ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Use Of Povidone Iodine In The Prevention and Management Of Early Childhood Caries
Clinical Question In children at risk for early childhood caries does adding povidone iodine to oral hygiene and rehabilitation measures reduce caries prevalence more than oral hygiene and rehabilitation measures alone?
Clinical Bottom Line In children at risk for early childhood caries, adding povidone iodine to oral hygiene and rehabilitation measures can reduce caries prevalence more than oral hygiene and rehabilitation measures alone.
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) 12064491Lopez/2002Children at risk for early childhood cariesRandomized Controlled Trial
Key results“The estimated percents of participants to experience 12 months of disease-free survival were 91 +/- 5% for those receiving treatment and 54 +/- 9% for those in the control group.”The results are statistically significant P=0.0013.
#2) 20578661Simratvir/ 2010Children suffering from ECCRandomized Controlled Trial
Key resultsAt the 12 moth follow up the control group experienced a mean rise of 267.31 in S. mutans count from the initial post operative score compared with a mean rise of 35.5 in S. mutans count observed in the experimental group. “The difference in the rise of bacterial counts was statistically significant” (p=0.0041).
#3) 19486465Berkowitz/2009Children with severe ECCUncontrolled Clinical Study
Key results“The percentages of subjects with a greater than 50 percent reduction in MS level were 85 percent at 30 days, 83 percent at 60 days, 84 percent at 90 days.” “The changes from baseline to 30 days, 60 days, and 90 days were statistically significant (P < 0.0001).”
Evidence Search Search "Povidone-Iodine"[Mesh]Search "Child"[Mesh] Search "Dental Caries"[Mesh]
Comments on
The Evidence
The Lopez, et. al., article is a RCT with groups similar at start. Both groups were treated the same and there was adequate follow up. The study was not double blind, and recall bias as well as competing interests were unlikely. Simrativir, et. al., also conducted a RCT with groups similar and adequate follow up. Stimulated saliva samples were collected to assess changes in S. mutans count. The study was not double blind, and there is no indication of recall bias or competing interests. Clinical results revealed two children in the control group developed new lesions but this figure was not statistically significant (p=0.10174) Berkowitz, et. al is an exploratory study and did not use a control group. The subjects were similar at the start, all meeting the criteria for a diagnosis of S-ECC. This study assessed non-stimulated saliva samples which were placed on ice and processed within 2 hours. These samples were obtained at baseline, 30, 60, and 90 days post op. All subjects were treated the same and adequate follow up was performed. No indication of recall bias or competing interest was found.
Applicability The subjects are representative of children seen general practice. Application of povidone iodine is a feasible treatment option.
Specialty/Discipline (Public Health) (Oral Medicine/Pathology/Radiology) (General Dentistry) (Pediatric Dentistry)
Keywords children, caries, povidone iodine, early childhood caries
ID# 791
Date of submission: 03/30/2011spacer
E-mail chavezm5@livemail.uthscsa.edu
Author Maritza Chavez
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Bennett T. Amaechi, BDS, MSc, PhD
Faculty mentor/Co-author e-mail Amaechi@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?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Jennifer La and Jonathan Abay (San Antonio, Texas) on 11/28/2017
PubMed & TRIP Database were searched for CAT #791 on November 2017 regarding the efficacy of povidone iodine (PI) in reducing early childhood caries (ECC), and a more recent publication was found: Twetman and Dhar, 2015 (PMID 26063553). This systematic review examined the effectiveness of PI for ECC prevention, and it was concluded that there is insufficient evidence to support that anticaries agents other than fluoride, such as PI, reduced the incidence of ECC. The review disagreed with the information from the Simratvir study that was used as one of the higher level evidences on this clinical question.
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