Mutans Streptococci Dose Response to Xylitol Chewing Gum

Abstract

Xylitol is promoted in caries-preventive strategies, yet its effective dose range is unclear. This study determined the dose-response of mutans streptococci in plaque and unstimulated saliva to xylitol gum. Participants (n = 132) were randomized: controls (G1) (sorbitol/maltitol), or combinations giving xylitol 3.44 g/day (G2), 6.88 g/day (G3), or 10.32 g/day (G4). Groups chewed 3 pellets/4 times/d. Samples were taken at baseline, 5 wks, and 6 mos, and were cultured on modified Mitis Salivarius agar for mutans streptococci and on blood agar for total culturable flora. At 5 wks, mutans streptococci levels in plaque were 10x lower than baseline in G3 and G4 (P = 0.007/0.003). There were no differences in saliva. At 6 mos, mutans streptococci in plaque for G3 and G4 remained 10x lower than baseline (P = 0.007/0.04). Saliva for G3 and G4 was lower than baseline by 8 to 9x (P = 0.011/0.038). Xylitol at 6.44 g/day and 10.32 g/day reduces mutans streptococci in plaque at 5 wks, and in plaque and unstimulated saliva at 6 mos. A plateau effect is suggested between 6.44 g and 10.32 g xylitol/day.

Chewing Xylitol Gum Improves Self-Rated and Objective Indicators of Oral Health Status under Conditions Interrupting Regular Oral Hygiene

“…Second, this study reveals that chewing xylitol gum may dampen the increase in salivary total bacteria quantity during this particular scenario, which serves as a marker of objective oral health status. Previous studies have investigated the relationship between the combined use of xylitol chewing gum and daily tooth brushing and oral health characteristics such as plaque, gingival index scores, stimulated salivary flow rate, and Streptococcus mutans quantity (Steinberg et al 1992;Fure et al 1998;Ly et al 2006;Milgrom et al 2006;Seki et al 2011;Al-Haboubi et al 2012). To our knowledge, the present study is the first to simultaneously examine the effects of chewing xylitol gum on both self-rated and objective indicators of oral health status in a simulating situation of natural disasters that interrupt daily tooth brushing.…”

Xylitol Content in Dental Care and Food Products Available on the Polish Market and Their Significance in Caries Prevention

“…However, it is worth emphasizing that, according to the thesis and results of Milgrom et al [11], "a dose of 3.44 g/day or less is not likely to show changes in mutans streptococci level".…”

“…This may result from the ceiling effect -using more than about 10 g a day has no justification in the significant reduction of the quantity of SM in saliva. According to Milgrom et al [11], xylitol in the amount of 6.44 g per day and 10.32 g per day may reduce the quantity of SM in dental plaque over 5 weeks from the initiation of application, and in resting saliva -over 6 months. The authors estimate the ceiling effect for xylitol between 6.44 g and 10.32 g per day.…”

Adding Value Prior to Pulping: Bioproducts from Hemicellulose

“…Due to its structure, xylitol is a non-fermentable sugar alcohol with dental health benefits in caries prevention, showing superior performance to other polyols (polyalcohols). Its plaque-reducing effect is manifested by attracting and starving harmful micro-organisms because cariogenic bacteria prefer fermentable six-carbon sugars as opposed to the nonfermentable xylitol (Milgrom et al, 2006).…”