The human oral cavity is one of the most densely populated sites in the body. It contains a diversity of microbial populations that give rise to distinct bacterial communities, including dental caries and dental plaque.¹ Dental caries stands as the most widespread infectious microbial ailment on a global scale.² It is often caused by acidic demineralization of tooth enamel and dentin due to biofilm produced by microorganisms associated with plaque. Dental plaque forms when bacteria colonise the acquired enamel pellicle.¹ 1 gram of plaque contains 10¹¹ bacteria. While dental plaque occurs naturally, it is also linked to two of the most common diseases in industrialized societies: caries and periodontal diseases.²

Early Childhood Caries (ECC) is recognized as the most severe and damaging manifestation of dental caries, impacting children under the age of 6. The leading organism of the microbiota of oral cavity is Streptococcus mutans (SM) and its elevated level in the saliva has been the primary factor causing Early Childhood Caries.³ By decomposing sugars present on the surface of the tooth, this facultative anaerobe generates an environment that is acidic, leading to the eventual demineralization of calcium on the surface of the tooth. Lactobacillus acidophilus is the second most common microorganism found in oral microflora. While not serving as the initiator of caries, it plays a crucial role in the progression of dental decay. The primary characteristic of the Lactobacillus genera is the production of acids from sugars that are fermentable, which contribute to the process of tooth decay.⁴

Also, Saliva plays an important role as a non-invasive local tool for diagnosis of systemic diseases, as it consists of glycoprotein, electrolytes, immunoglobulins and variety of enzymes. The omnipresent enzyme in saliva is salivary alpha-amylase, which hydrolyses  insoluble form of starch into the form which is soluble and helps in the digestion of carbohydrates. The enzyme’s notable characteristic is its strong affinity for binding to both tooth structure and streptococci present in oral cavity and therefore increased salivary alpha-amylase levels indicate the presence of dental caries in the oral cavity. ⁵

Researchers have undertaken various studies to compare the efficacy of different dentifrices. There have been studies comparing fluoridated dentifrices with other Non -fluoridated as well as Herbal dentifrices. As of today, there is no documented research conducted in India for the use of highly fluoridated dentifrices in children with Early childhood caries.