Comparison of efficacy of three chemotherapeutic agents on Streptococcus mutans count in plaque and saliva: A randomized controlled triple blind study.

BACKGROUND: There is a need for exploration of the role of chemotherapeutic agents and its role in the prevention of early childhood caries (ECC) and its recurrence. AIM: The aim of this study was two-fold: (1) To compare the antimicrobial efficacy of three commonly used chemotherapeutic agents in the prevention of ECC in comparison with a control and (2) To ascertain the role of chemotherapeutic agents in the prevention of ECC. MATERIALS AND METHODS: Sixty children with ECC in the age group 3-6 years were randomly allocated into four groups. To each group of children after full oral rehabilitation either 10% povidone-iodine (PI), or chlorhexidine (CHX) varnish (Cervitec Plus), or fluoride varnish (Fluor Protector) were applied twice at an interval of 1 week, Group 4 served as control. Streptococcus mutans count in saliva and plaque were collected at baseline, 30, 60, and 90 days and the presence of S. mutans was evaluated using the Dentocult SM strip mutans kit. The efficacy of 10% PI, CHX varnish (Cervitec Plus), and fluoride varnish (Fluor Protector) was compared with the control group at 30, 60, and 90 days. An intergroup comparison was also done during the same time intervals. RESULTS: The reduction of S. mutans count in the plaque and saliva was greatest in the fluoride varnish treated groups at all time intervals (30, 60, and 90 days). Fluoride varnish, CHX varnish, and 10% PI showed significant improved efficacy when compared to the control group (P < 0.001). Fluoride varnish showed significantly lower counts of S. mutans compared to CHX varnish at all time intervals (30, 60, and 90 days) and also significantly lower counts compared to 10% PI at 60 and 90 days interval (P < 0.001).