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Title Chlorhexidine Does not Reduce caries Incidence In School-Based Programs Compared with Regular Fluoride Use and Oral Hygiene
Clinical Question In school-based programs with children and adolescents, is it more beneficial to use Chlorhexidine to prevent dental caries compared to fluoride treatment?
Clinical Bottom Line In school-based programs, repeated application of chlorhexidine does not lower the caries incidence in young individuals any more than regular fluoride use and oral hygiene practices. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18560640Ersin/2008149 eleven to thirteen year olds with high caries risk and low caries incidenceRandomized Clinical Trial
Key resultsParticipants were randomized into three different groups: chlorhexidine varnish, sodium fluoride gel, and dental health education programs. At the end of the two year study the caries increment, dental plaque scores, and salivary Streptococcus mutans counts were measured. The dental health education program group had higher Streptococcus mutans counts at the end of the study, but all three groups had similar plaque and caries values at the end of the study. Mean DMFS +/- standard deviation was 0.95 +/- 1.33, 0.88 +/- 1.47, and 1.05 +/- 2.01 in the chlorhexidine varnish, sodium fluoride gel, and education groups, respectively.
Evidence Search PubMed search using the following terms: "School Dentistry"[Mesh] AND "Dental Caries"[Mesh] AND "Chlorhexidine"[Mesh] AND "Sodium Fluoride"[Mesh] ...view in PubMed
Comments on
The Evidence
All the subjects received initial and periodic education regarding oral hygiene. Fluoride gel showed the best results, but the difference was not significant. Researchers reported difficulties in patient compliance with the treatment plans.
Applicability This would apply loosely to any young patient at increased risk for caries, but more specifically to anyone planning an effective school-based program to reduce caries incidence among their students.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry) (Dental Hygiene)
Keywords Chlorhexidine; fluoride; dental caries; school-based prevention; adolescents; children
ID# 452
Date of submission: 12/10/2009spacer
E-mail FrancisJ@uthscsa.edu
Author Robert B. Alexander
Co-author(s) J. Christian Francis
Co-author(s) e-mail
Faculty mentor/Co-author Carl W. Haveman, DDS
Faculty mentor/Co-author e-mail HAVEMAN@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
Comments and Evidence-Based Updates on the CAT
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by Chase A. Nesloney (San Antonio, Texas) on 04/09/2012
In April 2012, a search on this topic was conducted using PubMed. The publications listed in this CAT are the most recent and the highest level of evidence related to this clinical question.

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