Effect of CPP-ACP paste on dental caries in primary teeth: a randomized trial

Area of Science:

• Pediatric Dentistry
• Cariology
• Preventive Dentistry

Background:

• Dental caries remains a significant public health issue in preschool children.
• Early childhood caries (ECC) necessitates effective preventive strategies.
• Fluoride toothpaste is a standard preventive measure.

Purpose of the Study:

• To evaluate the additional benefit of 10% CPP-ACP paste in preventing dental caries.
• To assess the efficacy of CPP-ACP when used with fluoridated toothpaste in high-caries-risk preschoolers.
• To compare caries progression and regression between CPP-ACP and placebo groups.

Main Methods:

• A 1-year randomized controlled trial involving high-caries-risk preschool children (2.5–3.5 years old).
• Participants received either 10% CPP-ACP paste or a placebo, alongside regular fluoridated toothpaste brushing.
• Caries assessment used the International Caries Detection and Assessment System (ICDAS) at baseline, 6 months, and 1 year.

Main Results:

• Both groups showed a significant increase in enamel and dentin caries lesions and dmfs over 1 year (p < 0.001).
• No statistically significant differences were found between the CPP-ACP and placebo groups for any caries outcome measures (p > 0.23).
• The likelihood of caries lesion regression or stability did not differ between the groups (OR = 1.00, 95% CI [0.86, 1.17]).

Conclusions:

• Daily application of 10% CPP-ACP paste, when added to fluoridated toothpaste, did not provide a significant additional benefit in preventing primary dentition caries in preschoolers.
• The findings suggest that standard fluoride toothpaste use is the primary determinant of caries prevention in this population.
• Further research may explore different CPP-ACP formulations or application frequencies for potential efficacy.