Polyol‐combinant saliva stimulants and oral health in Veterans Affairs patients—An exploratory study

Abstract

An exploratory study investigated the root caries incidence in Department of Veterans Affairs patients with exposed root surfaces. For a period of six to 30 months, the subjects were systematically assigned to groups which used chewable dragees or chewing gums that contained either xylitol or sorbitol as bulk sweeteners. The mean treatment time was 1.8 years (standard deviation = 0.8). The consumption levels of both polyols was up to 8.5 g daily, used typically in five episodes during a 16-hour period. The subjects were examined every six months in connection with their standard scheduled visits at the Veterans Affairs Medical Center. The risk for a root-surface lesion in the xylitol group was only 19% of that for a surface in the sorbitol group (relative risk, 0.19; 95% confidence interval, 0.06-0.62; p < or = 0.0065). Simultaneous study in periodontal patients showed that both polyols significantly reduced the gingival index scores, and slightly (but not significantly) reduced the plaque index scores. Collectively, both studies suggest that frequent daily consumption of chewable, saliva-stimulating products containing essentially nonfermentable or slowly fermentable dietary carbohydrate sweeteners (xylitol and sorbitol) may have an oral-health-improving effect in Department of Veterans Affairs Medical Center patients. It is necessary to evaluate if these procedures would be efficacious in larger and expanded patient cohorts.

Sugar Alcohols: What Is the Evidence for Caries-Preventive and Caries-Therapeutic Effects?

“…Approximately 15% of the subjects used gum, the others used the dragées. In the xylitol group there were 2.6 lesion onsets per 1,000 surfaces a year contrasting with 13.7 onsets in the sorbitol group [Mäkinen et al, 1996b]. Potential confounders of this study were related to the fact that the individuals in the xylitol group were younger than the individuals in the sorbitol group, and the prebaseline root surface caries increment rates were lower in the sorbitol than in the xylitol group.…”

Vitamin D and dental caries in controlled clinical trials: systematic review and meta-analysis

“…This scale factor is a number reflecting the magnitude of the within‐patient correlation of caries events . The estimate of 2.1 was derived from two large clinical trials in which the typical scale factor for primary teeth and permanent teeth was 1.9 (range, 1.7–2.3) and 2.2 (range, 1.9–3.2), respectively . Differences in baseline caries severity across the compared groups were evaluated using logistic regression models.…”

Xylitol Lozenges Were Not Effective in Overall Dental Caries Prevention in Adults

“…In studies between mother-child, the use of 1.8 to 5 g/day of xylitol have reported a delayed colonization of mutans streptococci and a reduced caries incidence. The effect seen on root caries 1 might be because their risk could have been higher, especially if they had salivary flow issues and poor hygiene habits, 16 although these data are not presented. 13 Cumulative weighted lesion progression was overall low in this study, suggesting that a population having at least one D 2 lesion/restoration present within the previous year likely resulted in a wide range of risk levels, and might have not been enough to identify high risk individuals (i.e., subjects with clear disease activity and lesion progression).…”