title: The optimum time to initiate habitual xylitol gum-chewing for obtaining long-term caries prevention.
abstract: Habitual xylitol gum-chewing may have a long-term preventive effect by reducing the caries risk for several years after the habitual chewing has ended. The goal of this report was (1) to determine if sorbitol and sorbitol/xylitol mixtures provide a long-term benefit, and (2) to determine which teeth benefit most from two-year habitual gum-chewing - those erupting before, during, or after habitual gum-chewing. Children, on average 6 years old, chewed gums sweetened with xylitol, sorbitol, or xylitol/sorbitol mixtures. There was a "no-gum" control group. Five years after the two-year program of habitual gum-chewing ended, 288 children were re-examined. Compared with the no-gum group, sorbitol gums had no significant long-term effect (relative risk [RR], 0.65; 95% confidence interval [c.i.], 0.39 to 1.07; p < 0.18). Xylitol gum and, to a lesser extent, xylitol/sorbitol gum had a long-term preventive effect. During the 5 years after habitual gum-chewing ended, xylitol gums reduced the caries risk 59% (RR, 0.41; 95% c.i., 0.23 to 0.75; p < 0.0034). Xylitol-sorbitol gums reduced the caries risk 44% (RR, 0.56; 95% c.i., 0.36 to 0.89; p < 0.02). The long-term caries risk reduction associated with xylitol strongly depended on when teeth erupted (p < 0.02). Teeth that erupted after 1 year of gum-chewing or after the two-year habitual gum use ended had long-term caries risk reductions of 93% (p < 0.0054) and 88% (p < 0.0004), respectively. Teeth that erupted before the gum-chewing started had no significant long-term prevention (p < 0.30). We concluded that for long-term caries-preventive effects to be maximized, habitual xylitol gum-chewing should be started at least one year before permanent teeth erupt.
authors: Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle 98195, USA.
authors: P P
authors: PP
authors: Hujoel
authors: K K
authors: KK
authors: Mäkinen
authors: C A
authors: CA
authors: Bennett
authors: K P
authors: KP
authors: Isotupa
authors: P J
authors: PJ
authors: Isokangas
authors: P
authors: P
authors: Allen
authors: P L
authors: PL
authors: Mäkinen
mesh_terms: D001531:Belize / Q000453:epidemiology; D002638:Chewing Gum / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002648:Child; D015331:Cohort Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D012306:Risk; D013012:Sorbitol / Q000627:therapeutic use; D013997:Time Factors; D014078:Tooth Eruption; D014993:Xylitol / Q000627:therapeutic use
chemical_list: D002638:Chewing Gum; D013012:Sorbitol; D014993:Xylitol