COMPARISON OF THE EFFICACY OF 40-PERCENT CHLORHEXIDINE VARNISH AND 1-PERCENT CHLORHEXIDINE FLUORIDE GEL IN DECREASING THE LEVEL OF SALIVARYMUTANS STREPTOCOCCI

The aim of the study was to compare the efficacy of a 40% chlorhexidin e (CHX) varnish (EC40, Certichem, Nijmegen, The Netherlands) with a 1% CHX-0.2% NaF gel in decreasing the level of salivary mutans streptoco cci (MS). The subjects were screened for a high level of MS using a De ntocult-SM(R) strip method (Orion Diagnostica, Finland). In varnish gr oups with fluoride (V-CHXF, n = 20) and without fluoride (V-CHX, n = 1 9), the CHX varnish was applied on dry teeth using an ampoule and an a nesthetic syringe with blunt needle, and removed after 15 min. In grou p V-CHXF an additional 2.26% fluoride varnish (Duraphat(R), Woelm Phar ma GmbH, Eschwege, Germany) was applied. The CHX-NaF gel treatment inc luded the application of the gel with rubber cups and dental tape for 5 min on three occasions during a week in group G(CHXF) (n = 21). The level of MS (MSB agar) was significantly lower after 4 weeks than at b aseline in V-CHX, (p<0.001) and V-CHXF (p<0.05), but not after 12 week s. In G(CHXF) a significant decrease (p = 0.001) was observed after 4 weeks only with the strip method. In V-CHX and V-CHXF the strip values for MS were still reduced after 12 weeks. In V-CHX and G(CHXF) a smal l, although statistically significant, increase was observed in the to tal number of microorganisms after 4 and 12 weeks. Opinions on taste s ensations associated with the treatments were generally negative, but least negative in the V-CHXF group; fewer side effects were also repor ted in the V-CHXF group. The results indicate that one treatment with CHX varnish gives an equal or a longer suppression of salivary MS than three treatments with the gel form. Although the concentration of CHX is high, the varnish was associated with fewer side effects and compl aints of bad taste than the 1% CHX-NaF gel, especially when coated by a fluoride varnish. This is probably due to an accurate application on teeth with a minimal contact with the oral mucosa.