Dental plaque formation and salivary mutans streptococci in schoolchildren after use of xylitol-containing chewing gum

Department of Odontology, Paediatric Dentistry, Faculty of Medicine, Umeå University, Umeå, Sweden.
International Journal of Paediatric Dentistry (Impact Factor: 1.34). 03/2007; 17(2):79-85. DOI: 10.1111/j.1365-263X.2006.00808.x
Source: PubMed


The aim of this study was to investigate the effect of a fixed daily dose of xylitol on mutans streptococci in saliva and the amount of visible dental plaque. A second aim was to explore if the possible effects differed between children with and without caries experience.
The study was designed as a double-blind randomized controlled trial with two parallel arms. All pupils (n=149) in grades 1-6 in a comprehensive school in northern Sweden were invited, and 128 children (mean age=12.7 years) consented to participate. The children were stratified as having caries experience (DMFS/dmfs>or=1) or not before the random allocation to a test or control group. The control group (A) was given two pellets containing sorbitol and maltitol three times daily for 4 weeks, and the test group (B) received corresponding pellets with xylitol as single sweetener (total dose=6.18 g day). Clinical scoring and saliva samples were collected at baseline and immediately after the test period. The outcome measures were visible plaque index, salivary mutans streptococci counts and salivary lactic acid production.
The amount of visible plaque was significantly reduced in both groups after 4 weeks (P<0.05). Likewise, the sucrose-induced lactic acid formation in saliva diminished in both groups (P<0.05). The proportion of mutans streptococci decreased significantly in the test group compared to baseline, but not in the control group (P<0.05). The alterations in the test group seemed most prominent among children without previous caries experience.
The results suggest that chewing gum with xylitol or sorbitol/maltitol can reduce the amount of dental plaque and acid production in saliva in schoolchildren, but only the xylitol-containing gum may also interfere with the microbial composition.

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    • "Studies have focused on its effect on MS. The majority of short-term (6 or fewer mos) studies with a daily xylitol dose of over 6 g have reported reduced oral MS levels (Loesche et al., 1984; Söderling et al., 1989; Ly et al., 2006; Milgrom et al., 2006; Holgerson et al., 2007). Very few studies have presented the long-term (over 12 mos) effect of xylitol use on MS and showed mixed results (Söderling et al., 2000; Mäkinen et al., 2008; Zhan et al., 2012a). "
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    ABSTRACT: The aim of the study was to investigate whether xylitol-wipe use in young children prevented caries by affecting bacterial virulence. In a double-blinded randomized controlled clinical trial, 44 mother-child pairs were randomized to xylitol-wipe or placebo-wipe groups. Salivary mutans streptococci levels were enumerated at baseline, 6 months, and one year. Ten mutans streptococci colonies were isolated and genotyped from each saliva sample. Genotype-colonization stability, xylitol sensitivity, and biofilm formation of these isolates were studied. Despite a significant reduction in new caries at one year in the xylitol-wipe group, no significant differences were found between the two groups in levels of mutans streptococci. Children in the xylitol-wipe group had significantly fewer retained genotypes (p = 0.06) and more transient genotypes of mutans streptococci (p = 0.05) than those in the placebo-wipe group. At one year, there was no significant difference in the prevalence of xylitol-resistant genotypes or in biofilm formation ability of mutans streptococci isolates between the two groups. The mechanism of the caries-preventive effect of xylitol-wipe use may be related to the stability of mutans streptococci colonization. Further studies with genomic characterization methods are needed to determine specific gene(s) that account for the caries-preventive effect of xylitol.
    Advances in dental research 09/2012; 24(2):117-22. DOI:10.1177/0022034512449835
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    • "These sugar alcohols were reported to exhibit a potential suppressive effect on biofilm formation in vitro [34–36], implicating some effects on periodontal condition. However, the concentrations of these sugar alcohols used for the test tablet were much lower than those reported in the studies [29, 37, 38]. Therefore, it is conceivable that the aforementioned components of the tablet would not influence clinical and bacteriological profiles. "
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    ABSTRACT: This study was undertaken to evaluate the effect of oral administration of lactoferrin (LF) and lactoperoxidase-(LPO-)containing tablet on periodontal condition. Seventy-two individuals with chronic periodontitis were randomly assigned to take either bovine LF and LPO-containing tablets (test group, n = 37) or control tablets (control group, n = 35) every day for 12 weeks. Periodontal parameters and levels of subgingival plaque bacteria, human and bovine LF, and endotoxin in gingival crevicular fluid (GCF) were evaluated at baseline, 1 week, 4 weeks, and 12 weeks. Significant differences were observed in GCF levels of bovine LF between the test and control groups throughout the study (P < .05). However, clinical and bacteriological parameter values proved comparable between the two groups at 1 week to 12 weeks. Therefore, the effect of oral administration of LF and LPO-containing tablets might be weak on periodontal and bacteriological profile in this study.
    International Journal of Dentistry 04/2011; 2011(1687-8728):405139. DOI:10.1155/2011/405139
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    • "Hence, this may be indicative that for effective mechanical action of plaque removal by the gum, more than one pellet are needed to be chewed at a time. Holgerson et al.9 and Mouton et al.20 have previously confirmed the antiplaque effect of chewing gum. They conducted their study with a kind of sugar free gum containing xylitol as a sweetener which is an active ingredient unlike aspartame used as the sweetener in the present study. "
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    ABSTRACT: Chewing-gum may serve as an effective oral hygiene device when brushing may not be possible. The aim of the present study was to evaluate the effect of chewing sugar-free gum twice a day after meals in addition to tooth brushing on dental plaque and interdental debris. Twenty four (12 males and 12 females aged 20-21 years) healthy third-year dental students participated in the study. It was a prospective single blind and non-randomized before and after study. The control group followed tooth brushing habit twice a day plus water rinsing after meals at noon and night for 10 days. The study group followed tooth brushing habit twice a day plus chewing one pellet of sugar-free gum after meals at noon and night for 30 minutes for 3 weeks. Personal hygiene performance index (PHP-M) was used to assess the dental plaque and self-designed interdental debris index for interdental debris. ANOVA, Tukey and 't' tests were used for data analysis. The level of significance was fixed at α = 0.05. The baseline percentages of cumulative plaque and interdental debris were 63.12% and 76.44%, respectively. There was no significant difference in the plaque scores following either water rinsing (61.73%) or gum chewing (59.44%) after meals, but a statistically significant reduction of 14.18% in interdental debris was observed among those who chewed the gum (P < 0.05). After meal, gum chewing in addition to daily tooth brushing reduced interdental debris, but had no effect on established buccal and lingual dental plaques.
    Dental research journal 03/2010; 7(2):64-9.
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