Influence of a low xylitol-dose on mutans streptococci colonisation and caries development in preschool children

Oscarson, P.; Holgerson, Pernilla Lif; Sjöström, Inger; Twetman, Svante; Stecksén‐Blicks, Christina

doi:10.1007/bf03262555

Cited by 31 publications

(53 citation statements)

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“…29,30,35 Water was inadequately fluoridated in 1 trial 30 and water fluoridation status was not reported in the other 2. The trials varied with respect to dosing and formulation of xylitol.…”

Section: Xylitolmentioning

confidence: 99%

“…A fair-quality randomized trial (n = 115) of children 2 years of age found xylitol tablets (0.48 g) associated with reduced dmfs increment after 2 years, but the difference was not statistically significant (mean percent reduction 52%, absolute mean reduction in affected surfaces 0.42). 29 One small (n = 37) fairquality randomized trial found xylitol wipes used 3 times per day for 1 year markedly more effective than placebo wipes in reducing caries among children aged 6 to 35 months (reduction in dmfs increment 91%, P , .05). 35 A poor-quality, nonrandomized trial found no effect of xylitol chewing gum (1.33 g) 4 times daily on incidence of caries in 4-year old children in Japan.…”

Section: Xylitolmentioning

confidence: 99%

“…[66][67][68] Trials of xylitol in children ,5 years of age found no clear effects on caries incidence, although studies differed in the doses and formulations evaluated. 29,30,35 The most promising results were from a small trial of xylitol wipes that reported a marked decrease in caries incidence, but require confirmation. 35 Evidence remains limited on the accuracy of primary care clinicians in identifying caries lesions in children ,5 years of age or predicting caries incidence.…”

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Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

et al. 2013

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) and reference lists, we included trials and controlled observational studies on the effectiveness and harms of screening and treatments. One author extracted study characteristics and results, which were checked for accuracy by a second author. Two authors independently assessed study quality. RESULTS:No study evaluated effects of screening by primary care providers on clinical outcomes. One good-quality cohort study found pediatrician examination associated with a sensitivity of 0.76 for identifying a child with cavities. No new trials evaluated oral fluoride supplementation. Three new randomized trials were consistent with previous studies in finding fluoride varnish more effective than no varnish (reduction in caries increment 18% to 59%). Three trials of xylitol were inconclusive regarding effects on caries. New observational studies were consistent with previous evidence showing an association between early childhood fluoride use and enamel fluorosis. Evidence on the accuracy of risk prediction instruments in primary care settings is not available. CONCLUSIONS:There is no direct evidence that screening by primary care clinicians reduces early childhood caries. Evidence previously reviewed by the US Preventive Services Task Force found oral fluoride supplementation effective at reducing caries incidence, and new evidence supports the effectiveness of fluoride varnish in higher-risk children. All authors made substantial contributions to conception and design, acquisition of data, and analysis and interpretation of data, and gave final approval of the version to be published. Dr Chou drafted the article and revised it critically for important intellectual content. He is guarantor for this article. Drs Cantor, Zakher, Mitchell, and Pappas revised the article critically for important intellectual content. Staff at AHRQ and members of the USPSTF developed the scope of the work and reviewed draft manuscripts. Approval from AHRQ was required before the manuscript was submitted for publication, but the authors are solely responsible for the content and the decision to submit it for publication. 332CHOU et al by guest on May 11, 2018 http://pediatrics.aappublications.org/ Downloaded from Dental caries is an infectious process involving breakdown of the tooth enamel. 1,2 It is the most common chronic disease of children in the United States, and is increasing in prevalence among 2-to 5-yearolds. [3][4][5] Approximately three-quarters of children with caries have not received treatment. 5 Early childhood caries is associated with pain and tooth loss, as well as impaired growth, decreased weight gain, and negative effects on speech, appearance, self-esteem, school performance, and quality of life. 2,6,7 Dental caries disproportionately affects minority and economically disadvantaged children. 5 Risk factors for dental caries include high levels of colonization by cariogenic bacteria, frequent exposure to dietary sugar and refined carbohydrates, inappropriate bottle feeding, low saliva flow rates, developmental de...

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Section: Xylitolmentioning

confidence: 99%

Section: Xylitolmentioning

confidence: 99%

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confidence: 99%

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Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

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“…Similarly to chewing gum, there are no explicit instructions on the amount the customer is supposed to administer. Considering the benefits of applying xylitol lozenges or hard candies, it is recommended to use them after meals in children over 5 years old [13]. Inulin, present in one of the products, is a naturally occurring probiotic, now gaining popularity.…”

Section: Discussionmentioning

confidence: 99%

“…Another study has shown that xylitol intake of 10.32 g daily in chewing gum yields a significant reduction of SM in resting saliva and dental plaque and that an inverse proportion occurs between the frequency of chewing xylitol gum and bacteria count [12]. Oscarson et al [13] have acknowledged that applying 0.48 g per day and, after 6 months, 0.96 g per day in children over 2 years old has no significant preventive anticarious effect.…”

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Xylitol Content in Dental Care and Food Products Available on the Polish Market and Their Significance in Caries Prevention

Turska‐Szybka¹,

Pasternok²,

Olczak‐Kowalczyk³

2016

Dent. Med. Probl.

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Sugar alcohols (or polyols), natural organic compounds, may be used in order to replace sucrose. There are many sugar alcohols administered in dental care and food products, such as maltitol, lactitol, sorbitol, mannitol, erythritol and xylitol.Xylitol (E 967) is a five-carbon sugar alcohol of crystalline structure and sweetness similar to sucrose and has the same relative sweetness, which is 1, and provides less energy compared to sucrose (2.4 kcal vs 4 kcal). It occurs naturally in certain fruits, such as plums, raspberries and strawberries, and in birch trees; it is also developed in the digestive reactions of the human body in the amount of 15 g/day. It can be industrially produced using products rich in xylans, such as corncobs and birch wood. Xylitol obtained in the reduction reaction of xylose in the presence of catalytic converters is used in the food and cosmetic industry as an ingredient of chewing gum, lozenges, sprays, mouth rinses, gels, toothpastes, wipes, candies and AbstractCaries pertains to most of the Polish community and is associated with a high intake of sucrose and monosaccharides. Their non-cariogenic analogue is xylitol -equally sweet as sucrose, but not metabolized by the majority of bacteria existing in the oral cavity. The aim of this paper is to evaluate the content of xylitol in dental care and food products available on the Polish market and their significance in caries prevention. The products were selected based on the literature, informational leaflets and information from manufacturers. The toothpastes and gels taken into consideration contain up to 25% xylitol, mouth rinses -25%, dental care sprays -35%, chewing gum -66-67% and candies -96%. A large number of dental care and food products recommended in caries prevention contain xylitol in diverse concentrations. If caries-producing sugars are replaced with non-cariogenic sugar alcohols, the frequency of caries may be diminished. On one hand, xylitol, as an acknowledged anti-carious agent, is included in many caries-prevention programs, in precise concentrations and regularly used, on the other hand -there is a lack of EBM (Evidence-Based Medicine) data indicating the effectiveness of xylitol, apart from those pertaining to fluoride toothpastes with the addition of xylitol. It is emphasized that more detailed trials are necessary to answer the question whether it is xylitol that is relevant in caries prevention or the alteration of habits -lessened sucrose intake or its complete substitution with a sweetener and the act of chewing, which stimulates salivation (Dent. Med. Probl. 2016, 53, 4, 542-550).

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Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years

Chou

Pappas

Dana

et al. 2021

JAMA

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IMPORTANCE A 2014 review for the US Preventive Services Task Force (USPSTF) found that oral fluoride supplementation and topical fluoride use were associated with reduced caries incidence in children younger than 5 years. OBJECTIVE To update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF. DATA SOURCES Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews (to September 2020); surveillance through July 23, 2021.STUDY SELECTION Randomized clinical trials (RCTs) on screening, preventive interventions, referral to dental care; cohort studies on screening and referral; studies on diagnostic accuracy of primary care oral examination or risk assessment; and a systematic review on risk of fluorosis included in prior USPSTF reviews.DATA EXTRACTION AND SYNTHESIS One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality.RESULTS Thirty-two studies (19 trials, 9 observational studies, and 4 nonrandomized clinical intervention studies [total 106 694 participants] and 1 systematic review [19 studies]) were included. No study evaluated effects of primary care screening on clinical outcomes. One study (n = 258) found primary care pediatrician examination associated with a sensitivity of 0.76 (95% CI, 0.55 to 0.91) and specificity of 0.95 (95% CI, 0.92 to 0.98) for identifying a child with cavities, and 1 study found a risk assessment tool associated with sensitivity of 0.53 and specificity of 0.77 (n = 697, CIs not reported) for a child with future caries. No new trials of dietary fluoride supplementation were identified. For prevention, topical fluoride compared with placebo or no topical fluoride was associated with decreased caries burden (13 trials, n = 5733; mean caries increment [difference in decayed, missing, and filled teeth or surfaces], −0.94 [95% CI, −1.74 to −0.34]) and likelihood of incident caries (12 trials, n = 8177; RR, 0.80 [95% CI, 0.66 to 0.95]; absolute risk difference, −7%) in higher-risk populations or settings, with no increased fluorosis risk. Evidence on other preventive interventions was limited (education, xylitol) or unavailable (silver diamine fluoride), and no study directly evaluated primary care dentistry referral vs no referral. CONCLUSIONS AND RELEVANCEThere was no direct evidence on benefits and harms of primary care oral health screening or referral to dentist. Dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.

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Influence of a low xylitol-dose on mutans streptococci colonisation and caries development in preschool children

Abstract: The findings do not support a low-dose xylitol tablet program for caries prevention in preschool children.

Cited by 31 publications

References 23 publications

Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

Xylitol Content in Dental Care and Food Products Available on the Polish Market and Their Significance in Caries Prevention

Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years

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Influence of a low xylitol-dose on mutans streptococci colonisation and caries development in preschool children

Abstract: The findings do not support a low-dose xylitol tablet program for caries prevention in preschool children.

Cited by 31 publications

References 23 publications

Preventing Dental Caries in Children &lt;5 Years: Systematic Review Updating USPSTF Recommendation

Preventing Dental Caries in Children &lt;5 Years: Systematic Review Updating USPSTF Recommendation

Xylitol Content in Dental Care and Food Products Available on the Polish Market and Their Significance in Caries Prevention

Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years

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Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation