The Effect of Chlorhexidine Varnish Treatment on Salivary Mutans Streptococcal Levels in Child Orthodontic Patients

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Abstract
A chlorhexidine dental varnish was applied to the teeth of 26 children, ten to 17 years of age, in an attempt to limit the increase in colonization by mutans streptococci that normally accompanies the placement of fixed orthodontic appliances and to assess the acceptance of the application procedure. Despite the insertion of the appliances in the month following the varnish application, the numbers of detectable salivary mutans streptococci in the children were found to remain significantly lower than baseline values for seven months (p < 0.01). Among the 26 children, 16 exhibited high counts (> 2.5 x 105 cfu/mL saliva) at baseline, but none exhibited such counts until three months post-treatment, when one child did. By seven months, eight children had high counts. No significant difference in effectiveness was observed between varnish formulations containing 10% or 20% chlorhexidine acetate, or between children of different ages or past caries experience. The lack of drop-outs and the results of a questionnaire indicated that acceptance of the treatment by the children was excellent. The study indicates that chlorhexidine varnish therapy was acceptable to the children and was effective in suppressing oral mutans streptococcal levels for long periods, even when used prior to the placement of fixed orthodontic appliances.