Six months of high-dose xylitol in high-risk caries subjects - a two-year, randomised, clinical trial

Objectives: The hypothesis was that the daily use of a high dose of a xylitol chewing gum for 6 months would reduce the increment of decayed permanent first molar surfaces (ΔD6S) in high-risk schoolchildren after 2 years. Methods: In this randomised, clinical trial, 204 schoolchildren with a high caries risk were assigned to two experimental groups, xylitol and non-xylitol. Caries status, salivary mutans streptococci, and lactobacilli were re-evaluated 2 years later in 74 xylitol-treated and 83 non-xylitol-treated schoolchildren. Differences in mean {increment}D6S between groups registered at baseline and at follow-up were evaluated using the nonparametric Mann-Whitney U test. Results: Outcome was the development of detectable carious lesions initial (D1-D2) and manifest (D3) in the permanent first molars. In the xylitol group, the difference in proportion of children with decayed first permanent molars at baseline and follow-up was 1. 43 % for manifest lesion and 2. 86 % for initial lesions; while in the non-xylitol group was 10. 26 % (p < 0. 01) and 16. 66 % (p < 0. 01), respectively. A statistically significant difference regarding means was also observed in the non-xylitol group: the {increment}D6S for manifest lesion was 0. 18 (p = 0. 03) and 0. 67 (p = 0. 02) for initial lesion. Conclusion: The use of a chewing gum containing a high dose of xylitol for a period of 6 months has been shown to produce a long-term effect on caries development in high caries-risk children. Clinical relevance: A school-based preventive programme based on 6 months' administration of a high dose of xylitol via chewing gum proved to be efficacious in controlling caries increment in high-risk children.