A prospective longitudinal cohort study of the effectiveness of 25% xylitol toothpaste on mutans streptococci in high caries-risk young children.

AIM: To compare the prevalence of mutans streptococci (SM) prevalence and categorical distribution in the saliva of high caries-risk children after their 24 months exposure to 25% xylitol toothpaste applied twice a day. To also examine the early caries susceptibility at baseline. BACKGROUND: An observational design with two times of collection. A total of 270 mother-infant dyads (mean age of infant 6.7 months) were initially recruited. At baseline, a dental exam looked for any early clinical signs of caries, and saliva collections were performed to assess SM prevalence. Two years later, other saliva collections were performed on a residual sample of 102 young children at the endpoint. METHODS: Two hundred four saliva samples were analysed with Dentocult, a commercial kit estimating in four categories, the SM distribution, expressed as the number of colonies forming units per milliliter of saliva (CFU/ml). The dental exam used the ICDAS system to include initial carious lesions (d1-2). The dentist administrated a maternal socio-economic questionnaire as the study collector. CONCLUSION: A domestic strategy using a natural toothpaste containing 25% of xylitol as a vehicle, and tooth brushing as a habit, showed a promising antibacterial cariogenic effect. This approach could be a relevant alternative to in-home care to prevent ECC and early SM contamination.

Effectiveness of fluoride varnish four times a year in preventing caries in the primary dentition: A 2 year randomized controlled trial.

OBJECTIVES: To test the effectiveness of fluoride varnish in preventing caries in early childhood in children at high risk of caries. BASIC RESEARCH DESIGN: Randomized controlled trial. PARTICIPANTS: 504 participants, with mean age of 21 months at baseline randomly allocated into a test and a control group. 427 children remained in the study after two years. INTERVENTION: Fluoride varnish applied four times a year, every three months. The intervention lasted for two years. MAIN OUTCOME MEASURES: Dental status was recorded based on the International Caries Detection and Assessment System (ICADS). RESULTS: Mean dmfs was similar in the control and test groups at baseline (1.0 and 1.2 respectively) but was significantly different (10.1 and 5.2, p ⟨ 0.001, ANOVA) at endpoint. The proportion caries free in the two groups was 40% and 69.4% after two years. CONCLUSIONS: The application of fluoride varnish four times a year prevented the incidence and reduced the severity of caries in pre-school children. TRIAL REGISTRATION NUMBER: DRKS00013980.

Association between salivary level of infection with Streptococcus mutans/Lactobacilli and caries-risk factors in mothers.

AIM: Understanding factors in mothers associated with high and low salivary levels of Streptococcus mutans and Lactobacilli is an important strategy for early childhood caries prevention. Aim of the study was to identify the association between salivary levels of Streptococcus mutans/Lactobacillus and potential caries risk factors in mothers. MATERIALS AND METHODS: Cross-sectional design used a voluntary sample of 300 mothers of young children. Close-ended questions and observations were used to identify mothers' potential caries risk factors. The presence of Streptococcus mutans and Lactobacilli was determined using the CRT bacteria test (Ivoclar Vivadent). All collected information was converted into frequency and proportion describing the prevalence factor in correlation with Streptococcus mutans and Lactobacilli cariogenic bacteria levels of infection. Results Sample participants showed a high caries risk based on socioeconomic, behavioural and clinical factors. RESULTS: also showed high levels (>105) of Streptococcus mutans and Lactobacilli infections among 28% of mothers. Three factors were significantly associated with Streptococcus mutans infection: level of education, past caries experiences, and observable dental plaque, whereas, a fourth factor, frequency of daily tooth brushing, was associated to Lactobacilli infection. CONCLUSION: This study showed that easily collectible informations such as maternal level of education, frequency of daily tooth brushing and past clinical factors tend to be associated with high level of Streptococcus mutans and Lactobacilli infections in caregivers.