Influence of a Fluoride Mouthrinse on Mutans Streptococci in Schoolchildren

Efficacy of Probiotic, Chlorhexidine, and Sodium Fluoride Mouthrinses on Mutans Streptococci in 8- to 12-Year-Old Children: A Crossover Randomized Trial

INTRODUCTION

The oral cavity is home to a diverse and distinct microbiome. While the role of oral bacteria in cariogenic and other dental diseases is irrefutable, their beneficial effects in the form of probiotics (PB) has been less studied, especially pertaining to oral diseases in children. This study compares the efficacy of a PB mouthrinse with 0.12% chlorhexidine (CHX) and 0.05% sodium fluoride (NaF) mouthrinse on the colony counts of mutans streptococci (MS) in children.

METHODS

A triple-blind crossover randomized trial between interventional groups was planned. Fifty-one children between 8 to 12 years of age were divided into three groups (I, II, and III) and were exposed to all three mouthrinses (A, B, and C) by randomized allocation for a period of two weeks with an inter-phase washout period of four weeks. Pre- and post-interventional MS counts (CFU/mL) were assessed, and the mean change was analysed using the t test (intragroup) and ANOVA (intergroup and crossover).

RESULTS

The mean changes in the colony counts obtained with the use of PB, CHX, and NaF mouthrinses were -1.0223 (-1.2201 to -0.8246), -0.9564 (-1.1503 to -0.7626), and -0.9511 (-1.1554 to -0.7467), respectively, which were statistically significant (p < 0.0001). However, the intergroup comparison for the mean change in colony counts revealed no statistically significant differences (p > 0.05).

CONCLUSION

The study concluded that the PB mouthrinse was equally efficacious as compared to CHX and NaF mouthrinses against MS in 8- to 12-year-old children. However, further studies are recommended to strengthen the evidence.

Comparative study of Kefir yogurt-drink and sodium fluoride mouth rinse on salivary mutans streptococci

AIM

The level of mutans streptococci (MS) is reduced by regularly consumption of probiotic Kefir drink. The present study aiming at answer to this question 'may the Kefir drink be considered an alternative to fluoride rinse?'

MATERIALS AND METHODS

Twenty-two healthy volunteers aged 22-32 years with good oral hygiene participated in this study. None of participants had received any antibiotic or antimicrobial agent or professional fluoride therapy within the last month. None of them exhibited active caries lesions. Smokers and subjects who have chewing gums xylitol habit or who were undergoing orthodontic treatment were excluded. In a cross over design with 2 parallel groups, people in group A for 2 weeks received 100 ml of Kefir drink per day, then avoided brushing, eating and drinking for an hour. Simultaneously, people in group B were administered 0.05% sodium fluoride rinse in the same manner. After washout period, people in groups A and B respectively used 0.05% sodium fluoride rinse and Kefir drink. Saliva sampling was performed before and after interventions. The acidity and the count of MS were assessed and data were analyzed statistically.

RESULT

There was no significant difference between base line pH values of saliva in study groups (p > 0.05). Although, a significant difference was shown between MS counts before and after interventions (p ≤ 0.0001 and p ≤ 0.0001 for NaF and Kefir respectively), but the equal inhibitory effect was found between study groups (p > 0.05).

CONCLUSION

Kefir drink can inhibit salivary MS as well the sodium fluoride rinse. This beverage may be considered an alternative for fluoride rinse. Clinical significance: Probiotics containing dairy products was known with anticariogenic properties. These agents may be used in caries control strategies adjunctively.

Antimicrobial effect of different brushing frequencies with fluoride toothpaste on Streptococcus mutans and Lactobacillus species in children with fixed orthodontic appliances

OBJECTIVE

To evaluate the antimicrobial effect of different frequencies of brushing with fluoride toothpaste on the levels of salivary mutans streptococci and lactobacilli in children undergoing fixed orthodontic treatment.

METHODS

The study included 22 patients scheduled for fixed orthodontic therapy distributed between 2 groups with different hygiene regimes. All the subjects received identical braces, bands, and brackets bonded with the same material. Stimulated saliva samples were obtained before placement of the appliance and at 6, 12, and 18 weeks during the therapy. Saliva samples were cultured on selective microbial agar for the detection of microorganisms.

RESULTS

Salivary mutans streptococci were significantly suppressed throughout the experimental period in the group that brushed 4 times a day as compared to the group that brushed twice a day. Salivary lactobacilli were not significantly affected by the frequency of brushing with 0.32% sodium fluoride (NaF) toothpaste.

CONCLUSIONS

The use of 0.32% NaF-containing toothpaste more than 3 times a day has effective antimicrobial activity on mutans streptococci but not lactobacilli in the saliva of children with fixed orthodontic appliances.

Sodium fluoride and chlorhexidine effect in the inhibition of mutans streptococci in children with dental caries: a randomized, double-blind clinical trial

OBJECTIVE

We aimed to compare the effect of sodium fluoride and chlorhexidine on salivary levels of mutans streptococci (MS), in a double-blind, randomized clinical trial.

METHODS

Thirty-five healthy volunteers, aged 4-8 years, with at least one active carious lesion and no previous history of allergies were selected to participate in the study. A gel formulation containing either 1.23% sodium fluoride or 1% chlorhexidine was topically administered to the dentition every 24 h for 6 consecutive days. Salivary MS levels were measured at baseline (D1) and on the 6th (D6), 15th (D15), and 30th (D30) days. For microbiological analysis, Mitis Salivarius-Bacitracin agar medium was used.

RESULTS

Difference between treatments was only verified on D6. On the last day of treatment 1% chlorhexidine gel was significantly more effective than fluoride (P = 0.0000). The use of sodium fluoride did not cause a statistically significant variation in salivary MS levels throughout the duration of the study. Following treatment, a subsequent increase in MS counts between D6 and D15 (P = 0.0001) was observed with chlorhexidine.

CONCLUSION

A 6-day treatment with a 1% chlorhexidine gel was effective in reducing salivary MS; there was a significant MS increase once treatment was suspended. The use of 1.23% sodium fluoride under the same regimen was not able to reduce salivary MS levels. Our results suggest repeated treatment with 1% chlorhexidine as a means for maintaining low salivary MS levels in children with dental caries.