Effect of Chlorhexidine and Fluoride Varnishes on Streptococcus mutans Count and Dental Plaque Index

AbstractThe control of dental plaque by chemical means can be a valuable auxiliary resource for individuals who have difficulties in performing dental plaque control through regular oral hygiene procedures. The aim of this study was to evaluate the effect of chlorhexidine and fluorine varnishes on the levels of Streptococcus mutans (S. mutans) present in the dental biofilm and on the dental plaque index. The study was carried out in a sample comprised thirty-nine schoolchildren between 13 and 15 years of age, distributed into 2 groups. Group I received a single layer of varnish with chlorhexidine and thymol on the maxillary right first molar. Group II received the application of varnish with fluoride following the same methodology. S. mutans count and dental plaque index recording were performed 7 days before the application and 7, 15 and 30 days after the treatment. It was observed that chlorhexidine and fluoride varnishes significantly reduced the number of S. mutans in dental plaque for 30 days (p<0.05). There was no difference between the varnishes. With regard to the dental plaque index, there was no alteration in any of the experimental time periods for both groups. It was concluded that varnishes, mainly those that contain fluoride, can be an interesting alternative for the prevention of dental caries in collective oral health programs. Keywords: Chlorhexidine. Fluorides. Dental Plaque. ResumoO controle da placa dental por meios químicos pode ser um valioso recurso auxiliar para indivíduos que apresentam dificuldades em realizar o controle da placa dental por meio de procedimentos regulares de higiene bucal. O objetivo neste estudo foi avaliar o efeito dos vernizes de clorexidina e de flúor sobre os níveis de Streptococcus mutans (S. mutans) presentes no biofilme dental e sobre o índice de placa dental. O estudo foi realizado em uma amostra composta por 39 escolares, entre 13 e 15 anos de idade, distribuídos em 2 grupos. O grupo I recebeu uma única aplicação de verniz com clorexidina e timol no primeiro molar superior direito. O grupo II recebeu a aplicação de verniz com flúor seguindo a mesma metodologia. A contagem de S. mutans e o índice de placa dental foram registrados 7 dias antes da aplicação e 7, 15 e 30 dias após o tratamento. Observou-se que os vernizes de clorexidina e flúor reduziram significativamente o número de S. mutans na placa dental por 30 dias (p <0,05). Não houve diferença entre os vernizes. Com relação ao índice de placa dental, não houve alteração em nenhum dos períodos experimentais para ambos os grupos. Concluiu-se que os vernizes, principalmente aqueles que contêm flúor, podem ser uma alternativa interessante para a prevenção da cárie dentária em programas coletivos de saúde bucal. Palavras-chave: Clorexidina. Fluoretos. Placa Dentária.

[1]  Christina R. Scherrer,et al.  Cost-Savings of Fluoride Varnish Application in Primary Care for Medicaid-Enrolled Children in Virginia. , 2019, The Journal of pediatrics.

[2]  Yakov Sigal,et al.  Improving oral health through dental fluoride varnish application in a primary care paediatric practice , 2019, BMJ open quality.

[3]  Megha Sharma,et al.  A Comparative Evaluation of Efficacy of Streptococcus mutans Counts in Saliva: An in vivo Study , 2018, International journal of clinical pediatric dentistry.

[4]  S. Khanagar,et al.  Role of fluoride varnish in preventing early childhood caries: A systematic review , 2017, Dental research journal.

[5]  J. Carvalho,et al.  Mechanical and chemical plaque control in the simultaneous management of gingivitis and caries: a systematic review , 2017, Journal of clinical periodontology.

[6]  K. Thanveer,et al.  Effects of Fluoride Varnish on Streptococcus mutans Count in Saliva , 2017, International Journal of Clinical Pediatric Dentistry.

[7]  M. Stuani,et al.  Effects of chlorhexidine varnish on caries during orthodontic treatment: a systematic review and meta-analysis. , 2016, Brazilian oral research.

[8]  S. Tandon,et al.  Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children , 2016, International journal of clinical pediatric dentistry.

[9]  M. Lennon,et al.  Fluoride and Oral Health. , 2016, Community dental health.

[10]  T. Mohammadi,et al.  Fluoride Varnish Effect on Preventing Dental Caries in a Sample of 3-6 Years Old Children , 2015, Journal of international oral health : JIOH.

[11]  E. Bocian,et al.  Antibacterial activity of selected commercial products for mouth washing and disinfection, assessed in accordance with PN-EN 1040 , 2013, Medical science monitor : international medical journal of experimental and clinical research.

[12]  L. Petersson The role of fluoride in the preventive management of dentin hypersensitivity and root caries , 2012, Clinical Oral Investigations.

[13]  C. Pannuti,et al.  Daily biofilm control and oral health: consensus on the epidemiological challenge--Latin American Advisory Panel. , 2012, Brazilian oral research.

[14]  W. Sohn,et al.  Effect of 5% fluoride varnish application on caries among school children in rural Brazil: a randomized controlled trial. , 2012, Community dentistry and oral epidemiology.

[15]  D. E. Slot,et al.  The Effect of Chlorhexidine Varnish on Root Caries: A Systematic Review , 2011, Caries Research.

[16]  A. George,et al.  Chlorhexidine varnishes effectively inhibit Porphyromonas gingivalis and Streptococcus mutans — an in vivo study , 2010, Journal of Indian Society of Periodontology.

[17]  E. Coutinho,et al.  Fluoride varnishes and decrease in caries incidence in preschool children: a systematic review. , 2010, Revista brasileira de epidemiologia = Brazilian journal of epidemiology.

[18]  S. Leal,et al.  Association of chlorhexidine and fluoride for plaque control and white spot lesion remineralization in primary dentition. , 2008, International journal of paediatric dentistry.

[19]  D. Birkhed,et al.  Effect of Chlorhexidine Varnish and Gel on Mutans Streptococci in Margins of Restorations in Adults , 2002, Caries Research.

[20]  H. Lönnies,et al.  Effect of Four Dental Varnishes on the Colonization of Cariogenic Bacteria on Exposed Sound Root Surfaces , 1999, Caries Research.

[21]  H. Sandham,et al.  The Effect of Chlorhexidine Varnish Treatment on Salivary Mutans Streptococcal Levels in Child Orthodontic Patients , 1992, Journal of dental research.

[22]  C. Emilson,et al.  Effect of a fluoride-containing varnish on Streptococcus mutans in plaque and saliva. , 1982, Scandinavian journal of dental research.

[23]  J. Ainamo,et al.  Problems and proposals for recording gingivitis and plaque. , 1975, International dental journal.

[24]  J. van Houte,et al.  A selective medium for Streptococcus mutans. , 1973, Archives of oral biology.

[25]  E. Arrag,et al.  The effect of chlorhexidine-thymol and fluoride varnishes on the levels of Streptococcus mutans in saliva in children aged 6–8 years , 2019, Indian journal of dental research : official publication of Indian Society for Dental Research.

[26]  I. Arslan,et al.  Antibacterial effects of fluoride varnish compared with chlorhexidine plus fluoride in disabled children. , 2014, Oral health & preventive dentistry.

[27]  Radhika Arjunkumar,et al.  Chlorhexidine: The Gold Standard Antiplaque Agent , 2013 .

[28]  C. Friedrich,et al.  Effect of chlorhexidine-containing varnish (Cervitec) on microbial vitality and accumulation of supragingival dental plaque in humans. , 1994, Caries research.