Xylitol Gum Research Articles

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. 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. 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). 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. 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. 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. 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. Xylitol-containing chewing gums can be used as an adjunct to regular home care preventive procedures to prevent dental caries.

Effect of chewing gums containing probiotics and xylitol on oral health in children: A randomized controlled trial

Aims: Probiotics have been proven to be beneficial for general and systemic health. Many in vitro and in vivo studies have investigated the use of probiotics for the prevention or treatment of dental caries and gingival diseases. Lactobacillus reuteri is believed to possess anti-microbial and anti-inflammatory properties. The aim of our randomized controlled trial was to evaluate the effect of chewing gums containing probiotics and xylitol on the salivary Streptococcus mutans counts, plaque, and gingival scores after the intervention. Materials and Methods: In our 3-week, short-term trial, 40 healthy 7–12-year-old children consumed two commercially available chewing gums; Group 1 (BioGaia™ ProDentis) and Group 2 (Orbit®Gum, Wrigley's). Individuals consumed three chewing gums daily, immediately after major meals for 20 min each. The probiotic gum contained two strains of L. reuteri (ATCC 55730 and ATCC PTA 5282) along with artificial sweetener, sorbitol, and the xylitol gum consisted of both xylitol and sorbitol. Pre- and post-intervention whole unstimulated saliva samples were collected and cultured on Mitis Salivarius Bacitracin agar plates to check for colony forming units/ml of Streptococcus mutans. Plaque and gingival scores were also recorded at pre- and post-intervention appointments. Results: Following the intervention, the salivary Streptococcus mutans counts decreased in both groups. There was a significant reduction in plaque and gingival scores at postintervention examination. Conclusion: Probiotics can be used as an alternative to xylitol in the preventive regimen for dental caries or control in case of high caries risk.

Probiotic capsules and xylitol chewing gum to manage symptoms of pharyngitis: a randomized controlled factorial trial.

Reducing the use of antibiotics for upper respiratory tract infections is needed to limit the global threat of antibiotic resistance. We estimated the effectiveness of probiotics and xylitol for the management of pharyngitis. In this parallel-group factorial randomized controlled trial, participants in primary care (aged 3 years or older) with pharyngitis underwent randomization by nurses who provided sequential intervention packs. Pack contents for 3 kinds of material and advice were previously determined by computer-generated random numbers: no chewing gum, xylitol-based chewing gum (15% xylitol; 5 pieces daily) and sorbitol gum (5 pieces daily). Half of each group were also randomly assigned to receive either probiotic capsules (containing 24 × 109 colony-forming units of lactobacilli and bifidobacteria) or placebo. The primary outcome was mean self-reported severity of sore throat and difficulty swallowing (scale 0-6) in the first 3 days. We used multiple imputation to avoid the assumption that data were missing completely at random. A total of 1009 individuals consented, 934 completed the baseline assessment, and 689 provided complete data for the primary outcome. Probiotics were not effective in reducing the severity of symptoms: mean severity scores 2.75 with no probiotic and 2.78 with probiotic (adjusted difference -0.001, 95% confidence interval [CI] -0.24 to 0.24). Chewing gum was also ineffective: mean severity scores 2.73 without gum, 2.72 with sorbitol gum (adjusted difference 0.07, 95% CI -0.23 to 0.37) and 2.73 with xylitol gum (adjusted difference 0.01, 95% CI -0.29 to 0.30). None of the secondary outcomes differed significantly between groups, and no harms were reported. Neither probiotics nor advice to chew xylitol-based chewing gum was effective for managing pharyngitis. Trial registration: ISRCTN, no. ISRCTN51472596.

The Effects of Xylitol Gum on the Bacterial Composition of Saliva and Plaque

The Effects of Xylitol Gum on the Bacterial Composition of Saliva and Plaque

Effect of Chewing Xylitol Gum on Salivary Volume and Acidity

Dental caries or tooth decay is a result of the production of acid from fermentation ofbacteria that destroy tooth tissue. It can be prevented by maintaining the stability of salivaryvolume and acidity. Chewing xylitol gum is beneficial for increasing salivary volume andacidity. The aim of the study is to determine the effect of chewing xylitol gum on salivary volumeand acidity. The study is a quasi experiment conducted to 30 males aged between 17-25 yearsold. Pre and post treatment’s salivary volume are measured with measuring cup. Pre and posttreatment’s salivary acidity are measured using a pHmeter with 0,1 accuracy. Data areanalyzed with paired “t” test (a = 0,05). Average salivary volume after chewing xylitol gumincreased very significantly from 0,26 mL to 13,37mL (p=0,000). Average salivary acidity afterchewing xylitol gum increased very significantyly from 6,47 to 7,36(p=0,000). The researchconcludes that chewing xylitol gum increases salivary volume and acidity.Keywords : dental caries, xylitol, salivary volume, salivary acidity

Xylitol-containing Chewing Gum for Caries Prevention in Students with Disabilities: A Randomised Trial.

This cluster randomised controlled trial evaluated the effectiveness of a school-based xylitol chewing-gum programme on caries prevention among students with visual or hearing impairment. The study compared xylitol gum plus oral health education (intervention group, n = 93) with oral health education alone (control group, n = 81) among students aged 7-18 years in special needs schools in Khon Kaen, Thailand. The primary outcome was caries onset rate measured as the change in caries onset on tooth surfaces. The secondary outcome was plaque index. Between-group differences were determined using generalised estimated equations and a general linear model under the intention-to-treat approach. After 1 year, there was a significantly lower caries rate in the primary dentition among the intervention group compared to the control group (0.08 vs 0.12 surfaces per surface-year, respectively; adjusted relative risk = 0.64, 95% confidence interval 0.44-0.96; p = 0.03), but there was no significant difference in the caries rates for the permanent dentition. Remineralisation also occurred more in the intervention vs the control group in the primary dentition only. Oral hygiene was significantly improved in the intervention but not in the control group (p = 0.001). This programme reduced the caries rate and enhanced remineralisation in primary dentition, and improved oral hygiene in students with disabilities.

PERBEDAAN LAJU ALIRAN SALIVA TERSTIMULASI ANTARA PENGUNYAHAN PARAFIN WAX DENGAN PERMEN KARET XYLITOL PADA PASIEN TERINDIKASI GERD

Background: Gastroesophageal Reflux Disease (GERD) is a condition of irreversibility (reflux) of stomach contents into the esophagus exceeds the normal amount and causes a variety of complaints. Reduction in salivary flow and decreased secretion of bicarbonate in the saliva cannot be avoided so that the patient is symptomatic GERD in the oral cavity in the form of halitosis and tooth erosion. Paraffin wax and chewing xylitol gum can be an alternative to increase the rate of saliva and neutralize the acid in patients with GERD. This study aimsto observes salivary flow rate differences between paraffin wax and xylitol gum patient - indicated GERD at RSUDZA in Banda Aceh.Method: This research is an analytic study with cross sectional approach and a subject of 17 people. Data were analyzed by statistical tests using Wilcoxon test.The results of this study, the salivary flows by chewing paraffin wax at the low category (52.9%), whereas salivary flows by chewing xylitol gum is the normal category (76.5%).Result: The data obtained P = 0.001 (P <0.05) for the difference between chewing paraffin wax and chewing xylitol gum.Conclusion: The conclusion from this study is a significant difference between salivary flows chewing paraffin wax and chewing xylitol gum in patient-indicated GERD at RSUDZA in Banda Aceh

Xylitol Chewing Gums on the Market: Do They Prevent Caries?

To measure the xylitol content in sugar-free chewing gums available on the market in Gulf Cooperation Council (GCC) countries in the Middle East, in order to identify those products that can provide the recommended daily dose of xylitol for caries prevention (6-7 g). Acid production from chewing gums was also measured in vitro and in vivo. Twenty-one chewing gums containing xylitol were identified and collected from the GCC market (Kuwait, Bahrain, Qatar, Saudi Arabia, UAE and Oman). Xylitol was extracted and its concentration was analysed using a special enzymatic kit. The pH of extracts was measured during 30-min incubation with Streptococcus mutans. Changes in saliva and plaque pH were noted in four subjects after the consumption of highly concentrated xylitol gums. The xylitol content in grams was clearly mentioned only on one product's label. Twelve products stated the percentage of xylitol (3.5% to 35%). The rest did not specify the amount. The mean measured weight of one piece of gum was 1.67 ± 0.38 g. The mean measured xylitol content/piece was 0.33 ± 0.21 g. Xylitol content was < 0.3 g/ piece in 9 products, 0.3-0.5 g in 7 and > 0.5 g in 5 products. None of the highly concentrated xylitol gums showed a pH drop in vitro or in vivo. One chewing gum, containing xylitol and glucose, resulted in a low pH level (< 5.5) when tested in vitro. The majority of xylitol chewing gums sold on the GCC market do not provide the consumers with the recommended daily dose of xylitol for caries prevention. Clear, accurate labeling is recommended.

The evidence base for professional and self-care prevention--caries, erosion and sensitivity.

BackgroundThe aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures.MethodsA mapping of systematic reviews (SR) of literature was carried out in PubMed and the Cochrane library through April 2014 using established MeSH-terms and disease-related search words in various combinations. The search was restricted to SR's published in English or Scandinavian and all age groups were considered. The reference lists of the selected papers were hand-searched for additional review articles of potential interest. Meta-analyses, guidelines and treatment recommendations were considered only when SR's were lacking. In the event of updates or multiple systematic reviews covering the same topic, only the most recent article was included. No quality assessment of the systematic reviews was carried out. The quality of evidence was rated in four levels according to the GRADE scale.ResultsIn total, 39 SR were included. For primary caries prevention, the quality of evidence was high for the use of fluoride toothpaste (with and without triclosan) and moderate for fluoride varnish and fissure sealants. The quality of evidence for fluoride gel, fluoride mouth rinse, xylitol gums and silver diamine fluoride (SDF) was rated as low. For secondary caries prevention and caries arrest, only fluoride interventions and SDF proved consistent benefits, although the quality of evidence was low. Likewise, the GRADE score for preventing erosions located in the enamel with fluoride supplements was low. The quality of evidence for various professional and self-care methods to prevent and manage dentine hypersensitivity was very low.ConclusionsThere are knowledge gaps in many domains of cariology and preventive dentistry that must be addressed and bridged through clinical research of good quality.

Xylitol Gum Chewing to Achieve Early Postoperative Restoration of Bowel Motility After Laparoscopic Surgery.

Our objective was to evaluate the effects of postoperative xylitol gum chewing on gastrointestinal functional recovery after laparoscopy. Altogether, 120 patients undergoing elective gynecologic laparoscopy were randomly divided into 2 groups of 60 each (final numbers: 53 controls, 56 patients). Controls underwent a routine postoperative regimen. Starting 6 hour after surgery, study patients chewed mint-flavored, sugarless xylitol gum until flatus occurred thrice a day. Other postoperative management was routine. First bowel sounds, first flatus, first bowel movement, and discharge times were recorded. Symptoms included abdominal distension, nausea, and vomiting. First flatus and first bowel sounds occurred significantly (P<0.001) earlier in the study patients. No significant differences were found for first defecation time, hospitalization duration, or mild/severe intestinal obstruction (all P>0.05). Thus, xylitol gum chewing after laparoscopy can effectively shorten the time to first flatus and helps with postoperative gastrointestinal functional recovery. It is simple, convenient, and well tolerated.

The Role of Xylitol Gum Chewing in Restoring Postoperative Bowel Activity After Cesarean Section.

The goal of this study was to evaluate the effects of xylitol gum chewing on gastrointestinal recovery after cesarean section. Women who underwent cesarean section (N = 120) were randomly allocated into Group A (xylitol gum), Group B (nonxylitol gum), or the control group (no chewing gum). Every 2 hr post-cesarean section and until first flatus, Groups A and B received two pellets of chewing gum and were asked to chew for 15 min. The times to first bowel sounds, first flatus, and first defecation were then compared among the three groups. Group A had the shortest mean time to first bowel sounds (6.9 ± 1.7 hr), followed by Group B (8 ± 1.6 hr) and the control group (12.8 ± 2.5 hr; one-way analysis of variance, p < .001; Scheffe's post hoc comparisons, p < .05). The gum-chewing groups demonstrated a faster return of flatus than the control group did (p < .001), but the time to flatus did not differ significantly between the gum-chewing groups. Additionally, the differences in the time to first defecation were not significant. After cesarean section, chewing gum increased participants' return of bowel activity, as measured by the appearance of bowel sounds and the passage of flatus. In this context, xylitol-containing gum may be superior to xylitol-free gum.

Maternal xylitol and mutans streptococci transmission

PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials databases and the ClinicalTrials.gov registry were searched with related articles'. Experts were contacted and a manual search of reference lists was undertaken. Randomised or quasi-randomised controlled trials that evaluated the maternal use of xylitol gum on Mutans Streptococci (MS) colonisation in infants. Two independent reviewers performed data extraction with a third reviewer asked to resolve any disagreements. Cochrane risk of bias tool was used to assess the quality of studies. Two reviewers independently appraised the methodological quality. The primary outcome measure was presence of MS in the saliva or plaque of infants, with the secondary outcome measure being occurrence of dental decay. 11 studies published between 2000 and 2012 involving a total of 601 patients were included. Sample sizes ranged from 60 to 195 and the daily dose of xylitol consumption ranged from 1.95g to 5.28g. Follow-up ranged from six months to 120 months. There was a significant difference between the two groups, with infants in the control group experiencing greater incidences of MS in their plaque or saliva. Risk ratios were 0.44 (95% CI: 0.08-2.40) at 6-9 months, 0.54 (95% CI: 0.39-0.73) at 12-18 months, 0.60 (95% CI: 0.34-1.08) at 24 months, 0.56 (95% CI: 0.40-0.79) at 36 months and 0.61 (95% CI: 0.48-0.76) at 60 months. Caries data could not be pooled. Xylitol consumption by mothers with high MS levels was associated with a significant reduction in the mother-to-child transmission of salivary MS. These findings are based on evidence that may have suffered from biases.

A review on preventive measures and treatment of white spot lesions in patients with fixed orthodontic appliances

Objective: One complication of fixed orthodontic treatment in patients with poor oral hygiene is development of demineralized enamel lesions compromising esthetics. This study aimed to review preventive measures and treatment of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Review of Literature: In this review study, PubMed and Google Scholar databases were searched for articles published during 1964-2013 using the keywords “white spot lesions”, “demineralization”, “mastic gum”, “casein phosphopeptide amorphous calcium phosphate or CPP-ACP”, “chitosan” and “orthodontics”; 96 articles were evaluated. Conclusion: White spot lesions can be prevented by conventional plaque control and adjunct measures such as the use of fluoride-containing compounds, chlorhexidine (CHX), xylitol gums, chitosan compounds and laser. Low-concentration fluoride, CPP-ACP compounds and laser help remineralize these lesions. If not treated, bleaching, microabrasion and tooth restoration are the final solutions.

Effect of maternal use of chewing gums containing xylitol on transmission of mutans streptococci in children: a meta-analysis of randomized controlled trials.

Mutans streptococci (MS) are the major causative bacteria involved in human dental decay. Habitual consumption of xylitol has been proved to reduce MS levels in saliva and plaque. To evaluate the effect of the maternal use of xylitol gum on MS reduction in infants. A structured literature review and meta-analysis. A random effects model was used to assess the relative risks of the incidence of MS in the saliva or plaque of children who were 6, 9, 12, 18, and 24 months old. We reviewed 11 RCTs derived from 5 research teams that included 601 mothers. Our results indicated that the incidence of MS in the saliva or plaque of the infants was significantly reduced in the xylitol group (risk ratio: 0.54; 95% confidence interval: 0.39-0.73, at 12-18 months) and (risk ratio: 0.56; 95% confidence interval: 0.40-0.79, at 36 months) compared with the control groups. The long-term effect of maternal xylitol gum exposure on their children's dental caries was controversial. Habitual xylitol consumption by mothers with high MS levels was associated with a significant reduction in the mother-child transmission of salivary MS.

Chewing xylitol gum improves self-rated and objective indicators of oral health status under conditions interrupting regular oral hygiene.

Chewing xylitol gum provides oral health benefits including inhibiting Streptococcus mutans plaque. It is thought to be especially effective in conditions where it is difficult to perform daily oral cleaning. Our study aim was to determine the effects of chewing xylitol gum on self-rated and objective oral health status under a condition interfering with oral hygiene maintenance. A randomized controlled intervention trial was conducted on 55 healthy ≥ 20-year-old men recruited from the Japan Ground Self Defense Force who were undergoing field training. Participants were randomly assigned to a test group (chewing gum; n = 27) or a control group (no gum; n = 28) and the researchers were blinded to the group assignments. The Visual Analog Scale (VAS) scores of oral conditions subjectively evaluated oral health, and the stimulated salivary bacteria quantity objectively evaluated oral health 1 day before field training (baseline) and 4 days after the beginning of field training (follow-up). VAS scores of all three oral conditions significantly increased in the control group (malodor: p < 0.001; discomfort: p < 0.001; dryness: p < 0.001), but only two VAS scores increased in the test group (malodor: p = 0.021; discomfort: p = 0.002). The number of salivary total bacteria significantly increased in the control group (p < 0.01), while no significant change was observed in the test group (p = 0.668). Chewing xylitol gum positively affects self-rated and objective oral health status by controlling oral hygiene under conditions that interfere with oral hygiene maintenance.

English

Among all oral diseases, tooth decay still imposes the greatest burden on health care systems. While patients prefer less complicated and time consuming preventive methods, the effectiveness of rinsing mouth with water has remained in the shadow. A great number of people, whether professional or not, believe that water rinse can be helpful where tooth-brush is not available. This study aimed to investigate that belief. In this study in three different attempts the basal saliva pH of 60 participants and their saliva pH after introducing to sugar solution, brushing teeth, chewing xylitol gum, and rinsing mouth with water were recorded. Data analysis showed that tap water may not be of any help in correcting oral pH after an acidic attack. Key words: Saliva pH, sugar-free chewing gum, mouth rinse, tap water, tooth brushing, xylitol.

Effects of short-term xylitol gum chewing on the oral microbiome

The aim of this study was to determine the effects of short-term xylitol gum chewing on the salivary microbiota of children. The study was a randomised, controlled, double-blind trial. Healthy children used xylitol chewing gum (xylitol group, n = 35) or sorbitol chewing gum (control group, n = 38) for 5 weeks. The daily dose of xylitol/sorbitol was approximately 6 g/day. At baseline and at the end of the test period, unstimulated and paraffin-stimulated saliva were collected. The microbial composition of the saliva was assessed using human oral microbe identification microarray (HOMIM). Mutans streptococci (MS) were plate cultured. As judged by HOMIM results, no xylitol-induced changes in the salivary microbiota took place in the xylitol group. In the control group, Veillonella atypica showed a significant decrease (p = 0.0001). The xylitol gum chewing decreased viable counts of MS in both stimulated (p = 0.006) and unstimulated (p = 0.002) saliva, but similar effects were also seen in the control group. The use of xylitol gum decreased MS, in general, but did not change the salivary microbial composition. Short-term consumption of xylitol had no impact on the composition of the salivary microbiota, but resulted in a decrease in the levels of MS.

The effect of Propolis and Xylitol chewing gums on salivary Streptococcus mutans count: a clinical trial.

Streptococcus mutans is one of the most common cariogenic microorganisms. Use of natural anticariogenic agents, such as Xylitol has been well-established in the literature. On the other hand, there is a scarcity of studies that have reported the antimicrobial potential of Propolis as an anticariogenic chewing agent; hence, the present study was designed. To evaluate and compare the anticariogenic action of two commercial chewing gums Propolis and Xylitol on the salivary S. mutans count in a group of children from Bengaluru city. Clinical setting and experimental design. Thirty healthy children aged 8-11 years with decayed, missing, and filled teeth (dmft)/DMFT index score≥3 were included in the study. Before the test, unstimulated saliva was collected. Children divided into Group I and II were given Propolis and Xylitol chewing gums respectively; to chew for 15 min. Saliva samples were then collected at 15 min (just after spitting) and after 1 h. The amount of S. mutans in saliva was evaluated using a selective media (MSAB). In addition, compliance of the two chewing gums among the children was tested with a questionnaire. Student's t-test. Six samples out of 30 were excluded due to no growth. The total number of bacterial colonies was significantly reduced when compared to baseline in both the groups. Propolis gum showed statistically significant reduction in the number of colonies as compared to Xylitol. Xylitol gum was more preferred than Propolis gum by the children. Propolis chewing gum can be used as an anticariogenic agent in children.

Long‐term effects of maternal prevention on children's dental decay and need for restorative treatment

In a Finnish study carried out in 1990s, high-caries-risk mothers used xylitol gum on daily basis when their child was 3-24-month old, whereas the high-risk control mothers received biannual fluoride or chlorhexidine treatments. The maternal prevention reduced colonization of mutans streptococci and early childhood caries in children. The present retrospective study aimed to extend the post-trial follow-up to 10-year-old children (n = 148). Additionally, the dental health of these high-caries-risk children was compared with a reference group comprising the rest of the children in the same age cohort (n = 359). The annual data on dental health and treatments were gathered from public dental care registers. The median caries-free age (dmft = 0 and DMFT = 0) was 8.2 in the xylitol, 5.8 in the control, and 8.1 in the reference group (xylitol versus control, P = 0.005, HR = 1.75; 95% CI 1.18-2.60, reference versus xylitol, P = 0.410, HR = 1.13; 95% CI 0.84-1.51 Cox regression). Thus, the children in the xylitol group had caries-free teeth longer than the control group. Compared to the reference group, the xylitol group did not show notable difference. Up to 4 years of age, figures for cumulative restorative treatment visits were 0.2 in the xylitol, 0.7 in the control, and 0.4 in the reference group (xylitol versus control P = 0.006, Student's t-test). The reduced mother-child transmission of mutans streptococci seems to have long-term effects on children's dental health. The maternal use of xylitol reduces caries occurrence and need for restorative treatment in assumed high-caries-risk children to the average level of the whole age cohort.