Article

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

ABSTRACT

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.
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    • "Although xylitol mechanisms are not fully known, several studies have demonstrated their clinical benefits both as noncariogenic and cariostatic agents [Edgar, 1998]. However, in order to obtain these positive effects, both a high daily dose of xylitol as well as frequent intake have recently been suggested [Milgrom et al., 2006; Holgerson et al., 2007; Ly et al., 2008]. "
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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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