Efficacy of 10% Povidone Iodine in Children Affected with Early Childhood Caries:An In Vivo Study

For prevention of dental caries, S. mutans numbers must be reduced and prevented from returning to the original level. An antibacterial agent that is effective and also acceptable to young children can help to establish a favorable oral environment and halt the caries process. Purpose: This study was conducted to evaluate the efficacy of topical antimicrobial (10% Povidone- Iodine) on S.mutans counts in children with Early Childhood Caries after full mouth rehabilitation. Also its effects on the clinical outcomes in terms of incidence of new caries and secondary caries were evaluated.

Method: Full mouth rehabilitation was done in 30 children (mean age 4.2 years) suffering from Severe Early Childhood Caries (SECC). Stimulated saliva samples were collected to determine the post operative baseline S.mutans counts. Thereafter the subjects were randomly divided into two groups. The experimental group received 10% Povidone Iodine at 3 months interval for a period of 12 months while the control group received placebo (deionized water) at similar intervals.

Change in the S.mutans count at 6 and 12 month intervals were compared to the baseline post-operative mutans score. Results revealed that application of 10% Povidone Iodine caused a significant reduction in the rise of Streptococcus mutans levels from the baseline postoperative score after 12 months of treatment thus decreasing the oral load of the organisms. Reduction in counts; in turn decreased the relapse of caries in these children. Conclusion: Thus oral rehabilitation coupled with regular application of 10% Povidone Iodine application can be a good alternative to control dental caries in children affected with Early Childhood Caries (ECC).

Early Childhood caries, Antimicrobial, Streptococcus mutans

1. Ersin NK, Eronat N, Cogulu D, Uzel A, Aksit S. Association of mater-nal-child characteristics as a factoring early childhood caries and sali-vary bacterial counts. J Dent Child, 73(2): 105–111, 2006.

2. van Houte J, Gibbs G, Butera C. Oral flora of children with “nursing bottle caries.” J Dent Res, 61(2): 382–385, 1982.

3. Alaluusua S, Renkonen OV. Streptococcus mutans establishment and dental caries experience in children from 2 to 4 years old. Scandinavian J Dent Res, 91: 453–457, 1983.

4. Wunsch PB, Park JH, Watson MR, Tinanoff N, Minah GE. Microbio-logical screening for cariogenic bacteria in children 9-36 months of age. Pediatr Dent, 26(3): 231–239, 2004.

5. Ota K, Kikuchi S, Beierle JW. Stannous fluoride and its effects on oral microbial adhesive properties in vitro. Pediatr Dent, 11(1): 21–25, 1989.

6. Twetman S. Antimicrobials in future caries control? Caries Res, 2004; 38: 223–229.

7. Amin MS, Harrison RL, Benton TS, Roberts M, Weinstein P. Effect of Povidone- iodine on Streptococcus Mutans in children with Extensive Dental Caries. Pediatr Dent, 26: 5–10, 2004.

8. Zhan L, Featherstone JD, Gansky SA, Hoover CI, Fujino T, Berkowitz RJ, Den Besten PK. Antibacterial treatment needed for severe Early Childhood Caries. J Public Health Dent, 66 (3): 174–179, 2006.

9. Peter S. Essentials of preventive and community dentistry. 1st Edition. Arya (medi) Publishing House 503, 1999.

10. American Academy of Pediatric Dentistry. Definition of Early Child-hood Caries (ECC). Pediatr Dent, 27(7): 14, 2005.

11. Ananthanarayan R, Paniker CKJ. Textbook of microbiology. 6th Edi-tion. Orient Longman Limited 187–189, 2000.

12. Ismail AI. Visual and visuo-tactile detection of dental caries. J Dent Res, 83(Spec Iss C): C56–C66, 2004.

13. Kidd EAM. Caries diagnosis within restored teeth. Adv Dent Res, 4: 10–13, 1990.

14. Lopez L, Berkowitz R, Spiekerman C, Weinstein P. Topical antimicro-bial therapy in prevention of early childhood caries: a follow-up report. Pediatr Dent, 24: 204–206, 2002.

15. Corby PM, Weiler JL, Bretz WA, Hart TC, Aas JA, Boumenna T, Goss J, Corby AL, Junior HM, Weyant RJ, Paster BJ. Microbiological risk indicators of Early Childhood caries. J Clin Microbiol, 43(11): 5753–5759, 2005.

16. Caufield PW, Gibbons RJ. Suppression of Streptococcus mutans in the Mouths of humans by A Dental prophylaxis and Topically-applied Iodine. J Dent Res, 58(4): 1317–1326, 1979.

17. Weinberg SJ, Wright GZ. Variables influencing Streptococcus mutans testing. Pediatr Dent, 12(5): 312–315, 1990.

18. Twetman S, Fritzon B, Jensen B, Hallberg U, Stahl B. Pre and post-treatment levels of salivary mutans streptococci and lactobacilli in pre-school children. Int J Paediatr Dent. 9: 93–98, 1999.

19. Gregory RL, El- Rahman AM, Avery DR. Effect of restorative treat-ment on mutans streptococci and IgA antibodies. Pediatr Dent, 20(4): 273–277, 1998.

20. Schaeken MJM, van den Kieboom CWA, Franken HCM, de Jong MH, van der Hoeven JS. Effects of Chlorhexidine, Iodine and 5, 7-Dichloro-

8- Hydroxyquinoline on the bacterial composition of rat plaque in vivo. Caries Res, 18: 440–446, 1984.

21. Bowden GH. Does assessment of microbial composition of plaque/saliva allow for diagnosis of disease activity of individuals? Commu-nity Dent Oral Epidemiol, 25: 76–81, 1997.

22. Tanzer JM, Slee AM, Kamay B, Scheer ER. In vitro evaluation of three iodine containing compounds as antiplaque agents. Antimicrobial agents and Chemotherapy, 12(1): 107–113, 1997.

23. Chase I, Berkowitz RJ, Mundorff-Shrestha SA, Proskin HM, Weinstein P, Billings R. Clinical outcomes of early childhood caries (ECC): the influence of salivary mutans streptococci levels. Eur J Paediatr Dent, 5(3): 143–146, 2004.

24. Caufield PW, Navia JM, Rogers AM, Alvarez M. Effect of Topically-applied solutions of Iodine, Sodium Fluoride, or Chlorhexidine on Oral Bacteria and Caries in Rats. J Dent Res, 60(5): 927–932, 1981.