Caries prevention with chlorhexidine-thymol varnish in high risk schoolchildren

In a prospective, randomised and blinded cohort study, the acceptance and effectiveness of a 3-monthly chlorhexidine-thymol varnish application was assessed in 8- to 10-yr-old children (n=29) with high caries incidence after brushing with a 1.23% fluoride gel. The children of the control group (n=25) brushed with a fluoride gel only. The standardised interview showed good acceptance of the varnish applications in spite of the bitter taste. Caries incidence in one year was 1.2 DMFS (SD 1.5, median 1; 95% confidence interval 0-1) for the test group and 2.1 DMFS (SD 2.3, median 2; 95% confidence interval 0-3) for the control group. Due to a slightly lower reduction in caries incidence (42.3%) than in other studies and a higher standard deviation than in unselected study groups, the power of the present study was not high enough to prove this difference in caries incidence to be statistically significant in the Mann-Whitney test (P=0.11). This was also found for the difference of 0.4 initial lesions. The distribution patterns of caries incidence for tooth groups (70% in the first permanent molar) and surfaces (58% on occlusal surfaces) did not differ between the test and the control group. The reductions of caries incidence which have been found in highly caries active children of the present study should be evaluated further with a larger study sample.