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The potential pathogenic role of mutans streptococci in the etiology of dental caries is well-documented. Mutans streptococci are sensitive to chlorhexidine (CHX), and several methods for the clinical use of CHX have been described. An important target group for caries-preventive measures is patients with impaired salivary secretion due to the use of therapeutic drugs such as psychotropics. The aim of the present study was to compare two methods for antimicrobial treatment in such patients. Twenty-four volunteering patients at a hospital clinic were randomly divided into three groups: Group A, in which each participant was treated with 10% CHX gel in gel trays on two consecutive days, followed by application of a fluoride varnish; Group B, in which the patients were treated with the same CHX gel as above; and Group C, which was used as a control. After treatment, there was a reduction of mutans streptococci in the two groups treated with CHX. In group A, the sames collected one, three, and five weeks after the treatment were significantly lower than baseline values. No clearcut reduction of the number of mutans streptococci was observed in the subjects not treated with CHX. These data indicate that treatment with CHX gel in gel trays is superior to polishing the teeth with CHX gel. From a clinical point of view, our observations suggest that it is important to monitor the effect of antimicrobial treatment individually in order to optimize preventive programs in patients with impaired salivary secretion.
Bondestam et al. (Wed,) studied this question.