Comparative evaluation of fluoridated, nonfluoridated, and herbal dentifrices with digital oral health intervention on salivary cariogenic microorganisms and alpha-amylase levels in children with severe early childhood caries.

CONTEXT: Early childhood caries (ECC) is a multifactorial biofilm-mediated disease strongly associated with cariogenic microorganisms such as Streptococcus mutans and Lactobacillus acidophilus . Salivary alpha-amylase has recently been proposed as a biochemical marker reflecting caries activity. With the availability of pediatric dentifrices of varying fluoride concentrations and herbal compositions, comparative clinical evidence of caries incidence in children with ECC remains limited.

AIM: To evaluate and compare the effects of high-fluoridated, low-fluoridated, nonfluoridated, and herbal pediatric dentifrices on salivary S. mutans , L. acidophilus, and salivary alpha-amylase levels in children with ECC.

SETTINGS AND

DESIGN

Prospective, randomized, double-blind, parallel-group clinical-microbiological trial.

MATERIALS AND

METHODS

Fifty-six children with Severe ECC (decayed, missing, filled, treated (dmft) ≥4) were randomly allocated into four groups ( n = 14). Participants brushed twice daily with the assigned dentifrice for 15 days. Unstimulated saliva samples were collected at baseline and postintervention. Microbial counts were assessed using selective culture media, and alpha-amylase levels were analyzed by kinetic colorimetric assay. Brushing compliance was reinforced and monitored using a mobile health application. Statistical analysis was performed using one-way analysis of variance, Tukey's post hoc test, paired t -test, and nonparametric equivalents where applicable. The level of significance was set at P < 0.05.

RESULTS

A significant reduction in S. mutans and L. acidophilus counts was observed in all groups postintervention ( P < 0.05). The high-fluoridated dentifrice group demonstrated the greatest percentage reduction in both microorganisms. Postintervention salivary alpha-amylase levels showed better modulation ( P = 0.030), with the lowest mean value in the high-fluoride group (109.43 ± 11.62 milliunits per milliliter [mU/mL]) and the highest in the nonfluoridated group (119.93 ± 7.33 mU/mL).

CONCLUSION

High-fluoridated pediatric dentifrice demonstrated superior antimicrobial efficacy in children with ECC. Salivary alpha-amylase may serve as a useful adjunctive biomarker in caries assessment.