Adjunctive Chemotherapeutic Suppression of MS in Children with Severe ECC

Objective: To assess the suppressive effect of 10% povidone iodine (PI) coupled with elimination of active carious lesions on salivary MS populations in children with S- ECC. Methods: 77 children (38F; 39M) were treated for S- ECC in one session; a 0.2 ml PI solution was applied to the dentition after dental surgery was completed and immediately wiped off. The subjects aged from 2-5y (mean-3.78y) at baseline. Whole non-stimulated saliva samples were obtained via a suction device at baseline, 30d, 60d, and 90d post dental surgery. Samples were placed on ice and processed within 2h. Samples were sonicated, serially diluted and plated onto MSB agar and incubated at 37^o C, 5% CO₂ for 48 h. The MS level in each sample was expressed as colony forming units (CFUs) per ml of saliva. Results: Approximately 50% of subjects had a >95% reduction in CFU/ml of saliva at each time point after baseline. Percentages of subjects with >50% reduction in MS level were 85% at 30d; 83% at 60d; 84% at 90d. The median (25th, 75th percentiles) CFUs/ml of saliva counts were 8.40x10⁵ (1.49x10⁵, 5.00x10⁶) at baseline (N=77). 4.12x10⁴ (8.40x10³, 1.89x10⁵) at 30d (N=74), 4.62x10⁴ (7.00x10³, 1.36x10⁵) at 60d (N=70) and 5.09x10⁴ (1.16x10⁴, 1.00x10⁵) at 90d (N=70). The changes from baseline to 30d, 60d, and 90d were statistically significant (p<0.0001). Conclusions: PI coupled with dental surgery has a significant suppressive effect on salivary MS levels in the setting of S- ECC for at least 90d. This observation may have important utility in improving clinical outcomes for young children treated for S- ECC. (This study was supported by NIDCR grant DE016280.)