2.3 Mineral and Antimicrobial Agents
Antimicrobials
Povidone-Iodine
Topically applied povidone-iodine has been shown to reduce MS levels. A prophylaxis followed by three applications of iodine solution reduces MS in dental plaque and saliva for up to 6 weeks. Topical povidone-iodine also reduces the risk for development of early childhood caries in children at high risk for dental caries. As with chlorhexidine, when using povidone-iodine in combination with topical fluoride, an additive anti-caries effect has been demonstrated.
Other Antimicrobials
Other antimicrobials such as delmopinol hydrochloride and Triclosan™ have shown potential for reducing dental caries. Delmopinol hydrochloride inhibits glucan synthesis by MS, reduces bacterial acid production, and disaggregates existing plaque in vitro. Triclosan is a broad-spectrum antibacterial agent found in many detergents, soaps, and surface decontaminants. It is incorporated into fluoridated toothpaste as a way to reduce plaque and gingivitis and enhance the anti-caries potential of fluoride.
Probiotics and Molecular Genetics
The use of probiotics and molecular genetics to replace and displace caries-causing bacteria with noncariogenic bacteria has shown encouraging results. OTC or prescription medications developed through probiotic theory or using molecular genetics for the prevention of caries may soon be available. Silver diamine fluoride and certain Chinese herbs such as Sophora flavescens have also shown promise for caries control; however, these products are not available in the United States.
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