Reducing Microbial Levels in High Caries Risk Adults – Randomized Clinical Trial

Abstract

Background: Dental caries is an infectious transmissible chronic disease.  Unless the microorganisms initiating decalcification of the enamel are dealt with initially, the restorative management of dental caries is doomed to failure.

Objective: The purpose of this pilot study was to determine if a NaOCl-povidone-I₂ rinse was more effective than a povidone-I₂ rinse alone in decreasing microbial levels in high caries risk adults.

Methods:  Forty-eight participants were examined to determine their caries experience and randomized into treatment (TX) and control (CT) groups.  At baseline, a saliva specimen was obtained for the CRT^® bacterial test and a plaque sample was obtained for the CariScreen^® test. The TX group rinsed with 15 ml of 1.6% NaOCl for one minute followed by rinsing with 15 ml of 10% povidone-I₂ for one minute.  The CT group rinsed with 15 ml of povidone-I₂ for one minute.  The CRT^® and  CariScreen^® tests were repeated at one, four, eight and twelve weeks.

Results: The CRT^® test showed that the TX group kept the level of Strep mutans lower than the CT group at four weeks and through all twelve weeks.  Both the TX and CT groups kept the level of  Lactobacillus low at four weeks and through twelve weeks. The CariScreen^® test showed that both groups kept organisms low for only one week.

Conclusion: The use of NaOCl before povidone-I₂ (TX) did enhance the effect of the povidone-I₂ (CT). The CariScreen^® readings were low at one week and increased rapidly thereafter unrelated to the microbial counts.