Abstract
The value for caries prevention of partial sugar substitution by xylitol was tested in a 32-month nonrandomized comparative field study. A total of 746 6- to 12-year-old children living on three islands of the Polynesian archipelago were enrolled in the study. The children of one island representing the control group were supplied with toothbrushes and fluoridated dentifrice, and received regular instruction on oral hygiene. Otherwise, they maintained their customary dietary habits. The children of the other two islands were assigned to the xylitol group. They were enrolled in an identical oral health programme but, in addition, were regularly provided with xylitol-based sweets, i.e. chewing gums, candies, chocolate, ice lollies and gumdrops, at school on a daily basis in amounts corresponding to not more than 20 g xylitol/day. 468 children completed the study. The 195 participants of the control group showed an overall mean caries increment of 7.1 DMFS. In the xylitol group with 273 children a mean caries increment of 4.5 DMFS was measured. It is concluded that partial sugar substitution by xylitol is a useful tool in preventing caries and should be considered in addition to fluoridation and oral hygiene measures in public oral health programmes.
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