Effect of chlorhexidine gel on approximal caries increment in adolescents with high caries risk using professional flossing compared to individual trays.

The aim of this study was to evaluate the effect of chlorhexidine gel treatment on approximal caries development during a three year-study in children with expected high risk of caries. New caries of this group was compared to the caries development in two groups with assumed moderate or low caries risk. One hundred and sixty-nine of 201 twelve-year-old children fulfilled the trial. A group of 77 children showed no caries experience and was expected to be a low caries risk group (R1). Ninety-two children had at least one approximal lesion and their salivary numbers of mutans streptococci (ms) were quantified. Forty-six of those showed less than 3 x 10(5) ms per ml saliva and were supposed to have a moderate caries risk (R2). Forty-six children, with high levels of ms, were expected to have a high caries risk (R3). Both R1 and R3 were treated with fluoride varnish every 18th month and R2 every 6th month. The R3 group was supplementary treated with 1% chlorhexidine gel (Corsodyl) by using either flossing combined with polishing (Flossing group), or gel in individual trays (Tray group) every third month, in two subsequent days. The mean caries development during three years was for R1 and R2, 1.5 and 3.0, respectively. For R3, the corresponding caries incidence was 2.9 in the Tray group and 2.8 in the Flossing group. Significantly less new caries was found in the R1 compared to R2 and R3, but no significant difference was found between R2 and R3 or between the two groups of R3. In conclusion both methods of professional chlorhexidine gel treatments showed a caries development corresponding to the group with moderate caries risk and could both be used for caries prevention.

Approximal caries increment in two cohorts of schoolchildren after discontinuation of a professional flossing program with chlorhexidine gel.

We have in two earlier studies evaluated the effect of professional flossing with chlorhexidine (CHX) gel treatment, in 4- to 7-year-old preschool children and in 12- to 15-year-old teenagers. The mean caries reduction after 3 years was around 40% compared to placebo gel or no gel treatment. The aim of the present investigation was to follow up these two clinical studies. The preschool children were followed up to the age of 16 years and the teenager group to the age of 19. Of the total number of original children, 71 and 80% were available at the age of 16 and 19 years, respectively. At the 9-year follow-up, when the children were 16 years old, the former CHX group had still significantly lower mean DFS than the control group (p < 0.05). The differences in caries increment occurred between 7 and 12 years of age, whereas the number of new caries lesions during the next 4 years were almost the same in the three groups. At the 4-year follow-up, when the teenagers were 19 years old, DFS was 6.9 in the former CHX group compared to 10.4 in the control group (p < 0.05). The main conclusion of these two follow-up studies after 9 and 4 years, respectively, is that caries reductions obtained at the end of professional flossing with a 1% CHX gel were maintained.