Adjunctive chemotherapeutic suppression of mutans streptococci in the setting of severe early childhood caries: an exploratory study.

OBJECTIVES: This investigational study assessed the suppressive effect of 10 percent povidone iodine (PI) coupled with elimination of active carious lesions on salivary mutans streptococci (MS) populations in children with severe early childhood caries (S-ECC). METHODS: 77 children (38 females, 39 males) were treated for S- ECC in one session; a 0.2 ml PI solution was applied to the dentition after dental surgery was completed and immediately wiped off. The subjects aged from 2 to 5 years (mean = 3.78 years) at baseline. Whole nonstimulated saliva samples were obtained at baseline, 30 days, 60 days, and 90 days post dental surgery. Samples were placed on ice and processed within 2 hours. The MS level in each sample was expressed as colony forming units (CFUs) per ml of saliva. RESULTS: Approximately 50 percent of subjects had a >95 percent reduction in CFU/ml of saliva at each time point after baseline. The percentages of subjects with a >50 percent reduction in MS level were 85 percent at 30 days, 83 percent at 60 days, 84 percent at 90 days. The median (25th, 75th percentiles) CFUs/ml of saliva counts were 8.40 x 10(5) (1.49 x 10(5), 5.00 x 10(6)) at baseline (n= 77), 4.12 x 10(4) (8.40 x 10(3), 1.89 x 10(5)) at 30 days (n = 74), 4.62 x 10(4) (7.00 x 10(3), 1.36 x 10(5)) at 60 days (n = 70), and 5.09 x 10(4) (1.16 x 10(4), 1.00 x 10(5)) at 90 days (n = 70). The changes from baseline to 30 days, 60 days, and 90 days were statistically significant (P < 0.0001). CONCLUSIONS: PI coupled with dental surgery has a significant suppressive effect on salivary MS levels in the setting of S-ECC for at least 90 days. These data strongly suggest that treatment with PI may be an important adjunct to dental surgery for S-ECC.

Effects of toothbrushes with tapered and cross angled soft bristle design on dental plaque and gingival inflammation: a randomized and controlled clinical trial.

OBJECTIVE: To investigate the effect of three manual toothbrushes on dental plaque and gingival inflammation. METHODS: The elmex Sensitive Extra Soft (ESES), elmex Sensitive Soft (ESS) and an ADA standard toothbrush (ADAS) were evaluated in a randomized clinical trial. Subjects brushed twice daily in their usual manner. Plaque index (PI), gingival index (GI) and plaque and gingival scores of interproximal spaces (IntPI and IntGI) were evaluated at day 15 and day 30. ANOVA and t-test were used to compare plaque and gingival scores. RESULTS: A total of 84 subjects with mild to moderate gingivitis completed the study. Plaque and gingival scores in ESES and ESS groups decreased from baseline to day 15 and day 30. At day 30, subjects in both ESES and ESS groups had lower plaque and gingival scores than those in the ADAS group (p<0.05). In the ESES group, PI reduced by 13.6% (p<0.0001), and GI by 10.5% (p<0.0001) at day 30 when compared to the baseline scores. In the ESS group, PI reduced by 11.8% (p<0.0001), and GI by 12.0% (p<0.0001) at day 30. The reduction in IntPI and IntGI scores were comparable to those of the overall PI and GI. In contrast, there were no changes in PI, GI, and IntPI and IntGI scores between baseline and the day 15 and day 30 evaluations in the ADAS group. CONCLUSIONS: Both the ESES and ESS toothbrushes are more effective in removing dental plaque and reducing gingival inflammation than the ADA standard toothbrush.