Clinical Results After 12 Months from a Study of the Incidence and Progression of Dental Caries in Relation to Consumption of Chewing-gum Containing Xylitol in School Preventive Programs

Abstract

This study was designed to evaluate the effect of chewing-gum containing xylitol on the incidence and the progression of dental caries. A sample of 433 children, aged 8 and 9 years, of low socio-economic status and high caries rate, was divided into two experimental groups (15% or 65% xylitol chewing-gum distributed three times a day at school) and one control group (without chewing-gum). The three groups were exposed to the same basic preventive program. Children who chewed gum had a significantly smaller DMF(S) increment over a 12-month period than did the control group. The former had increments of 1.58 surfaces, compared with 3.28 for the latter. No statistically significant difference, however, was demonstrated between the two experimental groups. The net progression of decay (progressions-reversals) showed a significant difference between the two experimental groups and the control group. In addition, 65% xylitol chewing-gum produced better results than did that containing 15% xylitol, suggesting a dose-response relationship. Chewing xylitol gum had a beneficial effect on the caries process for all types of tooth surfaces, but chewing gum with a higher xylitol content had an additional positive effect on buccolingual surfaces. A questionnaire asking the participants about stomach pain indicated that there was no difference between the experimental and control groups. The feasibility of such a preventive measure has been demonstrated by the excellent level of participation of both children and teachers. This activity could easily be integrated into existing preventive public health programs.

Oral Biochemical Status and Depression of Streptococcus mutans in Children during 24- to 36-Month Use of Xylitol Chewing Gum

“…The occurrence of S. mutans in the saliva or plaque of the subjects ra ther accurately followed this same pattern: the more frequently xylitol gums were used per day, the stronger the reduction in the numbers of S. mutans. It may be possible to draw a similar conclusion from the study of Kandelman and Gagnon [1987]: when the frequency of use was similar, 65% xylitol gum pro duced slightly better clinical results than 15% xylitol gum. Based on the proposed mechanism of action of xylitol, it is only logical to assume that such a dosedependent relationship exists.…”

Effect of Sorbitol, Xylitol, and Xylitol/Sorbitol Chewing Gums on Dental Plaque

“…On the other hand, both animal and human studies have shown XYL to be anticario genic or perhaps therapeutic, these effects manifest ing themselves in a dose-or frequency-dependent manner [Scheinin et al, 1975a, b;Galiullin, 1981;Kandelman and Gagnon, 1987;Isokangas et al, 1988]. The anticariogenic effect has been demon strated even with an approximately 1:4 mixture of XYL (15%) and SOR (50%), although a higher amount of XYL (65%) only resulted in a stronger anticariogenic effect [Kandelman and Gagnon, 1987], Plaque studies involving chewing gums with XYL/ SOR ratios varying from 1:4 to 7:1 have, as a rule, reduced the amount of plaque [Rekola et al, 1980;Birkhed et al, 1983;Topitsoglou et al, 1983;Kandel man and Gagnon, 1987]. In a short-term plaque study, the effect of a XYL/SOR gum containing only 17.3% XYL (XYL/SOR = 1:3) on the amount of plaque was as beneficial as that of a gum containing 64.5% XYL [Topitsoglou et al, 1983].…”

Xylitol and caries prevention — is it a magic bullet?

“…' The results of a similarly-designed (although not blind) field study in Montreal showed that children who chewed xylitol gum had significantly lower net progression of caries than the control group children after 24 months, and a significant number of reversals of carious lesions were seen in the test group suggesting that remineralisation had occurred. 19 A series of double blind clinical studies carried out in Belize approximately 10 years ago were the first to provide direct comparisons between xylitol and sorbitol gums. 27,28,30,31 Before this study, trials of xylitol-containing gum had given superior results to trials of sorbitol-containing gums, but they had not been compared in the same trial.…”