufficient availability of fluoride in water and oral healthcare products, caries levels escalate steadily as people get older and caries remain a main public health issue to be settled. In the last two decades the scientific community intensified efforts of exploring other products for caries prevention, herbal products being one of these approaches. Preliminary evidence indicated that clinical trials for caries prevention with herbal products are heterogeneous in design, quality and products evaluated, we therefore performed a scoping review intended to explore the main characteristics of such clinical trials. From an initial collection of 1986 unique papers from different literature databases, 56 articles satisfied the inclusion and exclusion criteria. The species investigated, dosage forms, study designs, duration of intervention, controls, endpoints, quality of reporting, and risk of bias are discussed. Of the trials reviewed here, 85.71% reported positive results but given the methodological flaws and biases affecting them, it is difficult to conclude on the efficacy of those products based on the studies published thus far.

Total and soluble fluoride concentration present in various commercial brands of children toothpastes available in Saudi Arabia - A pilot study

Objective

The aim of this pilot study was to perform chemical analysis and investigate the total and soluble fluoride concentrations in various brands of children toothpastes.

Materials and methods

Three samples of five different commercial brands of children toothpastes were collected and divided into five groups; group A – Biorepair Oral Care toothpaste containing no fluoride (control), group B – Signal Kids Strawberry toothpaste having 500 ppm fluoride, group C – Aquafresh Milk Teeth toothpaste having 500 ppm fluoride, group D – Aquafresh Little Teeth toothpaste having 500 ppm fluoride, and group E – Siwak F Junior having 400 ppm F. The total fluoride (TF) and total soluble fluoride (TSF) concentration of the toothpastes was determined using fluoride ion selective electrode. Data were analysed using Paired sample t-test.

Results

The measured TF values were inconsistent with that of the declared concentrations by the manufacturers. Mean TF found in the toothpastes ranged between 2.37 and 515.74 ppm whereas, the mean TSF ranged between 2.00 and 503.4 ppm. For two groups, TF was more than the declared TF whereas for the other three groups, it was less than the declared concentration. All the differences between the declared and observed TF concentration were statistically significant (p < .05) except for one group. All the toothpastes demonstrated mean TSF slightly lower than their respective observed mean TF concentrations.

Conclusion

The analysis of TF and TSF concentrations revealed variations from the labelled claims. Therefore, some of the toothpastes may have doubtful anti-caries effectiveness owing to deficiency of total and soluble fluoride.