Comparative evaluation of the efficacy of tricalcium phosphate, calcium sodium phosphosilicate, and casein phosphopeptide – amorphous calcium phosphate in reducing Streptococcus mutans levels in saliva

Abstract

Background: There are only limited studies that have determined the antibacterial effects of various remineralizing agents that can be beneficial to children.

Aim: The aim of this study is to compare the efficacy of tricalcium phosphate (TCP), calcium sodium phosphosilicate (CSP), and casein phosphopeptide‑amorphous calcium phosphate (CPP‑ACP) enhanced with fluoride in reducing the Streptococcus mutans (SM) levels in saliva of children.

Materials and Methods: Out of 245 children, 120 of them with SM colony forming units (CFU)/ml in the range of 104– 106/ml of saliva were assigned to four groups: (I) TCP; (II) CSP; (III) CPP‑ACP enhanced with fluoride; and (IV) control. Salivary samples were collected at intervals of 1 week, 2 weeks, and 4 weeks and the number of CFU/ml of SM in saliva were counted post 48 hour incubation.

Results: After 1 week, 2 weeks, and 4 weeks, there was a significant reduction in the mean score of SM (P < 0.05). The maximum reduction in the CFU/ml in the saliva was seen in the 1^st week after the commencement of the brushing in all the three test groups. Group III children demonstrated the maximum reduction of 15 × 10⁵ CFU/ml, followed by Group II children with 10 × 10⁵ CFU/ml.

Conclusions: Twice daily use of CPP‑ACP with fluoride, CSP, and TCP caused a significant reduction in the levels of SM in saliva.

Keywords: Calcium sodium phosphosilicate, fluoride, saliva, Streptococcus mutans, tricalcium phosphate