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  • 1. Björnström, H
    et al.
    Naji, S
    Simic, D
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Twetman, Svante
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Fluoride levels in saliva and dental plaque after consumption of snacks prepared with fluoridated salt.2004In: European journal of paediatric dentistry, Vol. 5, no 1, p. 41-5Article in journal (Refereed)
    Abstract [sv]

    AIM: To determine the concentration of fluoride in saliva and supragingival dental plaque at designated time intervals after consumption of snacks prepared with a standardised amount of fluoridated salt. STUDY DESIGN: The investigation had a single blind prospective crossover design. METHODS: A group of 11 healthy young adults volunteered to participate after verbal and written information and consent. After a 1-week fluoride depletion period, the subjects consumed popcorn prepared with either fluoridated (250 mg/kg) or non-fluoridated salt during 30 minutes. Unstimulated whole saliva and samples of supragingival plaque were collected before consumption (baseline) and at 30, 60 and 120 minutes after the intake. Fluoride concentration was determined with a fluoride-specific electrode and the post-ingestion levels were compared with baseline by ANOVA. RESULTS: In saliva, the mean fluoride concentrations at baseline ranged from 0.021 to 0.027 mg/L and after the 30 minutes consumption of fluoride prepared snacks a 15-fold increase (p<0.001) was found. The same pattern was disclosed in the plaque samples. In both saliva and plaque, the fluoride levels remained significantly elevated after 2 hours (p<0.001 and p<0.05, respectively). CONCLUSION: Consumption of snacks prepared with fluoridated table salt resulted in significantly increased fluoride levels in saliva and supragingival plaque for a period of at least two hours.

  • 2. Engström, Kristina
    et al.
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry. Pedodonti.
    Petersson, Lars G
    Twetman, Svante
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry. Pedodonti.
    Lactic acid formation in supragingival dental plaque after schoolchildren's intake of fluoridated milk.2004In: Oral Health Prev Dent, ISSN 1602-1622, Vol. 2, no 1, p. 13-17Article in journal (Refereed)
    Abstract [en]

    Purpose: Milk can be used as vehicle for fluoride administration. The aim of this study was to investigate the lactic acid formation in dental plaque after daily intake of fluoridated milk. Materials and Methods: The study group consisted of 15 healthy schoolchildren, 6-15 years of age, in a double-blind crossover study design. After a one-week fluoride depletion period, 250 ml of fluoridated standard milk (5ppm; total amount 1.25 mg F) or non-fluoride control milk was consumed once daily together with an ordinary meal during 3 days of plaque accumulation with no oral hygiene. On the fourth day, plaque samples were collected immediately before a final milk intake and then after 30, 60 and 180 minutes. After a washout period of at two weeks, the whole procedure was repeated with the corresponding fluoridated or non-fluoridated milk regimen. All samples were suspended and the sucrose-challenged lactic acid formation rate was determined enzymatically. Results: The results showed a statistically significant (p<0.05) increase of the lactic acid levels 30 min after the intake of the standard (control) milk while no such elevation was evident after the fluoride-containing milk. No differences were found after 60 and 180 min compared with baseline for any of the milks. Conclusion: The findings suggest that fluoride added to milk may counteract the lactic acid formation that follows a non-fluoridated milk intake.

  • 3.
    Hedberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Odontology, Oral Microbiology.
    Hasslöf, Pamela
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Stecksén-Blicks, Christina
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Twetman, Svante
    University of Copenhagen.
    In vitro inhibition of mutans streptococci by probiotic lactobacilli2009Report (Other academic)
  • 4.
    Holgerson, Pernilla L
    et al.
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry. Pedodonti.
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry. Pedodonti.
    Stecksen-Blicks, Christina
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry. Pedodonti.
    Twetman, Svante
    Dental plaque formation and salivary mutans streptococci in schoolchildren after use of xylitol-containing chewing gum.2007In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 17, no 2, p. 79-85Article in journal (Refereed)
    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.

  • 5.
    Holgerson, Pernilla Lif
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Department of Odontology.
    Twetman, Svante
    Decreased salivary uptake of [14C]-xylitol after a four-week xylitol chewing gum regimen.2007In: Oral health and preventive dentistry, ISSN 1602-1622, Vol. 5, no 4, p. 313-319Article in journal (Refereed)
    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.

  • 6.
    Lif Holgerson, Pernilla
    et al.
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Stecksén-Blicks, Christina
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Twetman, Svante
    Effect of xylitol-containing chewing gums on interdental plaque-pH in habitual xylitol consumers.2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, no 4, p. 233-238Article in journal (Refereed)
    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.

  • 7.
    Rosén, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Rydberg, Annika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Lundgren, Ted
    Intitute of Odontology, the Sahlgrenska acadamy, University of Gothenburg.
    Stecksén-Blicks, Christina
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Acidity and in vitro effects on dental hard tissues of pharmaceutical preparations used in paediatric cardiologyManuscript (preprint) (Other academic)
    Abstract [en]

    Background: The knowledge of oral health effects caused by long-term medication in medically compromised children is sparse. Besides the effects on salivary secretion, pharmacotherapy may also act directly on the dental hard tissues, with dental caries and/or erosive lesions as possible outcomes of their acid and fermentable sugar content.

    Methods: Thirteen pharmaceutical preparations commonly used on a long-term basis in paediatric cardiology were selected. The endogenous pH of water solutions of tablets, capsules, and liquid medicines were measured with a pH meter. The titratable acidity and the dissolution of calcium and phosphate after immersion of tooth specimens were quantified for preparations with an endogenous pH below 5.5.

    Results: The endogenous pH values varied between 3.03 and 9.02. Six of the 13 preparations (46%) had an endogenous pH below the critical value for enamel dissolution (pH 5.5). The captopril (12.5 mg) tablet water solution had the lowest pH while the propranolol hydrochloride mixture displayed the highest titratable acidity. The highest dissolved calcium and phosphate was displayed for captopril (12.5 mg) tablet water solution followed by acetylsalicylic acid (75 mg) tablet water solution.

    Conclusion: It is concluded that some pharmaceutical preparations that are commonly used on a long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.

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