The Effect of Chlorhexidine/Xylitol Chewing-Gum on Cariogenic Salivary Microf lora: A Clinical Trial in Elderly Patients

Abstract

The effects of 14-day use of either a chlorhexidine/xylitol or a xylitol chewing-gum on salivary levels of mutans streptococci, lactobacilli, and yeasts were determined for 53 subjects (mean age 79.49 ± 7.7 years) participating in this randomised, double-blind, placebo-controlled trial. Salivary flow rates and enamel staining were measured and the attitudes of the subjects to gum chewing were evaluated by the use of structured questionnaires. The chlorhexidine/xylitol gum significantly reduced the salivary levels of mutans streptococci (p < 0.0001), lactobacilli (p < 0.05) and yeasts (p < 0.05) while the xylitol placebo gum produced significant reductions in mutans streptococci (p < 0.01) only. The study population found chewing gum twice per day for 10 min an acceptable method of receiving medication and improving oral health. Prior to gum use participants recognised persistent symptoms of dry mouth and their subjective evaluation of dry mouth was significantly (p < 0.001) related to the number of prescribed medications with xerostomic side-effects. The desire to continue gum use was significantly related to the subjects’ evaluation of their oral dryness at baseline and to their perceived oral health gain from gum usage. Only those participants with stained enamel at baseline exhibited increased enamel staining following chlorhexidine/xylitol gum usage.

The Effect of Medicated Chewing Gums on Oral Health in Frail Older People: A 1‐Year Clinical Trial

“…Alternative methods of effectively managing the oral health of frail older people and reducing oral microbial levels are required. The antimicrobial effects of chlorhexidine‐containing chewing gums 5 and mouthwashes 6 have been reported. The disadvantage of mouthwashes of tooth staining and adverse taste effects have been reported to be minimal with chlorhexidine‐containing chewing gum 5 .…”

“…The antimicrobial effects of chlorhexidine‐containing chewing gums 5 and mouthwashes 6 have been reported. The disadvantage of mouthwashes of tooth staining and adverse taste effects have been reported to be minimal with chlorhexidine‐containing chewing gum 5 . In addition, gum chewing increases salivary flow, 7 which, in many older subjects, may be reduced because of prescribed xerostomic medications 8 .…”

Çeşitli sakızların ağız ve diş sağlığı üzerine etkilerinin değerlendirilmesi

“…41 Tükürük bezi hipofonksiyonu olan hastaların CH ve ksilitol içeren sakız çiğnemesi ile tükürük SM, LB ve mantar düzeyinin azaldığı gösterilmiştir. 42 Klorheksidin diglukonatın acımsı tadı ve dişlerde, dolgularda ve dilde renklenme oluşturması gibi dezavantajları vardır. CH içe-ren sakızların tadının gargaradan daha iyi olması, daha az renkleşme yapması kullanımlarını kolaylaştırır.…”

STEP - Europäische Leitlinie für das standardisierte evidenzbasierte präventive Assessment älterer Menschen in der medizinischen Primärversorgung

“…Zähne-putzen und Fluoridanwendung sind ein wichtiges Adjuvans für jedes Präventionsprogramm. Andere präventive Mittel wie Chlorhexidinspülungen (197) und Zahnpflegekaugummi mit Xylitol (198) waren hilfreich, wenn der Gesundheitszustand und Behinderungen die Fähigkeit alter Menschen einschränk-ten, Mundhygiene effektiv durchzuführen (199). Orale Gesundheitsprobleme sind bei den nicht in Pflegeeinrichtungen lebenden Menschen prävalent; sie behindern und schränken die Lebensqualität ein (200)(201).…”