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Purpose To compare the effects of a fluoride dentifrice alone, versus a topical CPP–ACP crème used as a dentifrice, versus the combination of both agents (fluoride dentifrice followed by CPP–ACP crème) on early caries lesions (ECL) in primary anterior teeth of children over a 6-month period. Methods In this single blinded randomised clinical trial, children ( n  = 114, aged 4–5 years) with high caries risk and who had at least one ECL (ICDAS 2) on their primary anterior teeth were allocated to three groups. Subjects used different agents twice daily: fluoride dentifrice (500 ppm F, n  = 42), CPP–ACP crème (10% w/v, n  = 35), and the fluoride dentifrice followed by CPP–ACP crème ( n  = 37). Changes in lesions were tracked using QLF, comparing the baseline situation to 3 and 6 months of treatment. Results QLF changes consistent with mineral gain (∆F/fluorescence, lesion area) occurred in all three groups (baseline versus 3 months or 6 months, p  ≤ 0.05 for all three groups). Differences between treatment groups were not statistically significant ( p  > 0.05). Conclusion The topical CPP–ACP crème used alone gave effects similar to the fluoride dentifrice; however, the combination of the two did not give additive benefits over either agent used in isolation.