Efficacy of Four Fluoride Mouth Rinses on Streptococcus mutans in High Caries Risk Children - A Randomized Controlled Trial.

Abstract

Dental caries has been traditionally described as a multifactorial disease that involves the interaction of various factors like host, agent, substrate and time. Landmark studies have established the fact that Mutans Streptococci are the primary etiologic agents of dental caries. The prevention of dental caries by fluoride supplements in various vehicles, such as water and toothpaste, constitutes one of the most successful prevention measures. The aim of the present study was to compare the clinical efficacy of four fluoride mouth rinses on Streptococcus mutans in high caries risk children and also to check the efficacy of the ingredient Triclosan which is present in two of the four mouth rinses. The study is double blinded, consisting of 1000 children in age group 6-14yrs who were screened from residential schools. Of the total, 200 children were categorized as high caries risk group based on caries risk assessment tool form given by American Association of Pediatric Dentistry (AAPD) guidelines 2011. Prior to the study, salivary samples were collected and sent for microbial analysis to estimate Streptococcus mutans counts. Out of 200 salivary samples, 132 showed 106CFU of Streptococcus mutans and these children were included in the study. The 132 children from each group received the assigned mouth wash for 14 consecutive days. On 15th day the salivary samples were collected and sent for microbial analysis and the obtained results were subjected to statistical analysis. All the mouth washes showed a significant reduction in Colony Forming Units (CFU) counts of Streptococcus mutans. Among the four groups Group D (S flo) showed greater percentage reduction of Streptococcus mutans followed by Group A (Act), B (Kidodent) and C (Zerocary). There was no stastically significance reduction of Streptococcus mutans among the Triclosan containing and non containing groups. The mean pre rinse CFU was significantly higher than post rinse CFU for all the study groups, suggesting that all the four mouth rinses were effective in decreasing the levels of Streptococcus mutans in the saliva. Both the Triclosan containing and non Triclosan groups showed the same amount of CFU count reduction.