Assessment and prevention of tooth decay in children

It has been solidified by science that dental decay is transmittable. Despite improvements in other age groups, there is indication that dental decay in young children is on the rise. There has not been an improvement in practice as a result of risk assessment research. Although definite trials are required, antiseptics, chlorhexidine varnish, and polyvinylpyrrolidone iodine (PVI-I) may be useful. Despite not being extensively distributed to the most vulnerable, fluorides continue to be the most beneficial interventions. Although conclusive trials have not been carried out, fluoride varnish is a fairly efficient topical preventative for young children. The promise of silver diamine fluoride must be studied in the US. Xylitol is safe and reliable, according to the data, although it is not widely used. Despite numerous studies, wide adoption of dental sealants has not taken place, despite being a fundamental component of public policy. We draw the conclusion that while research has demonstrated the negative public health impact of tooth decay, not enough of it has been conducted to address the growing incidence of pediatric dental disease globally. Technology must be translated from studies to practice in order to stop childhood teeth decay. This should include conducting translational studies and putting the latest technological and scientific developments into use.

In vitro effect of low-fluoride toothpaste supplemented with sodium trimetaphosphate, xylitol, and erythritol on enamel demineralization

Abstract Regular use of toothpaste with fluoride (F) concentrations of ≥ 1000 ppm has been shown to contribute to reducing caries increment. However, when used by children during the period of dental development, it can lead to dental fluorosis. Objective: In this study, we aimed to evaluate the in vitro effect of a toothpaste formulation with reduced fluoride (F) concentration (200 ppm) supplemented with sodium trimetaphosphate (TMP: 0.2%), Xylitol (X:16%), and Erythritol (E: 4%) on dental enamel demineralization. Methodology: Bovine enamel blocks were selected according to initial surface hardness (SHi) and then divided into seven experimental toothpaste groups (n=12). These groups included 1) no F-TMP-X-E (Placebo); 2) 16% Xylitol and 4% Erythritol (X-E); 3) 16% Xylitol, 4% Erythritol and 0.2%TMP (X-E-TMP); 4) 200 ppm F (no X-E-TMP: (200F)); 5) 200 ppm F and 0.2% TMP (200F-TMP); 200 ppm F, 16% Xylitol, 4% Erythritol, and 0.2% TMP (200F-X-E-TMP); and 7) 1,100 ppm F (1100F). Blocks were individually treated 2×/day with slurries of toothpastes and subjected to a pH cycling regimen for five days (DES: 6 hours and RE: 18 hours). Then, the percentage of surface hardness loss (%SH), integrated loss of subsurface hardness (ΔKHN), fluoride (F), calcium (Ca), and phosphorus (P) in enamel were determined. The data were analyzed by ANOVA (1-criterion) and the Student-Newman-Keuls test (p<0.001). Results: We found that the 200F-X-E-TMP treatment reduced %SH by 43% compared to the 1100F treatments (p<0.001). The ΔKHN was ~ 65% higher with 200F-X-E-TMP compared to 1100F (p<0.001). The highest concentration of F in enamel was observed on the 1100F treatment (p<0.001). The 200F-X-E-TMP treatment promote higher increase of Ca and P concentration in the enamel (p<0.001). Conclusion: The association of 200F-X-E-TMP led to a significant increase of the protective effect on enamel demineralization compared to the 1100F toothpaste.

Efectos del xilitol en el crecimiento bacteriano frente a Streptococcus sanguinis: Estudio in vitro

Streptococcus sanguinis forma parte del biofilm bucal, tiene función decisoria en el desarrollo de las enfermedades bucales prevalentes y a nivel sistémico actúa como patógeno oportunista. Objetivo: Evaluar in vitro los efectos del xilitol en el crecimiento bacteriano frente a Streptococcus sanguinis (ATCC 10556). Métodos: la muestra del estudio fue distribuida en 6 grupos: 4 grupos experimentales (xilitol 1M; 0,75M; 0,50M y 0,25M), un control negativo (agua destilada) y un control positivo (clorhexidina); el análisis estadístico se hizo mediante el software estadístico Infostat y se empleó las pruebas t-Student, ANOVA y Tukey para contrastar la hipótesis. Resultados: diferentes concentraciones de xilitol (0,25M; 0,50M; 0,75M y 1M) causaron un halo de inhibición entre 9,89 - 12,89 mm (24 horas) y 10,85 - 13,45 mm (48 horas). Conclusiones: diferentes concentraciones de xilitol inhiben el crecimiento bacteriano del Streptococcus sanguinis, este efecto inhibitorio aumenta a mayor concentración y tiempo de exposición.

Streptococcus sanguinis faz parte do biofilme oral, tem papel decisivo no desenvolvimento de doenças bucais prevalentes e atua como patógeno oportunista em nível sistêmico. Objetivo: Avaliar in vitro os efeitos do xilitol no crescimento bacteriano contra Streptococcus sanguinis (ATCC 10556). Métodos: A amostra do estudo foi distribuída em 6 grupos: 4 grupos experimentais (1M; 0,75M; 0,50M e 0,25M xilitol), um controle negativo (água destilada) e um controle positivo (clorexidina); a análise estatística foi feita com o software estatístico Infostat e os testes t-Student, ANOVA e Tukey para testar a hipótese. Resultados: diferentes concentrações de xilitol (0,25M; 0,50M; 075M e 1M) causou um halo de inibição entre 9,89 - 12,89 mm (24 horas) e 10,85 - 13,45 mm (48 horas). Conclusões: diferentes concentrações de xilitol inibem o crescimento bacteriano de Streptococcus sanguinis, este efeito inibitório aumenta com maior concentração e tempo de exposição.

Streptococcus sanguinis forms part of the oral biofilm, has a decisive role in the development of prevalent oral diseases and acts as an opportunistic pathogen at the systemic level. Aims: To evaluate in vitro the effects of xylitol on bacterial growth against Streptococcus sanguinis (ATCC 10556). Methods: The study sample was distributed into 6 groups: 4 experimental groups (1M; 0,75M; 0,50M and 0,25M xylitol), a negative control (distilled water) and a positive control (chlorhexidine). The statistical analysis was done using the statistical software Infostat and the tests used t-Student, ANOVA and Tukey to test the hypothesis. Results: different concentrations of xylitol (0,25M; 0,50M; 0,75M and 1M) caused an inhibition halo between 9,89 - 12,89 mm (24 hours) and 10,85 - 13,45 mm (48 hours). Conclusions: different concentrations of xylitol inhibit the bacterial growth of Streptococcus sanguinis, this inhibitory effect increases with higher concentration and exposure time.

Efectos de azúcares totales sustitutos de sacarosa en la salud bucal. Revisión bibliográfica / Effects of sucrose substitute total sugars on oral health. Bibliographic review

Se realizó una revisión bibliográfica sobre los efectos de azúcares totales sustitutos de sacarosa sobre el estado de salud bucal. Los artículos científicos fueron localizados en bases de datos científicas digitales: Scopus, PubMed, Web Of Science y Ovid. Las fuentes empleadas son de libre acceso, 49 de los manuscritos fueron descartados, quedando 23. El 43,5% de los artículos mostraban resultados de ensayos clínicos sobre las gomas de mascar con xilitol, el 39,1% acerca de otros compuestos (stevia, magnolia, eritritol, fostato de calcio), el 13% revisiones narrativas y el 4,4% metaanálisis. Las gomas de mascar hechas con sustitutos de sacarosa estimulan la producción salival, neutralizan y elevan su pH, reconociéndosele su función promotora de salud bucal en varias publicaciones científicas. Los efectos anticariogénicos del xilitol están establecidos en diversos estudios. No existen suficientes estudios sobre los efectos de las sustancias: stevia, d-tagatosa, magnolia, eritritol y fostato de calcio.

A bibliographic review was carried out on the effects of sucrose substitute total sugars on the state of oral health. The scientific articles were in the following digital scientific databases: Scopus, PubMed, Web of Science and Ovid. The sources used were freely accessible, 49 of the manuscripts gotten by the search were discarded and 23 were used. 43.5% of the articles inclu-ded showed results of clinical trials on chewing gums with xylitol, 39.1% about other com-pounds (stevia, magnolia, erythritol, calcium phosphate), 13% narrative reviews and the 4.4% meta-analysis. Chewing gums made with sucrose substitutes stimulate salivary production, neutralize and raise its pH. That is why, its role in promoting oral health is recognized in several scientific publications. The anticariogenic effects of xylitol were established in various studies. There were not enough studies on the effects of the substances: stevia, d-tagatose, magnolia, erythritol and calcium phosphate

Symptom assessment after nasal irrigation with xylitol in the postoperative period of endonasal endoscopic surgery / Avaliação dos sintomas após irrigação nasal com xilitol no período pós-operatório de cirurgias endoscópicas endonasais

Abstract Introduction: Chronic rhinosinusitis is an inflammatory condition of the nasal cavity and the paranasal sinuses that requires multifactorial treatment. Xylitol can be employed with nasal irrigation and can provide better control of the disease. Objective: To evaluate the association between the effects of nasal lavage with saline solution compared to nasal lavage with a xylitol solution. Methods: Fifty-two patients, divided into two groups (n = 26 in the "Xylitol" group and n = 26 in the "Saline solution" group) answered questionnaires validated in Portuguese (NOSE and SNOT-22) about their nasal symptoms and general symptoms, before and after endonasal endoscopic surgery and after a period of 30 days of nasal irrigation. Results: The "Xylitol" group showed significant improvement in pain relief and nasal symptom reduction after surgery and nasal irrigation with xylitol solution (p < 0.001). The "Saline solution" group also showed symptom improvement, but on a smaller scale. Conclusion: This study suggests that the xylitol solution can be useful in the postoperative period after endonasal endoscopic surgery, because it leads to a greater reduction in nasal symptoms.

Resumo Introdução: Rinossinusite crônica é um quadro de inflamação da cavidade nasal e dos seios paranasais que necessita de tratamento multifatorial. O xilitol pode ser associado às irrigações nasais e pode prover melhor controle da doença. Objetivo: Avaliar a relação entre os efeitos da lavagem nasal com solução fisiológica em comparação à lavagem nasal com solução de xilitol. Método: Divididos em dois grupos (n = 26 no grupo Xilitol e n = 26 no grupo Soro), 52 pacientes responderam à questionários validados em língua portuguesa (NOSE e SNOT-22) sobre seus sintomas nasais e sintomas gerais, antes e depois de cirurgia endoscópica endonasal e após um período de 30 dias de irrigação nasal. Resultados: O grupo Xilitol apresentou melhoria significativa dos sintomas de dor e sintomas nasais após a cirurgia e a irrigação nasal com solução de xilitol (p < 0,001). O grupo Soro também apresentou melhoria dos sintomas, porém em menor escala. Conclusão: Este estudo sugere que a solução de xilitol pode ser usada no período pós-operatório de cirurgia endoscópica endonasal por levar a uma maior redução nos sintomas nasais.

Efecto de una pasta dental con xilitol sobre Streptcococcos mutans en pacientes con ortodoncia fija / Effect of a toothpaste with xylitol on Streptcococcus mutans in patients with fixed orthodontics / Efeito de um creme dental xilitol sobre Streptcococcus mutans em pacientes com ortodontia fixa

La terapia ortodóntica produce una mayor acumulación de placa bacteriana en los pacientes, observándose cambios ecológicos orales que causan aumento del número de estreptococos mutans, por lo que es importante una adecuada higiene bucal que ayude a disminuir las bacterias y prevenir la caries. Objetivo. El propósito fue comparar el efecto del uso de una pasta dental con xilitol, en el recuento de Streptcococcos mutans en pacientes con aparatología ortodóntica fija. Material y métodos. Se realizó un estudio cuasiexperimental de cegamiento simple. La muestra estuvo constituida por 34 pacientes adolescentes con aparatología ortodontica fija de ambo sexos que cumplieron los criterios establecidos, todos fueron instruidos en una técnica de cepillado y designados al azar a uno de los dos grupos: grupo experimental 17 pacientes que usaron una pasta dental con xilitol y 17 pacientes en el grupo control que utilizaron una pasta dental convencional con flúor. A ambos grupos se les tomó y procesó microbiológicamente placa bacteriana al inicio del estudio y a las 3 y 5 semanas para evaluar el recuento de streptococos mutans. Resultados. La prueba T-Student demostró que hubo menos unidades formadoras de colonias en los pacientes que utilizaron pasta dental con xilitol siendo significativa la diferencia en la quinta semana de uso (˂ 0.0001). Conclusiones. Existe mayor efectividad de la pasta dental con xilitol, en relación a la pasta dental solo con flúor en el recuento de Streptococos mutans, sin embargo, los pacientes de ambos grupos tuvieron menos unidades formadoras de colonias.

Orthodontic therapy produces a greater accumulation of bacterial plaque in patients, with oral ecological changes that cause an increase in the number of mutans streptococci, so it is important to have an adequate oral hygiene that helps to reduce bacteria and prevent caries. Objective. The purpose was to compare the effect of the use of a toothpaste with xylitol on the Streptococcus mutans count in patients with fixed orthodontic appliances. Material and methods. A single-blinded quasi-experimental study was carried out. The sample consisted of 34 adolescent patients with fixed orthodontic appliances of both sexes who met the established criteria. All were instructed in a brushing technique and randomly assigned to one of two groups: 17 patients in the experimental group used a toothpaste with xylitol and 17 patients in the control group used a conventional toothpaste with fluoride. Both groups had bacterial plaque taken and processed microbiologically at the beginning of the study and at 3 and 5 weeks to evaluate the streptococcus mutans count. Results. The T-Student test showed that there were fewer colony-forming units in patients who used xylitol toothpaste with the difference being significant at the fifth week of use (˂ 0.0001). Conclusions. There is greater effectiveness of toothpaste with xylitol in relation to toothpaste with fluoride alone in the Streptococcus mutans count; however, patients in both groups had fewer colony-forming units.

A terapia ortodôntica produz um maior acúmulo de placa bacteriana nos pacientes, com alterações ecológicas orais causando um aumento no número de estreptococos mutantes, razão pela qual uma higiene oral adequada é importante para ajudar a reduzir as bactérias e prevenir cáries. Objetivo. O propósito era comparar o efeito do uso de uma pasta de dentes com xilitol na contagem de Streptococcus mutans em pacientes com aparelhos ortodônticos fixos. Material e métodos. Foi realizado um estudo quase-experimental mono-cego. A amostra consistiu de 34 pacientes adolescentes com aparelhos ortodônticos fixos de ambos os sexos que preenchiam os critérios estabelecidos. Todos foram instruídos em uma técnica de escovação e distribuídos aleatoriamente em um dos dois grupos: 17 pacientes do grupo experimental que usaram uma pasta de dentes com xilitol e 17 pacientes do grupo controle que usaram uma pasta de dentes convencional com flúor. Ambos os grupos tiveram a placa bacteriana retirada e processada microbiologicamente na linha de base e com 3 e 5 semanas para avaliar a contagem de estreptococos mutantes. Resultados. O teste T-Student mostrou que havia menos unidades formadoras de colônias em pacientes que usavam pasta de dentes de xilitol, sendo a diferença significativa na quinta semana de uso (˂ 0,0001). Conclusões. A pasta de dente com xilitol é mais eficaz do que a pasta de dente com flúor apenas no Streptococcus mutans, entretanto, os pacientes de ambos os grupos tinham menos unidades formadoras de colônias.

Estimating the effectiveness of lollipops containing xylitol and erythritol on salivary pH in 3–6 years olds A randomized controlled trial

Background: Prevention of dental caries is important for nutrition and health of the child. Sucrose being considered an arch criminal, various substitutes are recommended. Xylitol is an artificial sweetener which cannot be metabolized by bacteria. Thus, it seems to be a promising method in prevention of dental caries. Materials and Methods: Fifty children between the age of 3–6 years were randomly divided into two groups; Group 1: Control group (without lollipops) and Group 2: Experimental group (with sugar substitute lollipops). The saliva sample was collected at four different time intervals, and pH of saliva was determined using universal pH indicator. Results: There was a significant drop in the pH after drinking sweetened beverages in both the groups, but there was a significant rise in pH after having xylitol + erythritol lollipops which almost returned to baseline after 15 min. Conclusion: Lollipops containing xylitol and erythritol can be used in small children and it has potential to increase salivary pH, thus not allowing the pH to fall below the critical value.

Effect of Xylitol Varnishes on the Inhibition of Demineralization in Vitro

Abstract Objective: To evaluate the efficacy of xylitol varnishes in the inhibition of enamel demineralization in vitro. Material and Methods: Bovine enamel blocks (n=120) were randomly allocated to four groups (n = 30), and the surface hardness (SH) was measured at baseline. The blocks were treated with the following varnishes: 20% xylitol, 20% xylitol plus F (5% NaF), Duraphat™ (5% NaF, positive control), and placebo (no-F/xylitol, negative control). The varnishes were applied and removed after 6 h of immersion in artificial saliva. The blocks were subjected to pH cycles (demineralization and remineralization for 2 and 22h/day, respectively, for 8 days). Surface and cross-sectional hardnesses were measured to calculate the percentage of SH loss (%SHL) and the integrated loss of the subsurface hardness (ΔKHN). Data were statistically analyzed using Kruskal-Wallis and Tukey's tests (p<0.05). Results: %SHL was significantly decreased by 20% xylitol plus F, Duraphat™, and 20% xylitol varnishes compared to placebo. The use of 20% xylitol plus F varnish led to a significantly lower percentage of SH loss compared to the use of 20% xylitol varnish without F. However, the experimental and commercial varnishes led to significantly lower subsurface demineralization compared to placebo and did not differ from each other. Conclusion: Xylitol varnishes, especially when combined with F, effectively prevent enamel demineralization (AU).

The Xylitol Applicability and its Effects in Health Area Worldwide: A Bibliometric Analysis Based on Randomized Controlled Trials

ABSTRACT Objective To describe and evaluate the xylitol products' applicability and its effects in the health area worldwide utilizing a bibliometric analysis from randomized controlled trials (RCT) with humans. Material and Methods Electronic searches were carried out in Medline/PubMed, Scopus, Cochrane Library, Web of Science, and VHL databases. The main data extracted were: year, area of applicability, type of treatment, country, journal, xylitol posology and concentration, presentation form, outcomes, and effects. Results From 1476 studies, 257 were included. These studies were published between 1973-2021. The majority was carried out in dentistry (73.9%) and under preventive treatment (67.4%). These studies were developed in the USA (15.4%) and published in Caries Research (6.6%). The posology and concentration ranged between 0.004-67 g/day and 0.002-100%, respectively. The xylitol is usually used in the chewing gum form (44.0%), and for antimicrobial activity evaluation (38.5%). A positive effect was observed in 204 studies (79.3%) and was associated with xylitol concentration ≥ 15(p=0.007). Side effects were reported in 8.2and were associated with posology ≥ 5 g/day (p=0.03). Conclusion Most studies with xylitol were conducted to prevent diseases in the dentistry field. The chewing gum form and antimicrobial activity evaluation were more frequent. Most xylitol products have a positive effect, and few studies report side effects.

Efeito de soluções ou dentifrícios contendo trimetafosfato de sódio, xilitol, eritritol e fluoreto, em diferentes associações, sobre biofilmes de interesse cariogênico / Effect of solutions or dentifrices containing sodium trimetaphosphate, xylitol, erythritol and fluoride, in different associations, on biofilms of cariogenic interest

Este estudo avaliou o efeito de dentifrícios ou soluções contendo trimetafosfato de sódio(TMP), xilitol(X), eritritol(E) e fluoreto(F), em diferentes associações, sobre cepas e biofilmes cariogênicos. Três subprojetos (SP1, SP2 e SP3) apresentaram os objetivos: SP1) Avaliar o efeito de dentifrícios contendo "TMP(0,25%)", "X(16%)", "E(4%)", "F(200 e 1100 ppm)" sozinhos ou em diferentes associações, sobre cepas isoladas de Streptococcus mutans(SM), Lactobacillus casei(LC), Actinomyces israelii(AI) e Candida albicans(CA). SP2) Avaliar o efeito de soluções contendo "TMP"(0,075%), "X"(4,8%), "E"(1,2%), "F"(60 e 330 ppm) e saliva artificial pura, sozinhos ou em diferentes associações sobre biofilmes mistos de SM e CA. SP3) Avaliar o efeito das mesmas soluções de SP2 sobre biofilmes microcosmos patogênicos com a incorporação ou não de SM. No SP1, cepas de SM, LC, AI e CA foram incorporadas ao meio de BHIágar, vertidas em placas, realizados poços no ágar e diferentes diluições de slurries dos dentifrícios foram adicionados. Os halos foram medidos com paquímetro digital. A análise estatística se deu por ANOVA dois critérios, e teste de Tukey HSD (p< 0,05). Para SM, o maior halo foi observado por "200F+TMP" em todas as diluições, seguido por "200F+X+E". Para LC, a tendência mostrou inibição microbiana promovida pelos polióis, potencializado pela associação com os outros compostos. Para AI, observou-se uma tendência menos definida. Para CA, o dentifrício experimental "200F+X+E+TMP" foi mais eficaz que os outros. No SP2, as mesmas soluções e grupos do SP1 foram usados a uma concentração final de 30% do valor inicial dos dentifrícios. Biofilmes mistos de SM e CA foram cultivados na presença contínua desses ativos e avaliou-se a quantificação de células viáveis (UFCs), biomassa total, atividade metabólica e componentes da matriz extracelular. A análise estatística se deu por ANOVA um critério e teste de Tukey HSD (p< 0,05). As contagens de UFCs foram afetadas pelo F, enquanto a biomassa e atividade metabólica pelo TMP. Adicionalmente, observou-se efeito sinérgico desses ativos. Os polióis tiveram efeitos mais pronunciados nos carboidratos da matriz extracelular, com pouca ou nenhuma ação nas demais variáveis. A associação dos quatro ativos promoveu aumento no efeito antibiofilme, e foi afetado por F e/ou TMP, com pouco efeito dos polióis isoladamente. No SP3, biofilmes microcosmos foram formados em um modelo de biofilme de alto rendimento com ou sem a incorporação da cepa de SM. As mesmas soluções e concentrações de SP2 estavam constantemente presentes no meio de cultura. Analisou-se as UFCs e produção de acido lático dos biofilmes. Os dados foram analisados por ANOVA ou Kruskal-Wallis, e StudentNewman-Keuls (p< 0,05). O grupo "60F+TMP" produziu quantidades de ácido lático significativamente menor, e apresentou reduções na contagem total de UFCs em biofilmes microcosmos, incorporados ou não com SM, comparado ao grupo controle. O grupo experimental promoveu diminuições sobre os parâmetros analisados. A associação de "F+TMP" e o grupo experimental reduziram as contagens de UFCs total e de SM, e a produção de ácido lático por biofilmes microcosmos derivados de saliva. Os resultados permitiram concluir que a associação dos quatro compostos ativos e "F+TMP" apresentaram reduções em todos os parâmetros avaliados(AU)

This study evaluated the effect of dentifrices or solutions containing sodium trimetaphosphate(TMP), xylitol(X), erythritol(E) and fluoride(F), in different associations, on cariogenic strains and biofilms. Three subprojects (SP1, SP2 and SP3) presented the objectives: SP1) To evaluate the effect of dentifrices containing "TMP(0.25%)", "X(16%)", "E(4%)", "F( 200 and 1100 ppm)" alone or in different associations, on isolated strains of Streptococcus mutans(SM), Lactobacillus casei(LC), Actinomyces israelii(AI) and Candida albicans(CA). SP2) Evaluate the effect of solutions containing "TMP"(0.075%), "X"(4.8%), "E"(1.2%), "F"(60 and 330 ppm) and pure artificial saliva, alone or in different associations on mixed SM and CA biofilms. SP3) To evaluate the effect of the same SP2 solutions on pathogenic microcosm biofilms with or without the incorporation of SM. In SP1, SM, LC, AI and CA strains were incorporated into the BHI-agar medium, poured into plates, wells were made in the agar, and different dilutions of dentifrice slurries were added. The halos were measured with a digital caliper. Statistical analysis was performed by two-way ANOVA and Tukey HSD test (p< 0.05). For SM, the largest halo was observed by "200F+TMP" in all dilutions, followed by "200F+X+E". For LC, the trend showed microbial inhibition promoted by polyols, potentiated by the association with the other compounds. For AI, a less defined trend was observed. For CA, the experimental dentifrice "200F+X+E+TMP" was more effective than the others. In SP2, the same solutions and groups of SP1 were used at a final concentration of 30% of the initial value of the dentifrices. Mixed biofilms of SM and CA were cultured in the continuous presence of these actives, and the quantification of viable cells (CFUs), total biomass, metabolic activity and extracellular matrix components were evaluated. Statistical analysis was performed by one-way ANOVA and Tukey HSD test (p< 0.05). CFU counts were affected by F, while biomass and metabolic activity by TMP. Additionally, a synergistic effect of these actives was observed. Polyols had more pronounced effects on extracellular matrix carbohydrates, with little or no action on other variables. The association of the four actives promoted an increase in the antibiofilm effect and was affected by F and/or TMP, with little effect of polyols alone. In SP3, microcosm biofilms were formed in a high-throughput biofilm model with or without the incorporation of the SM strain. The same SP2 solutions and concentrations were constantly present in the culture medium. The CFUs and lactic acid production of biofilms were analyzed. Data were analyzed by ANOVA or Kruskal-Wallis and StudentNewman-Keuls (p< 0.05). The "60F+TMP" group produced significantly lower amounts of lactic acid and showed reductions in total CFU counts in microcosm biofilms, whether or not incorporated with SM, compared to the control group. The experimental group promoted decreases in the analyzed parameters. The association of "F+TMP" and the experimental group reduced total and SM CFU counts and lactic acid production by saliva-derived microcosm biofilms. The results allowed us to conclude that the association of the four active compounds and "F+TMP" showed reductions in all evaluated parameters(AU)

Effectiveness of the use of xylitol chewing gum in prevention of dental caries A systematic review

This systematic review of the literature assessed the effectiveness of using chewing gum containing only xylitol compared to prevention strategies or placebo in reducing the incidence of carious lesions in children using data obtained from randomized controlled trials. Electronic search was carried out in PubMed MEDLINE, Latin American and Caribbean Literature on the Health Science, Web of Science, Scopus, Science Direct, and Scientific Electronic Library Online through the period between 2000 and 2020. Included clinical studies were done in children when the xylitol was dispensed in gum and the preventive effect of xylitol on tooth decay was compared to other preventive strategies or control groups. The studies were evaluated for their quality to obtain the level of evidence. The preventive fraction of each study was extracted. Two hundred studies were found. After analyzing the inclusion and removal of duplicates, only five studies were analyzed for the quality of evidence. With the analysis through the Grading of Recommendations Assessment, Development, and Evaluation system, it was possible to verify the very low level of scientific evidence on the effectiveness of gums containing only xylitol for the prevention of caries in children. The preventive fraction obtained varied between ? 0.31 and 0.57 depending on the compared prevention strategy. The conflicting results, limitations, and inconsistencies of the studies allow us to establish that there is insufficient evidence to support the use of gums containing only xylitol for the prevention of caries in children. Other properly designed clinical trials need to be carried out.

Remineralizing Effect of Xilitol, Juniperus Communis and Camellia Sinensis Added to a Toothpaste: An In Vitro Study / Efecto remineralizante del Xilitol, Juniperus Communis y Camellia Sinensis adicionados en pastas dentales: Estudio in vitro

ABSTRACT The aim of this study was to explore the remineralizing effect of toothpastes based on Xilitol, Camellia Sinensis and Juniperus Communis. An in vitro experimental study was carried out in an 18 human premolars sample, which were treated with one of the 3 evaluated toothpastes and a control fluoride one. The atomic percentages of Ca and P were evaluated by Energy Dispersive X-ray Spectroscopy (EDS). In addition, the enamel surface of treated teeth was visualized by Scanning Electron Microscopy (SEM). The evaluations were carried out in three stages: pre-treatment, after an artificial demineralization process and after the treatment with the toothpastes. In the statistical analysis, the one-way ANOVA and Pearson correlation tests were used. Xilitol and Juniperus Communis showed the greatest gain of P ions compared to the control group (p<0.01). As for Ca, the group treated with xylitol-based toothpaste showed more ion gain compared with the control group (p<0.01). In the Pearson correlation test between Ca and P, statistically significant correlations were observed in all groups (p<0.01), ranging between r=0.7413 (Xylitol Group) and r=0.9510 (Control Group). We concluded that Xylitol paste showed the highest remineralizing property, both in the EDS analysis and in the SEM images.

RESUMEN El objetivo de este studio fue explorer el efecto remineralizante de las cremas dentales compuestas de Xilitol, Camelia Sinensis y Juniperus Communis. Se llevó a cabo un estudio experimental in vitro en una muestra de 18 premolares humanos, los cuales fueron tratados con una de las tres pastas dentales evaluadas y una fluorada. Los porcentajes atomicos de Ca y P fueron evaluados por Espectroscopia de rayos X de energía dispersive (EDS). Además, la superficie del esmalte de los dientes tratados fue examinada por Microscopia Electronica de Barrido (SEM). Las evaluaciones fueron llevadas a cabo en tres etapas: pre-tratamiento, despues de un proceso artificial de desmineralizacion y después del tratamiento con las pastas dentales. Se usaron ANOVA de una via y correlacion de Pearson para el analisis estadistico. Xilitol y Juniperus Communis mostraron la mayor ganancia de iones P comparados con el grupo control (p<0.01), con rangos entre r=0.7413 (Grupo con Xylitol) and r=0.9510 (Group Control). Se concluyó que la pasta con Xilitol mostró las mayores propiedades remineralizantes, tanto en el analisis EDS y las imágenes SEM.

Efeito de dentifrícios com reduzida concentração de fluoreto contendo trimetafosfato de sódio e polióis na erosão inicial do esmalte / Effect of low-fluoride toothpaste containing sodium trimetaphosphate and polyols on initial enamel erosion

Este estudo in vitro avaliou o efeito de dentifrícios contendo fluoreto (F), trimetafosfato de sódio (TMP) e/ou xilitol e eritritol (XE) em inibir ou reparar lesão erosiva inicial do esmalte. Blocos de esmalte bovino (n=120) foram selecionados por dureza de superfície (SH) inicial e divididos em 5 grupos compostos por dentifrícios (24 blocos/grupo): Placebo (sem F, TMP e XE); 1100 ppm F; 16% xilitol + 4% eritritol (XE); 200 ppm F + 0,2% TMP (200 ppm F/TMP); e 200 ppm F + 0,2% TMP + 16% xilitol + 4% eritritol (200 ppm F/TMP/XE). Para a análise do efeito protetor, blocos hígidos (n=60) foram imersos 1x/2 minutos em suspensão de dentifrícios/saliva humana. Em seguida, os blocos foram submetidos a 4 desafios erosivos com ácido cítrico (0,75%, pH 3,5) de 1 minuto cada, sob agitação. A seguir, a SH foi determinada pós-tratamento (t) e após o 1º, 2º, 3º e 4º desafios ácidos erosivos (d) para o cálculo da porcentagem de variação da SH (%SH). Para a análise do efeito reparador, esmalte previamente erodido (n=60) foi tratado e submetido aos mesmos desafios erosivos descritos anteriormente. A %SH de recuperação (R) e %SHt foram calculadas, bem como, a diferença entre a %SHR e %SHd obtendo-se o Δ%SH para cada desafio. Experimento adicional foi realizado para análise da deposição de precipitados por Microscopia Eletrônica de Varredura (MEV) em esmalte hígido e erodido. Os dados foram submetidos à análise de variância de medidas repetidas a dois critérios, seguida pelo teste de Student-Newman-Keuls (p<0,05). Os resultados mostraram que o maior efeito protetor e reparador foi produzido pelo dentifrício 200 ppm F/TMP/XE quando comparado aos demais grupos (p<0,001). Os grupos 1100 ppm F e 200 ppm F/TMP apresentaram similar efeito protetor para o 1º, 2º e 3º desafios (p>0,05), e menor quando comparados ao XE (p<0,001). O efeito protetor e reparador foi: XE>200 ppm F/TMP>1100 ppm F>Placebo (p<0,001). Na MEV observou-se deposição de precipitado no esmalte para todos os grupos, formando uma camada mais espessa e homogênea nos grupos contendo XE e/ou TMP. Concluiu-se que dentifrício contendo 200 ppm F, TMP e polióis apresenta efeito protetor e reparador superior quando comparado a um dentifrício 1100 ppm F em lesões erosivas iniciais no esmalte(AU)

This in vitro study evaluated the effect of toothpaste containing fluoride (F), sodium trimetaphosphate (TMP) and/or xylitol and erythritol (XE) in inhibit or repair initial enamel erosion lesions. Bovine enamel blocks (n=120) were selected by initial surface hardness (SH) and divided into 5 groups of toothpastes (n=24 blocks/group): Placebo (no F, TMP or XE); 1100 ppm F; 16% xylitol + 4% erythritol (XE); 200 ppm F + 0.2% TMP (200 ppm F/TMP); and 200 ppm F + 0.2% TMP + 16% xylitol + 4% erythritol (200 ppm F/TMP/XE). For the analysis of the protective effect, sound blocks (n=60) were immersed in toothpaste slurry in human saliva once for 2 minutes. Hereafter, the blocks were submitted to 4 erosive challenges in citric acid (0.75%, pH 3.5) by 1 minute, under stirring. Then, the SH was determined after treatment (t) and after the 1st, 2nd, 3rd and 4th erosive acid challenges (d) to calculate the percentage of change of the SH (%SH). For the analysis of the repair effect, eroded enamel (n=60) were treated and submitted to erosive challenges as describe previously. The recovery (R) of %SH and %SHt were calculated, as well as the difference between the %SHR and %SHd obtaining the Δ%SH for each challenge. Additional experimental was performed to analysis the deposition of precipitates by Scanning Electronic Microscopy (SEM) on sound and eroded enamel. Variables were submitted to two-way repeated measures analysis of variance followed by StudentNewman-Keuls test (p<0.05). The results showed that the highest protective and repair effect was produced by the 200 ppm F/TMP/XE toothpaste when compared to the other groups (p<0.001). The 1100 ppm F and 200 ppm F/TMP groups had similar protective effect for the 1st, 2nd and 3rd challenges (p>0.05), and lower when compared to XE (p<0.001). The protective and repair effect was: XE>200 ppm F/TMP>1100 ppm F>Placebo (p<0.001). There were deposition of precipitates on enamel for all groups, with a thicker layer and homogeneous for XE and/or TMP groups. It was concluded that toothpaste containing 200 ppm F, TMP and polyols has superior protective and repair effect when compared to 1100 ppm F toothpaste in initial enamel erosive lesions(AU)

Sucrose and Xylitol-Induced Streptococcus mutans Biofilm Adherence

Abstract Objective: To study the adherence of Streptococcus mutans biofilm after induction with sucrose and xylitol. Material and Methods: Laboratory experimental study incorporating posttest-only control group design. S. mutans biofilm was generated for 24 hours at a temperature of 37°C using BHIB with 5% sucrose and BHIB with 1% xylitol. An adherence assay was conducted in accordance with the method applied previously. The quantity of adhered bacteria was measured by means of a spectrophotometer at 570 nm. The data were presented as mean and standard deviation. Results: A biofilm induced with sucrose has a higher adherence level (0.9294 ± 0.0431) compared with one induced with xylitol (0.5095 ± 0.0392). Sucrose induces adherence levels by increasing glucan binding protein and glucosyltransferase of the bacteria, whereas xylitol will inhibit the glycolysis process of the bacteria. Conclusion: The adherence of sucrose-induced S. mutans biofilm is higher than that of xylitol-induced S. mutans biofilm.

Efecto antibacteriano de una pasta dental con xilitol sobre Streptococcus mutans en saliva de gestantes / Antibacterial effect of a toothpaste with xylitol on Streptococcus mutans in pregnant women's saliva

RESUMEN Introducción: Durante la gestación, algunos cambios fisiológicos en la mujer propician un incremento de la placa dental y de la microbiota cariogénica. Esta condición unida a una modificación de la dieta y a una inadecuada higiene bucal condicionarían desfavorablemente la salud oral tanto de la madre como del bebé. Objetivo: Determinar el efecto antibacteriano de una pasta dental con xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes. Métodos: Ensayo clínico, a doble ciego, que se realizó en el Centro de Salud "José Olaya" (Chiclayo Perú), en enero de 2017. Se trabajó con una población muestral de 50 gestantes en el segundo trimestre que cumplieron con los criterios establecidos. Se crearon dos grupos: 25 gestantes usaron dentífrico con 10 por ciento de xilitol y 25 gestantes usaron dentífrico sin xilitol. Se les tomó y proceso microbiológicamente una muestra de saliva antes del inicio del estudio y 14 días después del uso de las respectivas pastas. Se realizó el recuento de unidades formadoras de colonias de Streptococcus mutans en saliva con una confiabilidad altamente significativa mediante el coeficiente de correlación intraclase, calibración intra e interexaminador (1,000 y 0,999, respectivamente). El análisis de los datos se realizó mediante la prueba U de Mann-Whitney, considerando un nivel de significancia del 5 por ciento. Resultados: No se encontró diferencia significativa entre las gestantes que emplearon pasta dental con xilitol en comparación con las que utilizaron pasta dental sin xilitol (p= 0,062). Conclusiones: El efecto antibacteriano de la pasta dental comercial con xilitol es similar a una pasta dental sin xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes(AU)

ABSTRACT Introduction: Some physiological changes occur in women during pregnancy which cause an increase in dental plaque and cariogenic microbiota. This situation, alongside a modification in the diet and inadequate oral hygiene, negatively affect the oral health of both the mother and the baby. Objective: Determine the antibacterial effect of a toothpaste with xylitol on the count of Streptococcus mutans in pregnant women's saliva. Methods: A double-blind clinical trial was conducted in José Olaya Health Center (Chiclayo, Peru) in January 2017. The sample population was 50 women in the second trimester of pregnancy who met the established inclusion criteria. Two groups were formed: 25 pregnant women used a toothpaste with 10 percent xylitol and the other 25 used a toothpaste without xylitol. A saliva sample was taken and processed microbiologically before the start of the study and 14 days after use of the two toothpastes. A count was performed of colony-forming units for Streptococcus mutans in saliva with highly significant reliability, using the intraclass correlation coefficient, and intra- and inter-rater calibration (1.000 and 0.999, respectively). Data analysis was based on the Mann-Whitney U Test, with a significance level of 5 percent. Results: No significant difference was found between the pregnant women who used the toothpaste with xylitol and those who used the toothpaste without xylitol (p= 0.062). Conclusions: The antibacterial effect of the commercial toothpaste with xylitol is similar to that of a toothpaste without xylitol in terms of the Streptococcus mutans count in pregnant women's saliva(AU)

Efecto de una Pasta Dental Comercial Conteniendo Xilitol Sobre el Recuento de Streptococcus Mutans en Saliva de Gestantes: Ensayo Clínico Controlado Aleatorizado / Effect of a Commercial Toothpaste Containing Xylitol on the Count of Streptococcus Mutans in Saliva of Pregnant Women: Randomized Controlled Clinical Trial

RESUMEN: El objetivo del presente trabajo fue determinar el efecto de una pasta dental comercial conteniendo xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes. El presente fue un ensayo clínico, a doble ciego, que se realizó en el Centro de Salud "José Olaya" (Chiclayo Perú), en enero de 2017. Se trabajó con una población muestral de 50 gestantes en el segundo trimestre que cumplieron con los criterios establecidos, distribuyéndolas en dos grupos: 25 gestantes usaron pasta dental con 10 % de xilitol y 25 gestantes usaron pasta dental sin xilitol. Se les tomó y procesó microbiológicamente una muestra de saliva antes del inicio del estudio y 14 días después del uso de las respectivas pastas. Se realizó el recuento de unidades formadoras de colonias (UFC) de Streptococcus mutans en saliva con una confiabilidad altamente significativa mediante el Coeficiente de Correlación Intraclase, calibración intra e interexaminador (1,000 y 0,999, respectivamente). El análisis de los datos se realizó mediante la prueba U de Mann-Whitney, considerando un nivel de significancia del 5 %. No se encontró diferencia entre las gestantes que emplearon pasta dental con xilitol en comparación con las que utilizaron pasta sin xilitol (p=0,062). Se concluyó que el efecto de la pasta dental comercial conteniendo xilitol es similar a una pasta sin xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes.

ABSTRACT: The objective of the present study was to determine the effect of a commercial toothpaste containing xylitol on the counts of Streptococcus mutans in saliva of pregnant women. The present was a double-blind clinical trial performed at the "José Olaya" health Centre (Chiclayo Peru) in January 2017. We worked with a sample population of 50 pregnant in the second trimester that met the established criteria, distributing in two groups: 25 pregnant women used toothpaste with 10 % xylitol and 25 pregnant used toothpaste without xylitol. They were taken and microbiologically processed a sample of saliva before the start of the study and 14 days after the use of the respective toothpastes. The Colony-forming units (CFU) of Streptococcus mutans in saliva were counted with a highly significant reliability through the intraclass correlation coefficient, Intra-and Interexaminer calibration (1.000 and 0.999, respectively). Data analysis was performed using the Mann-Whitney U test, considering a 5 % significance level. No difference was found among the pregnant women who used xylitol toothpaste compared to those who used toothpaste without xylitol (p = 0,062). It was concluded that the effect of xylitol containing commercial toothpaste is similar to a toothpaste without xylitol on the count of Streptococcus mutans in the saliva of pregnant women.

Effect of sugar-free chewing gum on plaque and gingivitis among 14–15-year-old school children: A randomized controlled trial

Aim: The aim of the study was to find out the effect of sugar-free chewing gums (xylitol and sorbitol) on plaque and gingivitis among 14–15-year-old school children. Materials and Methods: A single center, double-blind, randomized controlled trial was conducted on 14–15-year-old children. Sample size was determined to be 48. Participants were randomly allocated to test group (xylitol [n = 12], sorbitol [n = 12]) and control group (no gum, n = 24). Duration of the study was 14 days. Baseline assessment of plaque, gingival, and bleeding score, followed by oral prophylaxis. Selected children received daily two chewing gum (1.1 g each) to chew for 20 min postbreakfast and postlunch. Follow-up was done on 15th day. Analysis was done using independent t-test, ANOVA, and post hoc test. Significance level was kept at P < 0.05. Results: There was a significant reduction in plaque, gingival, and bleeding score in test group (P < 0.05) compared to control group. Conclusion: Sugar-free gum (xylitol and sorbitol) significantly reduced the plaque, gingival, and bleeding score.

Efecto Antibacteriano de enjuagues bucales pediátricos comercializados en el Ecuador sobre cepas de Streptococcus Mutans: Estudio in vitro / Efeito antibacteriano de colutórios pediátricos comercializados no Equador sobre ce-pas de Streptococcus Mutans: Estudo in vitro / Antibacterial effect of pediatric mouthwashes marketed in Ecuador on Streptococcus Mutans strains: In vitro study

La caries dental es considerada un problema de salud pública, siendo los niños la población más vulnerable por presentar hábitos alimentarios e higiene bucal inadecuados. Objetivo: Determinar y comparar el efecto antibacteriano de enjuagues bucales pediátricos a base de Cloruro de Cetilpiridinio (0,075%) y Xilitol (10%), sobre cepas de Streptococcus Mutans. Materiales y Métodos: Estudio experimental in vitro, conformado por 20 cepas de S. mutans obtenidas del repositorio del Instituto Nacional de Investigación en Salud Pública (INSPI) que fueron sembradas en medio agar tripticasa soya. Las 60 Placas Petri (N=60) fueron divididas en tres grupos experimentales (N=20 cada uno) de 10µL, 15µL y 20µL para cada enjuague, en cada placa se colocaron 5 discos de papel impregnados con la solucion de los grupos siendo: G1=Colgate Plax (Cloruro de Cetilpiridinio 0,075%), G2=Denture kids (Xilitol 10%), G3=Blendy (Xilitol 10%) C+= Control Positivo (Clor-hexidina 0,12%) C-= Control Negativo (Agua Destilada). Las placas fueron llevadas a incubación a temperatura de 37°C con baja presión de oxígeno. Luego de 48 horas se observaron para medir los halos de inhibición. Fue realizado el análisis estadístico de Kruskal Wallis y U Mann Whitney con nivel de significancia del 5%. Resultados: Las cantidades de 10, 15 y 20µL de Cloruro de Cetilpiridinio mostraron aumento significativo del halo > 14mm (p= 0,001) altamente sensible. Los enjuagues con Xilitol mostraron menor halo de inhibición ≥ 8mm (p=0,1) sensibilidad intermedia. La cantidad de 20µL de cloruro de cetilpiridinio no mostró diferencias significativas al compararlo con 15µL de Clorhexidina (p=1,0) Conclusio-nes: Los enjuagues bucales a base de Xilitol mostraron sensibilidad intermedia, siendo su efecto menor al compararlo con el Cloruro de Cetilpiridinio que se mostró altamente sensible.

Dental caries is considered a public health problem, children being the most vulnerable population due to inadequate eating habits and oral hygiene. Objective: To determine and compare the antibacterial effect of pediatric mouthwashes based on Cetilpiridinium Chloride (0.075%) and Xylitol (10%), on strains of StreptococcusMutans. MaterialsandMethods: In vi-tro experimental study, consisting of 20 strains of S. mutans obtained from the repository of the National Institute of Public Health Research (INSPI), which were planted in agar trypticase soy agar. The 60 Petri dishes (N = 60) were divided into three experimental groups (N = 20 each) of 10µL, 15µL and 20µL for each mouthwash, in each petri dishes were placed 5 paper discs impregnated with the solution of the groups being: G1= Colgate Plax (Cetylpyridinium Chloride 0.075%), G2= Denture kids (Xylitol 10%), G3= Blendy (Xylitol 10%) C+= Positive Control (Chlorhexidine 0.12%) C-= Negative Control (Distilled Water). Petri dishes were incubated at 37° C with low oxygen pressure. After 48 hours they were observed to measure the inhibition zones. The statistical analysis of Kruskal Wallis and U Mann Whitney with a level of significance of 5% was carried out. Results: The amounts of 10, 15 and 20µL of Cetilpiridinium Chloride showed a significant increase of halo > 14mm (p = 0.001) highly sensitive. The rinses with Xylitol showed a lower inhibition halo ≥ 8mm (p = 0.1) inter-mediate sensitivity. The amount of 20µL of cetylpyridinium chloride did not show significant differences when compared to 15µL of Chlorhexidine (p = 1.0). Conclusions: Mouthwashes based on Xylitol showed intermediate sensitivity, its effect being lower when compared to the Cetylpyridinium chloride that was highly sensitive.

Cárie dentária é considerada um problema de saúde pública, sendo as crianças a população mais vulneráveis por apresentar hábitos alimentários e higiene oral inadequados. Objectivo: Determinar e comparar o efeito antibacteriano de colutórios pediátricos de cloreto de cetilpiridínio (0,075%) e xilitol (10%), sob cepas de Streptococcus mutans. Materiais e Métodos: Estudo experimental in vitro, constituído por 20 cepas de S. mutans obtidas no repositório do Instituto Nacional de Pesquisa em Saúde Pública (INSPI), que foram semeadas em ágar tripticase de soja. 60 placas de Petri (N = 60) foram divididos em três grupos experimentais (n = 20 cada) 10 µL, 15µL e 20µL para cada colutório, em cada placa de petri 5 discos de papel impregnados com cada solução foram impregnados sendo os grupos: G1 = Colgate Plax (cloreto de cetilpiridínio 0,075%), G2 = Denture Kids (Xilitol 10%), G3 = Blendy (Xilitol 10%), C+= Controle positivo (0,12% de clorohexidina)e C-= Controle Negativo (Água Destilada). As placas de petri foram incubadas a 37° C com baixa pressão de oxigênio. Após 48 horas eles foram observados para medir as zonas de inibição. Foi realizada a análise estatística de Kruskal Wallis e Mann Whitney com um nível de significância de 5%. Resultados: As quantidades de 10, 15 e 20µL de cloreto de cetilpiridínio mostraram um incremento do halo de inibição > 14 mm (p = 0,001) sendo altamente sensível. Os colutórios com xilitol mostrou um menor halo de inibição ≥ 8 mm (p = 0,1) sensibilidade intermediária. A quantidade de 20µL de cloreto de cetilpiridínio não mostrou nenhuma diferença significativa quando comparado com 15µL de clorexidina (p = 1,0). Conclusão: Colutórios com xilitol mostraram sensibilidade intermediária, sendo menor o efeito quando comparado com Cloreto de cetilpiridínio que mostrou-se altamente sensível.

Effectiveness of casein phosphopeptide-amorphous calcium phosphate and xylitol chewing gums on salivary pH, buffer capacity, and Streptococcus mutans levels: An interventional study

The aim of the study is to compare the anticariogenic effectiveness of Casein phosphopeptide- Amorphous Calcium phosphate (CPP-ACP) and xylitol chewing gums based on salivary pH, buffer capacity, and Streptococcus mutans levels. Materials and Methods: A group of twenty individuals in the age group of 18–25 years were randomly divided into two Groups A and B. Test arm A received xylitol gums and test arm B received CPP-ACP gums and they were instructed to use the gums thrice daily for 2 weeks. Unstimulated salivary samples were collected before they began the use of the gums for baseline values, 24 h after beginning the usage of chewing gums and at the end of 14 days. The samples were analyzed for pH, buffer capacity, and S. mutans levels. Results: A statistically significant reduction of salivary S. mutans levels, improvement in salivary pH, and buffer capacity were displayed in both groups 24 h and 14 days after the intervention when compared with baseline. Group B showed more statistically significant improvement in pH than group A after 24 h (P = 0.028) and at the end of 2 weeks (P = 0.041). Conclusion: CPP-ACP has better ability than xylitol in improving the pH of saliva. Both CPP-ACP and xylitol gums individually have remarkable ability in bringing down S. mutans levels while simultaneously improving the pH and buffer of saliva.

Effectiveness of xylitol and polyol chewing gum on salivary streptococcus mutans in children: A randomized controlled trial

Dental caries is a multi-factorial, infectious disease, the prevention of which is based on multifaceted approaches. Chewing sugar-free gum has potential beneficial effects on dental health. Objectives: The aim of this study is to assess and compare the effectiveness of xylitol and polyol chewing gums on salivary Streptococcus mutans in 12–15 years old schoolchildren residing in hostels in Belgaum city. The acceptability of the two chewing gums was also assessed. Materials and Methods: Sixty children of 12–15 year age groups from three hostels, who fulfilled all the inclusion criteria, were included in this triple blind randomized controlled field trial. They were then randomly allocated into one of the three groups using lottery method. Xylitol chewing gum, polyol chewing gum and control group (no chewing gum). Patients were instructed to chew one pellet two times a day after meals for 5 min each for 30 days. Salivary samples were collected at baseline, 30 days after chewing gum use and 30 days after discontinuation, for microbiological analysis. The data were subjected to statistical analysis using SPSS software version 18. Results: Chewing 100% xylitol chewing gum 2 times a day for 5 min for 30 days can successfully reduce salivary S. mutans counts. The xylitol gum has shown a maximum benefit against salivary S. mutans when compared to polyol gum and control group. Conclusion: Xylitol-containing chewing gums can be used as an adjunct to regular home care preventive procedures to prevent dental caries.