|
Sign In to gain access to subscriptions and/or personal tools.
|
Xylitol Chewing Gums and Caries Rates: A 40-month Cohort Study
K.K. Makinen
Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078
C.A. Bennett
Belize City Hospital, Belize City, Belize
P.P. Hujoel
Department of Dental Public Health Sciences, University of Washington, Seattle
P.J. Isokangas
Ylivieska Health Center, Ylivieska, Finland
K.P. Isotupa
Institute of Dentistry, University of Turku, Turku, Finland
H.R. Pape, Jr
Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078
PL Makinen
Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078
Dental caries is a pandemic infectious disease which can affect the quality of life and consumes considerable health care resources. The chewing of xylitol, sorbitol, and even sugar gum has been suggested to reduce caries rates. No clinical study has simultaneously investigated the effectiveness of these gums when compared with a group receiving no chewing gum. A 40-month double-blind cohort study on the relationship between the use of chewing gum and dental caries was performed in 1989-1993 in Belize, Central America. One thousand two hundred and seventy-seven subjects (mean age, 10.2 years) were assigned to nine treatment groups: one control group (no supervised gum use), four xylitol groups (range of supervised xylitol consumption: 4.3 to 9.0 g/day), two xylitol-sorbitol groups (range of supervised consumption of total polyols: 8.0 to 9.7 g/day), one sorbitol group (supervised consumption: 9.0 g/day), and one sucrose group (9.0 g/day). The gum use during school hours was supervised. Four calibrated dentists performed the caries registrations by means of a modified WHO procedure. The primary endpoint was the development of an unequivocal caries lesion on a non-cavitated tooth surface. Compared with the no-gum group, sucrose gum usage resulted in a marginal increase in the caries rate (relative risk, 1.20; 95% confidence interval, 0.96 to 1.49; p = 0.1128). Sorbitol gum significantly reduced caries rates (relative risk, 0.74; 95% confidence interval, 0.6 to 0.92; p = 0.0074). The four xylitol gums were most effective in reducing caries rates, the most effective agent being a 100% xylitol pellet gum (relative risk, 0.27; 95% confidence interval, 0.20 to 0.36; p = 0.0001). This gum was superior to any other gum (p < 0.01). The xylitol-sorbitol mixtures were less effective than xylitol, but they still reduced caries rates significantly compared with the no-gum group. DMFS analyses were consistent with these conclusions. The results suggest that systematic usage of polyol-based chewing gums reduces caries rates in young subjects, with xylitol gums being more effective than sorbitol gums.
Key Words: Xylitol • sorbitol • sugar • chewing gum • caries increments
Journal of Dental Research, Vol. 74, No. 12,
1904-1913 (1995)
DOI: 10.1177/00220345950740121501
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
P. Kurola, T. Tapiainen, T. Kaijalainen, M. Uhari, and A. Saukkoriipi
Xylitol and capsular gene expression in Streptococcus pneumoniae
J. Med. Microbiol.,
November 1, 2009;
58(11):
1470 - 1473.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Milgrom, K.A. Ly, and M. Rothen
Xylitol and Its Vehicles for Public Health Needs
Advances in Dental Research,
August 1, 2009;
21(1):
44 - 47.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Milgrom, K. A. Ly, O. K. Tut, L. Mancl, M. C. Roberts, K. Briand, and M. J. Gancio
Xylitol Pediatric Topical Oral Syrup to Prevent Dental Caries: A Double-blind Randomized Clinical Trial of Efficacy
Arch Pediatr Adolesc Med,
July 1, 2009;
163(7):
601 - 607.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Deshpande and A. R. Jadad
The impact of polyol-containing chewing gums on dental caries: A systematic review of original randomized controlled trials and observational studies
J Am Dent Assoc,
December 1, 2008;
139(12):
1602 - 1614.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A. Ly, P. Milgrom, and M. Rothen
The Potential of Dental-Protective Chewing Gum in Oral Health Interventions
J Am Dent Assoc,
May 1, 2008;
139(5):
553 - 563.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. K. Stookey
The effect of saliva on dental caries
J Am Dent Assoc,
May 1, 2008;
139(suppl_2):
11S - 17S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Guzman-Armstrong and J. J. Warren
Management of High Caries Risk and High Caries Activity Patients: Rampant Caries Control Program (RCCP)
J Dent Educ.,
June 1, 2007;
71(6):
767 - 775.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. A. Burt
The use of sorbitol- and xylitol-sweetened chewing gum in caries control
J Am Dent Assoc,
February 1, 2006;
137(2):
190 - 196.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S.-J. Han, S.-Y. Jeong, Y.-J. Nam, K.-H. Yang, H.-S. Lim, and J. Chung
Xylitol Inhibits Inflammatory Cytokine Expression Induced by Lipopolysaccharide from Porphyromonas gingivalis
Clin. Vaccine Immunol.,
November 1, 2005;
12(11):
1285 - 1291.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. J. Anusavice
Present and Future Approaches for the Control of Caries
J Dent Educ.,
May 1, 2005;
69(5):
538 - 554.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. C. ROBERTS, C. A. RIEDY, S. E. COLDWELL, S. NAGAHAMA, K. JUDGE, M. LAM, T. KAAKKO, J. L. CASTILLO, and P. MILGROM
How xylitol-containing products affect cariogenic bacteria
J Am Dent Assoc,
April 1, 2002;
133(4):
435 - 441.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Tapiainen, T. Kontiokari, L. Sammalkivi, I. Ikäheimo, M. Koskela, and M. Uhari
Effect of Xylitol on Growth of Streptococcus pneumoniae in the Presence of Fructose and Sorbitol
Antimicrob. Agents Chemother.,
January 1, 2001;
45(1):
166 - 169.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
G. H. HILDEBRANDT and B. S. SPARKS
MAINTAINING MUTANS STREPTOCOCCI SUPPRESSION: WITH XYLITOL CHEWING GUM
J Am Dent Assoc,
July 1, 2000;
131(7):
909 - 916.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P.P. Hujoel, K.K. Makinen, C.A. Bennett, K.P. Isotupa, P.J. Isokangas, P. Allen, and P.-L. Makinen
The Optimum Time to Initiate Habitual Xylitol Gum-chewing for Obtaining Long-term Caries Prevention
Journal of Dental Research,
March 1, 1999;
78(3):
797 - 803.
[Abstract]
[PDF]
|
|
|
|
|
|
|
T. Imfeld
Chewing Gum--Facts and Fiction: a Review of Gum-Chewing and Oral Health
Critical Reviews in Oral Biology & Medicine,
January 1, 1999;
10(3):
405 - 419.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Uhari, T. Kontiokari, and M. Niemela
A Novel Use of Xylitol Sugar in Preventing Acute Otitis Media
Pediatrics,
October 1, 1998;
102(4):
879 - 884.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Mitchell
Xylitol Prophylaxis for Acute Otitis Media: Tout de Suite?
Pediatrics,
October 1, 1998;
102(4):
974 - 975.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Fure, P. Lingstrom, and D. Birkhed
Effect of Three Months' Frequent Use of Sugar-free Chewing Gum with and without Urea on Calculus Formation
Journal of Dental Research,
August 1, 1998;
77(8):
1630 - 1637.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M Uhari, T Kontiokari, M Koskela, and M. Niemela
Xylitol chewing gum in prevention of acute otitis media: double blind randomised trial
BMJ,
November 9, 1996;
313(7066):
1180 - 1183.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
G. B Winter
Commentary: What about the ethics?
BMJ,
November 9, 1996;
313(7066):
1183 - 1184.
[Full Text]
|
|
|
|
|
