Antibacterial agents for prevention and therapy of early childhood caries Antibakterielle Wirkstoffe zur Prävention und Therapie der frühkindlichen Karies

Early acquisition of caries-associated bacteria is a major risk factor for early childhood caries (ECC) and significantly increased proportions of mutans streptococci in saliva and biofilm are demonstrated in cases with severe ECC. Thus, an antibacterial approach to combat the disease may be considered and there are several antiseptics available for topical application such as chlorhexidine (CHX) and povidone iodine (PI). The aim of the present paper was to review the current evidence for topical applications of antibacterial agents in infants and preschool children and examine projects designed to interfere with the vertical transmission of caries-associated bacteria between the mother and her child. Due to methodological limitations, use of surrogate endpoints and mixed results, the evidence to support and recommend topical applications of CHX and PI in order to prevent and/or arrest early childhood caries were insufficient. The evidence for various antibacterial measures as part of preventive programs to combat the vertical transmission of mutans streptococci from mothers to their offspring’s was graded as limited. Yet, parents of infants and toddlers should be informed and encouraged to reduce behaviour that promote the early transmission of mutans streptococci. From the literature, it seemed clear that any antibacterial intervention should be an integrated part of a comprehensive preventive program.