Clinical Trial in Adults of an Antimicrobial Varnish for Reducing Mutans Streptococci

Abstract

An abbreviated treatment with a chlorhexidine-containing varnish was compared with a similar treatment with a placebo varnish and with a prophylaxis alone for its effects on the numbers of detectable salivary mutants streptococci in 51 adults. The varnishes, applied once weekly for four weeks, were held in place with a covering layer of either of two polyurethane sealants (FluorProtector or Adhesit). On the first appointment, the varnish-sealant combination was applied to all tooth surfaces, but on succeeding appointments only the occlusal and approximal surfaces were covered. The chlorhexidine varnish, covered with either sealant, reduced the salivary mutans streptococci by an average of 3 logs (99.9%) in all of the 20 subjects treated, and below detectable levels for at least four weeks in nine of them. In the groups receiving placebo varnish-sealant combinations, the mean log number of mutans streptococci of the subjects was reduced only by approximately 0.5 log (32%), and none of the subjects experienced loss of their detectable mutans streptococci for four weeks, although one subject did so for three weeks. No significant difference between the effects of the two polyurethane sealants was observed. Treatment with a single prophylaxis had no effect on mutans streptococcus levels. Subjects treated with chlorhexidine varnish also experienced an increase in S. sanguis and a small decrease in yeasts. Loss of detectable mutans streptococci did not cause changes in the numbers of other micro-organisms examined, beyond those observed with chlorhexidine varnish treatment alone.

The Role of Chlorhexidine in Caries Prevention

“…Chlorhexidine-containing varnishes were developed to increase the substantivity, length of the time of suppression [19][20] and effectiveness of the delivery of chlorhexidine to sites colonized by S mutans. 21 Varnish has been shown to reduce the numbers of S mutans in several studies.…”

“…21 Varnish has been shown to reduce the numbers of S mutans in several studies. 20,22 Suppression of S mutans for periods of up to five months has been achieved by the application of a varnish containing a high concentration of chlorhexidine (40%). [20][21][22][23][24] Twetman stated in his review that clinical data on caries prevention effects remain sparse and that the recent literature was inconclusive for the use of chlorhexidine varnishes for caries prevention in risk groups.…”

Effects of Different Chlorhexidine Formulations on Shear Bond Strengths of Orthodontic Brackets

“…[7][8][9] Studies of high and low concentrations of CHX have been reported to reduce the number of MS in plaque and saliva, and investigators have concluded that the use of 0.12% CHX mouth rinses could be beneficial for orthodontic patients in achieving improved oral hygiene. 10 Evidence of the efficacy of CHX in biofilms was reported by Pratten et al 11 The literature suggests that the use of 1% CHX gel significantly decreases MS levels.…”

Antimicrobial Effectiveness of a Highly Concentrated Chlorhexidine Varnish Treatment in Teenagers with Fixed Orthodontic Appliances

“…[9][10][11] High and low concentrations have been reported to reduce the number of ms in plaque and saliva for considerable periods of time. [12][13][14] Numerous studies have examined highly concentrated chlorhexidine varnishes as supersaturated solutions of chlorhexidine diacetate in ethanol, stabilized by the natural resin sandarac. [15][16][17][18][19] In these examinations, the optimal chlorhexidine varnish concentration suggested for suppression of ms amounted to 36% chlorhexidine, as represented by the varnish EC40ா (Dentres, Nijmegen, The Netherlands).…”