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Using chlorhexidine varnish to prevent early childhood caries in American Indian children. 2013

Lawrence D Robertson, and Kathy R Phipps, and Junhie Oh, and Walter J Loesche, and Niko Kaciroti, and John M Symington
Pediatric Health Research Consultant, White Salmon, WA 98672, USA.

OBJECTIVE To test the efficacy of 10% chlorhexidine (CHX) dental varnish applied to the mothers' dentition in preventing caries in American Indian children. METHODS This was a placebo-controlled, double-blind, randomized clinical trial. Mother-child pairs were enrolled when the child was 4.5-6.0 months. Mothers received 4 weekly applications of the study treatment (CHX or placebo) followed by single applications when her child was age 12 and 18 months. Children received caries examinations at enrollment, 12, 18 and 24 months. Analyses were limited to the intent-to-treat (ITT) group: children whose mothers received the first study treatment and who received at least one post-baseline exam. The outcome variable was the number of new carious surfaces (NNCS) at the child's last visit. Wilcoxon nonparametric and Fisher's exact tests were used to test differences between the active and placebo groups. RESULTS We randomized 414 mother-child pairs, with 367 (88.6%) included in the ITT group (active = 188, placebo = 179). The proportion of children caries-free at their final exam was 51.1% and 50.8% for the active and placebo groups (P > 0.99). The mean NNCS for the active and placebo groups was 3.82 (standard deviation [SD] = 8.18) and 3.80 (SD = 6.08), respectively (P = 0.54). The proportion with NNCS > 6 was 18.1% for active children versus 27.9% for placebo (relative risk [RR] = 0.65, P = 0.03). The number needed to treat to shift one child from NNCS > 6 to a lower severity was 10.2. CONCLUSIONS In this population CHX varnish did not reduce the mean NNCS or proportion of children with caries, but did reduce the proportion with severe caries.

UI MeSH Term Description Entries
D007198 Indians, North American Members of indigenous North American populations with pre-colonial contact origins. Amerinds, North American,Indigenous North Americans,American Indian, North,American, Indigenous North,Amerind, North American,Indian, North American,Indigenous North American,North American Amerind,North American Amerinds,North American Indian,North American Indians,North American, Indigenous
D007223 Infant A child between 1 and 23 months of age. Infants
D009034 Mother-Child Relations Interaction between a mother and child. Mother-Child Interaction,Mother-Child Relationship,Mother-Infant Interaction,Mother-Infant Relations,Interaction, Mother-Child,Interaction, Mother-Infant,Interactions, Mother-Child,Interactions, Mother-Infant,Mother Child Interaction,Mother Child Relations,Mother Child Relationship,Mother Infant Interaction,Mother Infant Relations,Mother-Child Interactions,Mother-Child Relation,Mother-Child Relationships,Mother-Infant Interactions,Mother-Infant Relation,Relation, Mother-Child,Relation, Mother-Infant,Relations, Mother-Child,Relations, Mother-Infant,Relationship, Mother-Child,Relationships, Mother-Child
D009922 Oregon State bounded on the north by Washington, on the east by Idaho, on the south by California and Nevada, and on the west by the Pacific Ocean.
D010919 Placebos Any dummy medication or treatment. Although placebos originally were medicinal preparations having no specific pharmacological activity against a targeted condition, the concept has been extended to include treatments or procedures, especially those administered to control groups in clinical trials in order to provide baseline measurements for the experimental protocol. Sham Treatment
D002710 Chlorhexidine A disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. Chlorhexidine Acetate,Chlorhexidine Hydrochloride,MK-412A,Novalsan,Sebidin A,Tubulicid,Acetate, Chlorhexidine,Hydrochloride, Chlorhexidine,MK 412A,MK412A
D003731 Dental Caries Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. Caries, Dental,Carious Lesions,Dental Cavities,Dental Cavity,Dental Decay,Dental White Spots,Carious Dentin,Decay, Dental,Dental White Spot,White Spot, Dental,White Spots, Dental,Carious Dentins,Carious Lesion,Cavities, Dental,Cavity, Dental,Dentin, Carious,Dentins, Carious,Lesion, Carious,Lesions, Carious,Spot, Dental White,Spots, Dental White
D003743 Dental Enamel A hard thin translucent layer of calcified substance which envelops and protects the dentin of the crown of the tooth. It is the hardest substance in the body and is almost entirely composed of calcium salts. Under the microscope, it is composed of thin rods (enamel prisms) held together by cementing substance, and surrounded by an enamel sheath. (From Jablonski, Dictionary of Dentistry, 1992, p286) Enamel,Enamel Cuticle,Dental Enamels,Enamel, Dental,Enamels, Dental,Cuticle, Enamel,Cuticles, Enamel,Enamel Cuticles,Enamels
D003804 Dentin The hard portion of the tooth surrounding the pulp, covered by enamel on the crown and cementum on the root, which is harder and denser than bone but softer than enamel, and is thus readily abraded when left unprotected. (From Jablonski, Dictionary of Dentistry, 1992) Dentine,Dentines,Dentins
D004245 DMF Index "Decayed, missing and filled teeth," a routinely used statistical concept in dentistry. Decayed, Missing, and Filled Teeth,DMF Indexes,DMF Indexe,DMF Indices,Index, DMF,Indexe, DMF,Indexes, DMF,Indices, DMF

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