The purpose was to study differences in the caries increment rate as influenced by various sugars. The trial involved almost complete substitution of sucrose (S) by fructose (F) or xylitol (X) during a period of 2 years. There were no significant initial differences as to caries status between the prospective sugar groups; 35 subjects in the S-group, 38 in the F-group, and 52 in the X-group. During the entire study 10 subjects discontinued or were excluded. The clinical and radiographical observer error was reported and discussed. After 2 years the mean increment of decayed, missed and filled tooth surfaces was 7.2 in the S-group, 3.8 in the F-group, and 0.0 in the X-group. The weakness of the DMFS-index in not showing the development of new secondary caries and the increase in size of the lesions was overcome by expressing the caries activity in terms of indices showing the total quantitative and qualitative development. The results showed a massive reduction of the caries increment in relation to xylitol consumption. Fructose was found to be less cariogenic than sucrose. It was suggested that the non- and anticariogenic properties of xylitol principally depend on its lack of suitability for microbial metabolism and physico-chemical effects in plaque and saliva.

sugar studies' I. An intermediate report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man. Acfa Odont. Scand. 32, 3 8 3 4 1 2 , 1974.The present report covers the results after the first year of a 2-year trial, carried out in order to evaluate eventual differences in the caries incidence as influenced by sucrose (S), fructose (F) and xylitol (X) consumption. The initial material comprised 125 persons, mean age 27.5 yrs., divided according to individual preference and randomly into three groups. The S-group included 35, the F-group 38, and the X-group 52 persons, the latter group rendered oversize due to fear of loss of material. Initially no significant differences were found between the groups with regard to age, sex, number of primary and secondary carious surfaces with and without defect, number of filled surfaces and extracted teeth, and the DMFS-index. During the first 12 months of diet only 1 participant in the X-group discontinued due to diarrhoea. In addition, 2 were excluded due to lack of cooperation. Caries activity was expressed in quantitative, qualitative and combined terms through clinical and radiographic assessment.Irrespective of these methods, the caries incidence, expressed as difference between positive and negative reversals, new fillings, and increase in lesion size was lowest in the X-group, the difference as compared to the S-group being highly significant, and close to 90 %. The F-group incidence was 25 % lower than in the S-group. The results showed a dramatical reduction of the caries incidence in the X-group and indicated a therapeutic and remineralizing effect on dental caries.