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Decreased salivary uptake of [14C]-xylitol after a four-week xylitol chewing gum regimen.
Umeå University, Faculty of Medicine, Odontology.
Umeå University, Faculty of Medicine, Odontology.
2007 (English)In: Oral health and preventive dentistry, ISSN 1602-1622, Vol. 5, no 4, 313-319 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aims were to evaluate a simple method to disclose a microbial shift in saliva and to investigate the short- and long-term effects of daily use of xylitol-containing chewing gums on mutans streptococci (MS) and [14C]-xylitol uptake in saliva. MATERIALS AND METHODS: In a pilot set-up, saliva samples were collected from 15 healthy adults and the uptake of xylitol was compared with a specific assay determining xylitol-sensitive MS. The main study consisted of 109 schoolchildren (mean age 9.9 years) who volunteered after informed consent. The children were randomly allocated to a test or control group. The control group was given two pellets containing sorbitol and maltitol 3 times daily for 4 weeks and the test group received identical pellets with xylitol as single sweetener (total dose 6.2 g/day). Saliva samples were collected at baseline, after 4 weeks and 6 months after the intervention. The outcome measures were MS and total viable counts, proportion of MS and salivary uptake of [14C]-xylitol. RESULTS: The pilot study disclosed a fair positive correlation (p < 0.05) between the assays. The proportions of MS and salivary xylitol uptake decreased significantly in the xylitol group by 60% and 30% respectively after 4 weeks compared to baseline which was in contrast to the sorbitol/maltitol group (p < 0.05). Six months after the intervention, the outcome measures did not differ significantly from baseline in any of the groups. CONCLUSION: A relatively high daily dose of xylitol could alter salivary microbial composition during the intervention period but no long-term impact was observed.

Place, publisher, year, edition, pages
2007. Vol. 5, no 4, 313-319 p.
URN: urn:nbn:se:umu:diva-22650PubMedID: 18173093OAI: diva2:217516
Available from: 2009-05-14 Created: 2009-05-14 Last updated: 2009-09-22
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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