Early childhood caries remains one of the most common chronic diseases affecting young children. By age three, approximately one in five children experiences tooth decay, and severe forms of the disease can lead to pain, infection, nutritional challenges, difficulties in school, and long-term impacts on quality of life. Despite the availability of effective preventive measures, children with limited access to dental care often continue to experience a disproportionate burden of disease.
With support from the Gerber Foundation, Jeff Banas, associate dean for research for the College of Dentistry, and Mike Kanellis, professor in the Department of Pediatric Dentistry, are leading a study to evaluate a simple, home-based approach that could help prevent tooth decay among children at highest risk for disease.
The project will investigate whether povidone iodine, a well-known antiseptic with antimicrobial properties, can reduce the incidence and severity of tooth decay by targeting harmful bacteria within dental plaque. Researchers will also examine whether combining povidone iodine with probiotics can further improve oral health by promoting a healthier balance of microbes in the mouth.
Current preventive approaches, including fluoride treatments and routine oral hygiene, are highly effective for many children. However, those strategies may be more difficult to implement consistently in families facing barriers to care. The Iowa research team hopes to determine whether a simple treatment that can be administered at home may provide additional protection for children who are at elevated risk for developing cavities.
The study will enroll children ages one to three who receive care at the College of Dentistry through the Infant Oral Health Program at the Iowa City Women, Infants, and Children (WIC) clinic. Participants will be assigned to receive povidone iodine, povidone iodine combined with probiotics, or a placebo treatment and will be followed for one year. Researchers will monitor both dental health outcomes and changes in the oral microbiome over time.
“Many of our current prevention strategies focus on managing the effects of the disease process rather than correcting the underlying microbial imbalance that contributes to tooth decay,” said Jeff Banas. “We believe povidone iodine may offer a practical way to target harmful bacteria, improve the health of the oral microbiome, and provide lasting protection for children who face the greatest risk of developing cavities.”
The research is designed with a strong focus on outcomes that matter most to children and families. Reducing early childhood tooth decay can help prevent pain and infection, support healthy nutrition and development, reduce the need for hospital-based dental treatment, and improve children's overall well-being.
“Early childhood caries is almost entirely preventable, yet it continues to affect too many children, particularly those who face barriers to accessing regular dental care,” said Mike Kanellis. “If this approach proves effective, it could provide families and community health programs with a simple, affordable tool to help children stay healthy and avoid the serious consequences of dental disease.”
The investigators also hope the findings will have implications beyond pediatric dentistry. Because povidone iodine may help reshape unhealthy microbial communities, the research could inform future prevention strategies for other populations at elevated risk for oral disease, including older adults and individuals with limited access to professional care.
Ultimately, the project reflects the University of Iowa's commitment to advancing practical, evidence-based solutions that improve health outcomes and reduce disparities in care. By focusing on prevention, accessibility, and the oral microbiome, the research aims to identify new ways to help children avoid cavities and achieve healthier futures.