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Effect of xylitol-containing chewing gums on interdental plaque-pH in habitual xylitol consumers.
Umeå University, Faculty of Medicine, Odontology, Cariology.
Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
2005 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 63, no 4, 233-238 p.Article in journal (Refereed) Published
Abstract [en]

Abstract. The aim was to investigate the effect of high and low amounts of xylitol on the interdental plaque-pH, directly and after sucrose challenge in schoolchildren with a habitual consumption. The study group consisted of 11 healthy children (10-15 years) with low caries risk and the experiment had a single-blind crossover (Latin square) design. After a 2-week run-in period with a daily 4.0 g xylitol intake, the children were subjected to single-dose exposures of chewing gums with i) paraffin (CTR; no xylitol), ii) low dose xylitol (LX; 2.0g xylitol), and iii) high dose xylitol (HX; 6.0g xylitol) in a randomised order separated by a wash-out period of one week. Samples of chewing-stimulated whole saliva were collected prior to and after the experimental period for determination of bacterial counts. The outcome measures were in situ plaque-pH (micro-touch method) and area under the curve (AUC) above pH 6.0. The AUC was significantly greater (p<0.05) in the HX group compared to the LX and control groups during the first 5 minutes after chewing. After a 10% sucrose rinse, the interdental plaque-pH dropped in all groups but the HX regimen displayed significantly less reduction 0-5 min after chewing (p<0.05). No significant alterations of the total viable counts or mutans streptococci levels in saliva were disclosed during the 4-week experimental period. The present results suggested that a high single dose of xylitol had a short and limited beneficial effect on interdental plaque-pH in habitual xylitol consumers while a low single dose, resembling a normal chewing gum use, did not differ from the control.

Place, publisher, year, edition, pages
2005. Vol. 63, no 4, 233-238 p.
URN: urn:nbn:se:umu:diva-13279DOI: 10.1080/00016350510019883PubMedID: 16040446OAI: diva2:152950
Available from: 2008-02-07 Created: 2008-02-07 Last updated: 2009-09-19Bibliographically approved
In thesis
1. Xylitol and its effect on oral ecology: clinical studies in children and adolescents
Open this publication in new window or tab >>Xylitol and its effect on oral ecology: clinical studies in children and adolescents
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Xylitol, classified as a natural sugar substitute, has for about 35 years been known as an agent that may act against caries. The mechanism of action; how it inhibits mutans streptococci (MS) and the clinical dose-response relationship are not however fully investigated. The general aim of the investigations was to evaluate the effect of xylitol on oral ecology in children and adolescents. A series of experimental and controlled clinical trials were performed in which samples of saliva and plaque was collected and analysed with respect to xylitol content, pH, microbial composition and lactic acid production. In paper I, significantly reduced proportions of xylitol-sensitive MS in saliva were demonstrated after 18 weeks of regular use of two dose regimens of xylitol-containing tablets (1.7g and 3.4g xylitol/day) but the acidogenicity in dental plaque was not affected. In paper II, the effect on interdental plaque-pH of two different single dose intakes (2.0g and 6.0g) of xylitol was evaluated. The higher xylitol dose counteracted the pH-drop significantly (p<0.05) when the chewing was followed by a sucrose rinse while the lower dose did not differ from the control. In paper III, the xylitol concentrations in saliva after use of different common xylitol-containing products (0.1g-1.3g) were investigated. Statistically significant elevations of salivary xylitol levels were demonstrated for all products during the first 8-16 min when compared with baseline (p<0.05) but the individual variation was considerable. In samples of supragingival dental plaque, a high dose rinse (6.0g) increased the xylitol concentrations for a longer period (>30 min) than a low dose rinse (2.0g). In paper IV, it was demonstrated that 6.0g of xylitol in chewing gums, every day in 4 weeks, gave significantly less visible plaque and a significantly reduced sucrose-induced lactic acid formation (p<0.05) in saliva. Furthermore, the proportion of MS decreased significantly (p<0.05) compared to baseline. In paper V, the salivary uptake of [14C]-xylitol was compared with a specific assay determining xylitol-sensitive MS and a fair positive correlation (p<0.05) between the two assays was found. In a controlled trial, the proportions of MS and the salivary xylitol uptake decreased significantly (p<0.05) in the xylitol gum test group after 4 weeks compared to baseline which was in contrast to the control gum group. No serious adverse effects were reported in any of the investigations.

The main conclusions from this thesis were: a) various xylitol-containing products increased the xylitol levels in saliva and plaque, b) 6.0g of xylitol could counteract the interdental pH-drop after sugar consumption and reduce lactic acid formation in saliva c) a daily dose of 6.0g xylitol reduced the amount of visible plaque and altered the salivary microbial composition, d) a transient shift of MS strains in saliva was demonstrated during periods of regular intake of xylitol products but no long-term impact was found after its termination. The relatively high amount of xylitol needed for a beneficial effect on the oral ecology calls for a further development of effective and safe routes for administration.

Place, publisher, year, edition, pages
Umeå: Odontologi, 2007. 60 p.
Umeå University odontological dissertations, ISSN 0345-7532 ; 97
chewing gum, dental plaque, dose-response relationship, interdental plaque-pH, oral microorganisms, saliva, xylitol
National Category
urn:nbn:se:umu:diva-986 (URN)91-7264-223-8 (ISBN)
Public defence
2007-02-23, Sal B, 9tr, Tandläkarhögskolan, Umeå, 09:00 (English)
Available from: 2007-01-31 Created: 2007-01-31 Last updated: 2009-05-29Bibliographically approved

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