Effects of Dental Treatment and Single Application of a 40% Chlorhexidine Varnish on Mutans Streptococci in Young Children under Intravenous Anaesthesia

Abstract

Clinical studies suggest that application of a highly concentrated chlorhexidine varnish results in a decrease in the number of mutans streptococci and thereby a decrease in the caries risks. The aim of this study was to determine the effect of dental treatment on the levels of mutans streptococci (MS) and lactobacilli (LB) and the additional effect of a single application of 40% chlorhexidine varnish (EC40) on the level of MS. Twenty–three children under the age of 5 years scheduled for full dental treatment were selected. Of these 23 children (mean dmf–s 27.1, SD 19.3), 11 children had nursing bottle caries. The mean sugar exposure was 6.4. Subjects were randomly distributed into two groups of approximately equal size. One group received an EC40 application after dental treatment, while the other group received only full dental treatment, both with intravenous anaesthesia with propofol as a single drug. An unstimulated saliva sample and a plaque sample were taken prior to dental treatment. The saliva and plaque sampling of the subjects was repeated after 6 weeks. MS and LB were isolated and counted. The number of children harbouring more than 10⁶ MS in a pooled plaque sample decreased significantly from 8 to 2 children 6 weeks after dental treatment. No additional effect of EC40 was found. The number of salivary MS did not change significantly between the groups or before and after treatment. The figures for LB remained at a high level of more than 10⁴/ml saliva before (21 children) and 6 weeks after treatment (17 children). The results of this study indicate that dental treatment results in a significant suppression of plaque MS, while a single application of EC40 showed no significant additional suppression after 6 weeks.

Current State of Topical Antimicrobial Therapy in Management of Early Childhood Caries

“…As an anticaries agent, CHX is used at concentrations ranging from 0.1 to 40 percent in solutions, gels, chewing tablets, and varnishes [27]. A previous meta-analysis of selected studies gave an overall caries inhibiting effect of CHX of around 46 percent [28].…”