Effect of Caries Preventive Programs in High-Caries-Risk Subjects

Objective: The aim of this study was to compare the caries preventive effectiveness of chlorhexidine varnish, sodium fluoride gel and dental health education programs among high-caries-risk subjects after 2 years period. Methods: A total of 149 subjects aged 11- to 13-year-old with low socio-economic status who had past caries experience in the primary dentition and Streptococcus mutans levels higher than 10⁵ cfu/ml with no active caries in the permanent dentition participated in this study. Subjects were allocated randomly to one of three caries-preventive programs; chlorhexidine varnish (n= 50),sodium fluoride gel treatments(n= 50) or dental health education (n= 49), in which these programs were applied periodically during 2 years. The caries increment (DMFS index), dental plaque scores and salivary Streptococcus mutans counts were investigated every 6 months in each group. Results: The salivary counts of Streptococcus mutans was found significantly higher in the dental health education group (p=0.004) compared with chlorhexidine and sodium fluoride gel treatment groups in which no increase was observed.The mean DMFS±SD values were found as 0.95±1.3, 0.88±1.7 and 1.05±2.0 in the chlorhexidine varnish, sodium fluoride gel and education groups respectively and no significant difference was found in the caries increment among the groups. Also no significant difference was observed in the pre-and post-treatment plaque scores among the treatment groups. Conclusions: Similar caries preventive effectiveness was observed in all the treatment groups after 2 years. However, regarding the positive effect of chemotherapeutic agents in the inhibition of Streptococcus mutans growth,within the limitations of this study, it could be suggested that dental health education programs should be supported with one of the chemotherapeutic agents in the high-caries-risk subjects.