Effect of Povidone-Iodine Fluoride Foam in Children with Active Decay

Methods: Sixty children were randomized to 10% povidone-iodine plus 5000ppm fluoride (PVPI-F) or 5000ppm fluoride foam (F) groups and received four weekly applications of PVPI-F or F foam at baseline and 6 months. The children’s caries scores were recorded at baseline and one year. Salivary levels of mutans streptococci and lactobacilli were enumerated at baseline, 2, 6, and 12 months. In addition, to understand the effect of additional fluoride application on caries prevention compared to routine practice, 60 children who met the study criteria and received routine-clinical-care during the study period were included as a routine-care control group (CTL). The CTL group received one fluoride foam treatment at baseline and six months. Their caries score were collected by chart review. 

Results: At 1 year, there was a significant difference in new decayed, missing and filled surfaces (dmfs/DMFS) among the three groups (Kruskal-Wallis Test, P<0.05) with children in PVPI-F group having significantly fewer new dmfs/DMFS than children in F and CTL groups [median (25-75 percentile) as 1 (0-4), 3 (1-6), 3 (1-8) respectively for PVPI-F, F and CTL groups, Wilcoxon W Test, P<0.05], but no significant difference between F and CTL groups (P=0.89). There were no significant differences in cariogenic bacterial levels at all time points between the two foam groups.    

Conclusions: These results suggest that topical povidone-iodine fluoride foam application is more effective than fluoride foam alone in reducing dental caries and additional fluoride foam application may not provide extra protection against caries in 6-9 year old children with active dental decay.