Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children.

Deepesh Prajapati,Rashmi Nayak,P Venkat Ratnanag,Namitha Kamath,Sarika Naidu,Shobha Tandon

doi:10.5005/jp-journals-10005-1381

Abstract

AimTo assess the effect of combined use of chlorhexidine and fluoride varnish on the remineralization of incipient carious lesions in young children.Materials and methodsTwenty caries-active children (80 lesions) were randomly divided into four groups and subjected to initial examination. Caries status was assessed visually and with the aid of DIAGNOdent. Baseline enamel biopsies were obtained. Subjects of groups I and II received fluoride and chlorhexidine varnish respectively. Group III received both fluoride and chlorhexidine varnish alternatively, for a period of 4 weeks. Group IV served as the control. At 3-month follow-up, the incipient lesions were assessed again with DIAGNOdent and enamel biopsy.ResultsIncreased calcium, phosphate, and fluoride levels were noticed in groups I, II, III compared to group IV, at the 3-month follow-up (p < 0.001).ConclusionThe combined therapy with fluoride and chlorhex-idine varnish may be considered an alternative therapy for early reversal of incipient lesions.How to cite this articleNaidu S, Tandon S, Nayak R, Ratnanag PV, Prajapati D, Kamath N. Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children. Int J Clin Pediatr Dent 2016;9(4):296-302.

Highlights

Fluoride is the most prominent drug used as an auxiliary preventive measure, which exerts its action by enamel remineralization
Increased calcium, phosphate, and fluoride levels were noticed in groups I, II, III compared to group IV, at the 3-month follow-up (p < 0.001)
Results of the present study showed that the fluoride, chlorhexidine, and combination of varnish groups demonstrated increased calcium, phosphate, and fluoride levels as compared to the negative control group, at 3-month follow-up

Summary

Introduction

Fluoride is the most prominent drug used as an auxiliary preventive measure, which exerts its action by enamel remineralization. Modern concepts of the mechanism of action of fluoride recommend daily fluoride supplies to establish and maintain a significant concentration in saliva and plaque fluids, preventing and controlling enamel dissolution. Isolated use of fluoride has proved to be insufficient to prevent progressive mineral loss and consequent lesion formation in children at a high risk for caries development. Chlorhexidine binds readily to negatively charged bacterial cell walls and can thereby disrupt the membrane integrity. Chlorhexidine is bactericidal and acts as a detergent by damaging cell membranes. Chlorhexidine can effectively reduce Streptococcus mutans levels in the plaque biofilm. Chlorhexidine controls the plaque formation and, at the same time, reduces its acidogenicity, thereby increasing the possibility of remineralization of the white spots.[1]

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