Six months of high-dose xylitol in high-risk caries subjects—a 2-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 (ΔD(6)S) 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 ∆D(6)S 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 (D(1)–D(2)) and manifest (D(3)) 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 ∆D(6)S 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.