Casein phosphopeptide–amorphous calcium phosphate fluoride treatment enriches the symbiotic dental plaque microbiome in children

Armelia Sari Widyarman, Nadeeka S. Udawatte, Citra Fragrantia Theodorea, Anie Apriani, Mario Richi, Tri Erri Astoeti, Chaminda Jayampath Seneviratne

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11 Citations (Scopus)


Objectives: The dysbiotic oral microbiome plays a key role in the pathogenesis of caries in children. Topical application of casein phosphopeptide–amorphous calcium phosphate containing fluoride (CPP-ACP/F) is an effective treatment modality for children with caries (CC). Hitherto the mechanism by which CPP-ACP/F modules the oral microbiome in CC has not been investigated. The study aimed to examine the CPP–ACP/F effect on the dental plaque microbiome of children group with caries. Methods: This preliminary prospective clinical cohort included 10 children with caries. The children received topical fluoride CPP–ACP/F once-a-week for one month. Plaque samples were collected before and after treatment and subjected to 16S rDNA-based next-generation-sequencing. Microbial composition, diversity and functional roles were analyzed in comparison to the clinical characteristics of cohort using standard bioinformatics tools. Results: CPP-ACP/F treatment modulated dysbiotic oral microbiome towards healthier community as the higher proportion of Proteobacteria and certain microbial protective species were enriched following CPP-ACP/F treatment. Despite overall uniformity of community structure in children with caries between the groups, some bacterial species were differentially represented in a statistically significant manner between pre- and post- treatments. Three bacterial species were found to be predictive of strongly sensitive to the CPP-ACP/F treatment, marked by decreased abundance of Lautropia mirabalis and increased abundance of Gemella haemolysans and Schwartzia succinivorans. Conclusion: Within the limits of the current study, it could be concluded that the CPP-ACP/F varnish treatment modulated the microbial composition of the dental plaque microbiome towards symbiosis. These symbiotic changes may demonstrate the potential clinical significance of CPP-ACP/F varnish treatment.

Original languageEnglish
Article number103582
JournalJournal of Dentistry
Publication statusPublished - Mar 2021


  • Early childhood caries
  • Oral microbiome


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