Lozenges containing hydrogenated starch hydrolysate (Lycasin), maltitol, sorbitol or xylitol were consumed 4 times daily during 3 months by 4 groups of persons (in all 85 subjects). In the maltitol-, sorbitol- and xylitol-group the plque wet weights were of the same magnitude before and after the test period. In the Lycasin-group, a higher value was found after than before the 3-month period (p less than 0.01). The acid production in suspensions of dental plaque material from Lycasin, maltitol and sorbitol expressed as per cent of that from glucose was approximately the same before and after the test period. From xylitol no acid production could be demonstrated either before or after the 3-month period. There were no statistically significant differences between the plaque pH-changes induced by rinsing with 50% solutions of Lycasin, maltitol, sorbitol or xylitol before and after the test period. However, there was a tendency (p less than 0.05) towards lower pH-values induced by the maltitrol and sorbitol rinse after the 3-month period compared with before. No difference in the relative numbers of facultative anaerobic streptococci. Streptococcus mutans or facultative anaerobic lactobacilli before and after the test period was found.
The aim was to study the effect of substitution of invert sugar for sucrose, in combination with fluoride varnish (Duraphat®) treatment twice a year, on caries development in preschool children. One hundred and eighty-seven 4-years-olds were divided randomly into four sugar groups: (1) sucrose (S), (2) sucrose-Duraphat (SD), (3) invert sugar (I), and (4) invert sugar-Duraphat (ID). All families were asked to buy beverages, biscuits, breakfast cereals, marmalade, ice cream, jam, ketchup, sweets and table sugar, totally 32 different food items, sweetened with invert sugar or sucrose. The substitution was, thus, restricted to a number of sugar-rich between-meal products. The study was carried out double-blind for 2 years. The children of those parents who did not want to participate in the sugar groups were divided randomly into one of the following two groups: (5) Duraphat (D), and control (C). Because of lack of cooperation, only 114 of the 187 children (61%) were considered to have completed the study. The mean caries increment, including initial lesions, was 3.86 dmfs in the combined groups S and SD (n = 63) and 3.10 dmfs in the combined groups I and ID (n = 51) during the 2 years (p = 0.34). The corresponding values for the 2nd year only were 1.84 and 0.67 dmfs, respectively (p = 0.09). The mean caries increment was 2.86 dmfs in group D (n = 113) and 4.10 dmfs (p = 0.08) in group C (n = 93). If initial caries lesions were excluded from the index, the difference between groups D and C was significant (p = 0.008). The main conclusion from this study in preschool children is that the use of invert sugar for 2 years instead of sucrose in sugar-rich between-meal food products resulted in a caries reduction of about 20%. The corresponding figure for the Duraphat treatment carried out twice a year was 30%.
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