Efficacy of Fluoride Varnish and Casein Phosphopeptide-Amorphous Calcium Phosphate for Remineralization of Primary Teeth: A Randomized Clinical Trial

Objective: We aimed to evaluate the efficacy of oral hygiene instruction, fluoride varnish and casein phosphopeptideamorphous calcium phosphate (CPP-ACP) for remineralizing white spot lesions (WSL), and the effect of these on the dmft index in primary teeth. Subjects and Methods: In this 1-year, randomized clinical trial, 140 children aged 12–36 months with WSL in the anterior maxillary teeth were selected and randomly divided into 4 groups of 35 children each. Group 1 (control) received no preventive intervention. In group 2, there was oral hygiene and dietary counseling. In group 3, there was oral hygiene and the application of fluoride varnish at 4, 8 and 12 months after baseline. In group 4, there was oral hygiene and tooth mousse was applied by the parents twice a day over a 12-month period. At baseline and 4, 8 and 12 months after the intervention, the size of WSL in millimeters and the dmft index were recorded. One hundred and twenty-two children completed the study. Data were analyzed using the repeated-measures ANOVA test. Results: In group 1, the mean percent WSL area and dmft index values had increased significantly at 12 months after baseline (p 0.001). The interventions led to significant decreases in the size of the WSL; the greatest reduction was in group 4 (63%) followed by group 3 (51%) and group 2 (10%) after 12 months. The smallest increase in the dmft index was in group 4 (0.17), followed by groups 3 (0.3) and 2 (0.42). However, there were no significant differences between the groups (p 0.001). Conclusions: Oral hygiene along with four fluoride varnish applications or constant CPP-ACP during the 12- month period reduced the size of WSL in the anterior primary teeth and caused a small increase in dmft index values.