The validity of Cariogram in relation to caries increment over a 2-year period was evaluated. In 2007, the caries risk profile in a group of Sardinian schoolchildren (957) aged 7–9 years was assessed using the Cariogram software. A re-examination using the same criteria was performed 2 years later on 861 individuals from the original sample (drop-out 10.0%). The possible correlated variables were analyzed using the principal component analysis (PCA). The performances of Cariogram in predicting caries increment were evaluated by receiver operating characteristic (ROC) analysis. At follow-up examination, 54.4% of the sample had developed new carious lesions (mean DFS 1.6, 95% CI 1.5–1.8). The mean caries increment (ΔDFS) was 0.5, 95% CI 0.4–0.5. PCA showed that Cariogram, gingival status and dietary sugar frequency, both at baseline and at follow-up, tend to form a separate cluster (goodness of fit ≧0.75). Sensitivity and specificity measured by ROC analysis were 0.83 and 0.85, respectively, so the gain in certainty was 1.68, while the area under the ROC curve was 0.93. A strong correlation between caries risk profiles at baseline and caries incidence in the permanent teeth after 2 years was found. The validity of Cariogram was confirmed, the software fulfilling the criteria for a good risk assessment model: precision, accuracy and ease of use.

ECC prevalence evaluated was similar to other western countries, and SES and behavioral habits influence the development of ECC.

ObjectivesThe hypothesis was that the daily use of a high dose of a xylitol chewing gum for 6 months would reduce the increment of decayed permanent first molar surfaces (ΔD6S) in high-risk schoolchildren after 2 years.MethodsIn this randomised, clinical trial, 204 schoolchildren with a high caries risk were assigned to two experimental groups, xylitol and non-xylitol. Caries status, salivary mutans streptococci, and lactobacilli were re-evaluated 2 years later in 74 xylitol-treated and 83 non-xylitol-treated schoolchildren. Differences in mean ∆D6S between groups registered at baseline and at follow-up were evaluated using the nonparametric Mann–Whitney U test.ResultsOutcome was the development of detectable carious lesions initial (D1–D2) and manifest (D3) in the permanent first molars. In the xylitol group, the difference in proportion of children with decayed first permanent molars at baseline and follow-up was 1.43 % for manifest lesion and 2.86 % for initial lesions; while in the non-xylitol group was 10.26 % (p < 0.01) and 16.66 % (p < 0.01), respectively. A statistically significant difference regarding means was also observed in the non-xylitol group: the ∆D6S for manifest lesion was 0.18 (p = 0.03) and 0.67 (p = 0.02) for initial lesion.ConclusionThe use of a chewing gum containing a high dose of xylitol for a period of 6 months has been shown to produce a long-term effect on caries development in high caries-risk children.Clinical relevanceA school-based preventive programme based on 6 months’ administration of a high dose of xylitol via chewing gum proved to be efficacious in controlling caries increment in high-risk children.

The effect of magnolia bark extract (MBE) on different variables related to caries and gingivitis administered daily through a sugar-free chewing gum was evaluated. The study was performed with healthy adult volunteers at high risk for caries as a randomized double-blind interventional study. 120 subjects with a salivary mutans streptococci (MS) concentration ≧10⁵ CFU/ml and presence of bleeding on probing >25% were enrolled and divided into three groups: magnolia, xylitol and control. The study design included examinations at baseline, after 7 days, after 30 days of gum use and 7 days after the end of gum use. Plaque pH was assessed using the strip method following a sucrose challenge. Area under the curve (AUC_5.7 and AUC_6.2) was recorded. Whole saliva was collected and the number of salivary MS (CFU/ml) was counted. Bleeding on probing was recorded as a proxy of dental plaque. Data were analyzed using ANOVA repeated measures. Magnolia gum significantly reduced plaque acidogenicity, MS salivary concentration and gingival bleeding compared to xylitol and control gums. Subjects from the magnolia and xylitol groups showed both MS concentration (p = 0.01 and 0.06, respectively) and AUC_5.7 (p = 0.01 and 0.04, respectively) to be significantly lower compared to baseline. Thirty-day use of a chewing gum containing MBE showed beneficial effects on oral health, including reduction of salivary MS, plaque acidogenicity and bleeding on probing.