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

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 1st 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.