Does chewing xylitol gum result in suppression of mutans streptococci?

Abstract

Design Randomised controlled trail using a health-centre population in Finland.

Intervention 195 pregnant women with high mutans streptococci counts were randomised into three groups, xylitol (X; n=127), chlorhexidine varnish (CHX; n=32) or fluoride varnish (F; n=36). In group X, mothers were recommended to chew xylitol gum two to three times per day, starting at 3 months from delivery and continuing until their child was 3 years of age. The CHX- and F-group mothers received chlorhexidine or fluoride varnish at 6, 12 and 18 months after the birth of the child. Children received routine dental care (oral hygiene instruction, dietary advice fluoride treatment and restorative treatment) where necessary. Standardised plaque and salivary sampling was undertaken.

Outcome measure Mutans streptococcus levels in plaque and saliva.

Results Loss to follow-up was 19% at 3 years and 25% at 6 years. The reported proportion of the children who were colonised by mutans streptococci are shown (see Table 1) with a calculated worst-case scenario analysis assuming the best possible outcomes for groups CHX and F and the worst for group X. Numbers-needed-to-treat are presented comparing groups X and F.

Conclusions Chewing xylitol gum by mothers who have high mutans streptococcus counts results in long-term suppression of the bacterium in their offspring.

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