SUMMARYThe use of chlorhexidine for caries prevention has been a controversial topic among dental educators and clinicians. In several reviews, it has been concluded that the most persistent reduction of mutans streptococci have been achieved by chlorhexidine varnishes, followed by gels and, lastly, mouth rinses. Also, the evidence for using different chlorhexidine modes or a combination of chlorhexidine-fluoride therapy for caries prevention has been "suggestive but incomplete." Variable study designs and lack of data in highrisk children and adults support the need to continue conducting randomized, well-controlled clinical trials and to search for a practical, effective mode of antimicrobial treatment that augments the known effect of fluoride treatments.Currently, the only chlorhexidine-containing products marketed in the United States (US) are mouthrinses containing 0.12 percent chlorhexidine. Based on the available reviews, chlorhexidine rinses have not been highly effective in preventing caries, or at least the clinical data are not convincing. Due to the current lack of long-term clinical evidence for caries prevention and reported side effects, chlorhexidine rinses should not be recommended for caries prevention. Due to the inconclusive literature and sparse clinical data on gels and varnishes, their use for caries prevention should also be studied further to develop evidence-based recommendations for their clinical role in caries prevention.Since dental caries is a disease with a multifactoral etiology, it is currently more appropriate to use other established, evidence-based prevention methods, such as fluoride applications, diet modifications and good oral hygiene practices. Recent findings also indicate that the effect of an antimicrobial agent for reducing the levels of mutans streptococci or plaque reduction may not always correlate with eventual caries reduction. The clinically important outcome is proven reductions in caries.Many advances in the treatment and prevention of dental caries have been introduced over the past century. The use of chlorhexidine in caries prevention has been referred to as a nonsurgical management of dental caries and has represented the modern medical model of caries treatment. However, there is a lack of consensus on evidence-based treatment protocols and controversy regarding the role of chlorhexidine in caries prevention among dental educators and The Role of Chlorhexidine in Caries PreventionJ Autio-Gold Clinical RelevanceChlorhexidine rinses should not be recommended for use in caries prevention due to the current lack of evidence for their effectiveness.*Jaana Autio-Gold, DDS, PhD This paper reviewed the literature on the effectiveness of different modes of chlorhexidine delivery for caries prevention and provides guidelines for chlorhexidine use in caries management. A literature search was conducted using the PubMed and Evidence-Based Medicine Reviews databases and the keywords "chlorhexidine" and "caries," limiting the search to "humans, "reviews" and "English...

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Students' attitudes toward caries prevention can impact their receptivity to training and subsequent involvement in preventive services in their future practices. The aim of this study was to evaluate dental students' opinions and knowledge regarding caries management and prevention at the University of Florida College of Dentistry. A twenty-six-item written survey instrument was administered to third-and fourth-year dental students. The response rate was 92.3 percent (72/78) for third-year and 45.5 percent (35/77) for fourth-year students. In their responses, 83 percent reported they would use chlorhexidine rinses for caries control, and 51 percent would use salivary tests for detecting cariogenic bacteria. Ninety-two percent reported they would use fluoride varnishes for caries control, and 40 percent were not sure if varnishes have associated dental or medical side effects. The majority of respondents felt that training and practice on caries prevention should be increased. Favorable responses to increasing education responses to increasing education to increasing education in preventive dentistry indicate that students may be receptive to modern caries management and prevention principles. This study suggests there is a need to update and integrate a more comprehensive caries prevention program into the predoctoral dental curriculum. Such programs should stress, in addition to actual training, the importance of prevention in students' future practice.