Association of Oral Candida albicans with Severe Early Childhood Caries - A Pilot Study.

INTRODUCTION: In early childhood, children are more susceptible to opportunistic microbial colonization in the oral cavity due to immature immune system and not fully established micro flora. The current literature proposes a probable role of Candida albicans, a fungus in the etiopathogenesis of dental caries. AIM: This study was conducted to compare the Candida albicans count in children with severe early childhood caries and caries free children. MATERIALS AND METHODS: A cross-sectional study was conducted in 40 randomly selected healthy children between 12 to 71 months of age, who were divided into two groups based on the caries experience as Severe Early Childhood Caries (SECC) (dmfs ≥4) and caries free (dmfs = 0). The caries experiences (dmfs index) of the 40 children were recorded using visible light and diagnostic instruments. A 2ml sample of unstimulated whole saliva collected from the children was transported to the microbiology laboratory in universal containers and evaluated for Candida albicans count using the selective media. The data was statistically analyzed using SPSS software 17.0. RESULTS: Candida albicans was found in both the SECC group and caries free group. Median Candida albicans of the SECC group was numerically greater than the caries free group and this difference was highly statistically significant (p=0.012). CONCLUSION: In this present cross-sectional study, we found a 100% prevalence of Candida albicans in the saliva of the study children. There was a highly significant increase in Candida albicans count in SECC children compared to the caries free children.

An in vitro Comparative Evaluation of Three Remineralizing Agents using Confocal Microscopy.

INTRODUCTION: The caries process has been thought to be irreversible, resulting in the permanent loss of tooth substance and eventually the development of a cavity. Recent approaches focused on application of remineralizing agents to incipient carious lesions, aim at controlling demineralization and promoting remineralization. Remineralizing agents create a supersaturated environment around the lesion; thus, preventing mineral loss and forces calcium and phosphate ions in the vacant areas. AIM: To compare and evaluate the remineralization potential of Fluoride Varnish, CPP-ACP Paste (Casein Phosphopeptide-Amorphous Calcium Phosphate) and fTCP Paste (functionalized Tricalcium Phosphate) using confocal microscope. MATERIALS AND METHODS: Two windows of 3X3mm were created on the labial cervical and incisal thirds in 60 permanent maxillary central incisors. The teeth were demineralized to create artificial caries and divided into three groups of 20 each. Group I specimens were coated with Fluoride Varnish once whereas those in CPP-ACP paste group and fTCP group were brushed for 2 minutes, twice daily for 20 and 40 days. The specimens were stored in artificial saliva during the study period and were later sectioned and observed under confocal microscope. Data obtained was statistically analyzed using Fischer's exact test, ANOVA and post-hoc Bonferroni's test. RESULTS: Fluoride Varnish, CPP-ACP Paste and fTCP Paste showed remineralization of artificial carious lesions at both the time intervals. Fluoride varnish showed the highest remineralization followed by CPP-ACP Paste and fTCP Paste. A statistically significant increase in remineralization potential of CPP-ACP Paste and fTCP Paste was observed at the end of 40 days as compared to 20 days. CONCLUSION: Fluoride varnish showed the greatest remineralization potential of artificial carious lesions followed by CPP-ACP Paste and fTCP Paste respectively.

Comparison of the antimicrobial efficacy of chlorhexidine, sodium fluoride, fluoride with essential oils, alum, green tea, and garlic with lime mouth rinses on cariogenic microbes.

BACKGROUND: A number of natural mouth rinse formulations are being proposed as an alternative to the widely used chemical mouth rinses. OBJECTIVE: To evaluate and compare the antimicrobial efficacy of chlorhexidine (0.2%), sodium fluoride (0.05%), fluoride with essential oils (0.05%), alum (0.02 M), green tea, and garlic with lime mouth rinses against Streptococcus mutans, lactobacilli, and Candida albicans. MATERIALS AND METHODS: The three microbes were isolated from the saliva samples collected from children with severe early childhood caries. The zone of minimum inhibition was assessed using agar diffusion method. The data were statistically analyzed using SPSS software. RESULTS: Against S. mutans and lactobacilli, chlorhexidine mouth rinse was found to be the most effective as compared to sodium fluoride (P < 0.001, P < 0.001), fluoride with essential oils (P < 0.001, P < 0.001), alum (P < 0.001, P < 0.001), green tea (P < 0.001, P < 0.001), and garlic with lime (P < 0.001, P < 0.001) mouth rinses, respectively. But against C. albicans, garlic with lime mouth rinse was found to be the most effective as compared to chlorhexidine (P < 0.001), sodium fluoride (P < 0.001), fluoride with essential oils (P < 0.001), alum (P < 0.001), and green tea (P < 0.001) mouth rinses. Against S. mutans and lactobacilli, after chlorhexidine mouth rinse, garlic with lime mouth rinse was found to be significantly more effective than sodium fluoride (P = 0.053, P = 0.001), fluoride with essential oils (P < 0.001, P < 0.001), alum (P < 0.001, P < 0.001), and green tea (P < 0.001, P < 0.001) mouth rinses. CONCLUSION: As a natural mouth rinse, garlic with lime mouth rinse was found to be the most promising. However, further studies are needed in this field.