Cited by 0Dental Health and Care UtilizationOral microbiology and periodontitis researchDental materials and restorations

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index; 6 of the 43 sources its claims cite were checked for support.

Effect of Three Different Topical Fluoride Varnishes on Streptococcus mutans Count in Biofilm Samples of Children Aged 6–10 Years: A Randomized Controlled Trial

Open access
Baidya, Debalina, Pathivada, Lumbini, Garg, Nishita, Karthik, Krishna M, Jain, Abhay K, Bhyri, Pallavi·2026·International Journal of Clinical Pediatric Dentistry

Abstract

the remineralization potential of saliva are constrained by the availability of calcium and phosphate ions.As a result, to boost the effectiveness of fluoride varnish in preventing cavities, calcium and phosphate ions have been added to improve the retention of both fluoride and calcium ions in the mouth.9,10 Mankind's quest for novel materials to overcome caries led to casein phosphopeptide-amorphous calcium phosphate IntroductIonDental plaque is a soft, sticky material that forms on the surface of teeth.The oral microorganisms present in dental plaque play a crucial role in the onset and development of dental caries. 1 These microorganisms consist of mutans streptococci (Streptococcus mutans and Streptococcus sobrinus), Lactobacillus species, Actinomyces species, nonmutans streptococci, and yeast.They become pathogenic under conditions causing prolonged plaque acidification.S. mutans adapts to low pH and increases acid production, resulting in cariogenic plaque. 2 There are different ways to manage tooth decay by stopping the interaction between risk factors like diet, bacteria, and weak teeth.These methods include changing eating habits, practicing good oral hygiene, and using fluoride and sealants.All these actions aim to affect the bacteria in the mouth, either directly or indirectly.3,4 Fluoride varnishes are designed to extend the contact time between fluoride and tooth enamel.They create a thin coating that clings to the tooth's surface for a prolonged period, preventing the rapid loss of fluoride after it is applied and acting as reservoirs that gradually release fluoride.Fluoride varnish can reduce the number of bacteria by interfering with how oral bacteria process carbohydrates.5,6 This varnish usually has 5% sodium fluoride (NaF) and is often used to prevent cavities.Studies show that applying it twice a year can greatly lower the risk of cavities by keeping a high level of fluoride on teeth for a long time.7,8 Fluoride alone does not offer a comprehensive solution for caries prevention, as the formation of fluoride reservoirs and 1,2,

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In a randomized controlled trial in children aged 6–10 years, three topical fluoride varnishes significantly reduced plaque *Streptococcus mutans* counts over 6 months. GC MI Varnish (CPP–ACP) produced the greatest and most consistent reductions, especially at 1 and 3 months.

Key findings

  • All three varnishes reduced *S. mutans* CFU/mL from baseline to 6 months: GC MI Varnish 7.64 ± 0.18 to 5.76 ± 2.05 (mean difference 1.88 ± 1.54; 24.6% change), Ultradent 7.79 ± 0.18 to 6.02 ± 1.30 (1.77 ± 1.26; 22.7%), and Fluor Protector S 7.83 ± 0.17 to 6.14 ± 1.85 (1.69 ± 1.46; 21.5%).
  • Between-group differences were significant at 1 month (p < 0.0001) and 3 months (p = 0.015), but not at 6 months (p = 0.55).
  • GC MI Varnish differed significantly from both Ultradent and Fluor Protector S at 1 month (p < 0.0001) and 3 months (p = 0.01); Ultradent vs Fluor Protector S was not significant (p = 0.22 at 3 months; p = 0.94 at 6 months).
  • Within-group reductions were significant for all groups (repeated-measures ANOVA p = 0.0001); GC MI Varnish showed a significant baseline-to-1-month reduction (p = 0.004), whereas Ultradent and Fluor Protector S did not (p = 0.30 and p = 0.75, respectively).

Methods

  • Randomized controlled trial in children aged 6–10 years who were healthy, free from systemic disorders, and had noncarious primary maxillary molar teeth with intact tooth structure; exclusions included artificial fluoride supplementation or antimicrobial therapy within the preceding 3 months, orthodontic treatment, or dental fluorosis. Children were randomly assigned via colored paper chits to GC MI Varnish, Ultradent Enamelast, or Ivoclar Fluor Protector S.
  • Plaque samples were collected from the right permanent maxillary first molar at baseline and at 1, 3, and 6 months after ultrasonic scaling and varnish application; samples were transported in reduced transport fluid within 3 hours and cultured using the Westergren and Krasse method, with *S. mutans* colonies counted by automated colony counter and expressed as CFU/mL.
  • Analysis used SPSS 26.0 with significance at p < 0.05; Shapiro–Wilk tested normality, one-way ANOVA with Bonferroni post hoc tested between-group differences, and repeated-measures ANOVA with post hoc tested within-group changes. Final analyzed sample was 48 per group (144 total) after dropouts; the text also reports 180 initially enrolled.

Limitations

  • The paper states the study used a small group from a single geographic location, lacked long-term follow-up, may have been affected by observer bias and differences in patient adherence, and did not include socioeconomic status in the analysis.
  • The paper states that microbial culture was used to measure *S. mutans*; molecular methods such as qPCR may provide higher sensitivity and specificity, and long-term clinical outcomes such as caries incidence were not assessed.
  • Evident from the text: enrollment/analysis numbers are inconsistent—the abstract says 144 children were divided into three groups, while the Results section says 180 were initially enrolled and 144 ultimately analyzed (48 per group) after dropouts.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.5005/jp-journals-10005-3470

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Fig. 1: Steps of fluoride application
Fig. 1: Steps of fluoride applicationCC BY-NC · PubMed Central
Fig. 2: Streak plate method to isolate S. mutans on agar plates for further analysis
Fig. 2: Streak plate method to isolate S. mutans on agar plates for further analysisCC BY-NC · PubMed Central
Flowchart 1: Flowchart according to CONSORT guidelines
Flowchart 1: Flowchart according to CONSORT guidelinesCC BY-NC · PubMed Central

Verification

Claims the paper makes

16 Own result · 11 Own method · 10 Not checked yet · 6 Sources not found · 4 Partly supported · 3 No full text of the sources · 2 Own interpretation · 2 No basis given · 1 Supported so far · accuracy not yet measured

Verify all 6 references — free account

Show all 20 claims

  • Probably not a substantial claim. 25
  • It may state two separate claims as one. 21
35 of 35
  • The paper relies on this without support.

    There is limited literature comparing the efficacy of different types of fluoride varnishes in reducing S. mutans counts in children, particularly with and without prophylactic procedures.

    “There is limited literature comparing the efficacy of different types of fluoride varnishes in reducing S. mutans counts in children, particularly with and without prophylactic procedures.”
1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

4 of 4

Citations

Cites

Show all 28 references

Research works printed but not linked: 6

  1. 19. Bowen WH. Do we need to be concerned about dental caries in the coming millennium? Crit Rev Oral Biol Med 2002;13(2):126–131.
  2. 24. Fejerskov O, Ekstrand J, Burt BA. Fluoride in Dentistry, 2nd edition. Munksgaard: Copenhagen; 1996. pp. 311–327.
  3. 32. Pukallus ML, et al. Randomized controlled trial of MI varnish in children at high caries risk. Pediatr Dent 2013;35(7):47–51.
  4. 33. Kitasako Y, et al. Inhibitory effects of casein phosphopeptide amorphous calcium phosphate on the progression of enamel caries. Aust Dent J 2014;59(2):180–187.
  5. 34. Baysan A, Lynch E. Fluoride release from resin-based fissure sealants. J Dent Res 2005;84(3):243–248.
  6. 39. Seppä L. Resin-modified glass ionomer materials: fluoride release and cariostatic properties. Aust Dent J 1998;43(2):63–69.

Cited by

Still being checked.

Metadata

Authors
Baidya, D., Pathivada, L., Garg, N., Karthik, K. M., Jain, A. K., & Bhyri, P.
Affiliations
  • Rungta College (IN)
  • Rajendra Institute of Medical Sciences (IN)
Corresponding author
Garg, Nishita
Venue
International Journal of Clinical Pediatric Dentistry
Published
2026-03-02
Volume
19
Issue
3
Pages
343-349
ISSN
  • 0974-7052 (ISSN-L)
  • 0975-1904
OpenAlex
W7133312010
Cited by
0
References
28
FWCI
0.00
Type
journal article
Language
en
Open access
Locations
  • International Journal of Clinical Pediatric Dentistry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc)
Topics
  • Health Sciences › Dentistry › General Dentistry › Dental Health and Care Utilization
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Dentistry › General Dentistry › Dental materials and restorations
Keywords
Streptococcus mutans, dental plaque, dental caries prevention, sodium fluoride, CPP-ACP, mutans streptococci

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