Change search
ReferencesLink to record
Permanent link

Direct link
Dental plaque formation and salivary mutans streptococci in schoolchildren after use of xylitol-containing chewing gum.
Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry. Pedodonti.
Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry. Pedodonti.
Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry. Pedodonti.
2007 (English)In: International Journal of Paediatric Dentistry, ISSN 0960-7439, Vol. 17, no 2, 79-85 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Place, publisher, year, edition, pages
2007. Vol. 17, no 2, 79-85 p.
National Category
Dentistry Dentistry
URN: urn:nbn:se:umu:diva-14271DOI: 10.1111/j.1365-263X.2006.00808.xPubMedID: 17263856OAI: diva2:153942
Available from: 2007-05-27 Created: 2007-05-27 Last updated: 2009-11-29Bibliographically 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

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Sjöström, IngerStecksen-Blicks, Christina
By organisation
Pediatric Dentistry
In the same journal
International Journal of Paediatric Dentistry

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 69 hits
ReferencesLink to record
Permanent link

Direct link