title: Decreased salivary uptake of [14C]-xylitol after a four-week xylitol chewing gum regimen.
abstract: OBJECTIVE
  The aims were to evaluate a simple method to disclose a microbial shift in saliva and to investigate the short- and long-term effects of daily use of xylitol-containing chewing gums on mutans streptococci (MS) and [14C]-xylitol uptake in saliva.
  
  
  METHODS
  In a pilot set-up, saliva samples were collected from 15 healthy adults and the uptake of xylitol was compared with a specific assay determining xylitol-sensitive MS. The main study consisted of 109 schoolchildren (mean age 9.9 years) who volunteered after informed consent. The children were randomly allocated to a test or control group. The control group was given two pellets containing sorbitol and maltitol 3 times daily for 4 weeks and the test group received identical pellets with xylitol as single sweetener (total dose 6.2 g/day). Saliva samples were collected at baseline, after 4 weeks and 6 months after the intervention. The outcome measures were MS and total viable counts, proportion of MS and salivary uptake of [14C]-xylitol.
  
  
  RESULTS
  The pilot study disclosed a fair positive correlation (p < 0.05) between the assays. The proportions of MS and salivary xylitol uptake decreased significantly in the xylitol group by 60% and 30% respectively after 4 weeks compared to baseline which was in contrast to the sorbitol/maltitol group (p < 0.05). Six months after the intervention, the outcome measures did not differ significantly from baseline in any of the groups.
  
  
  CONCLUSIONS
  A relatively high daily dose of xylitol could alter salivary microbial composition during the intervention period but no long-term impact was observed.
authors.affiliation: Department of Odontology, Pediatric Dentistry, Faculty of Medicine, Umeå University, Sweden. pernilla.lif@odont.umu.se
authors.forename: Pernilla Lif
authors.initials: PL
authors.lastname: Holgerson
authors.forename: Inger
authors.initials: I
authors.lastname: Sjöström
authors.forename: Svante
authors.initials: S
authors.lastname: Twetman
mesh_terms: D000328:Adult; D002250:Carbon Radioisotopes / Q000378:metabolism; D002638:Chewing Gum; D002648:Child; D015169:Colony Count, Microbial; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008320:Maltose / Q000031:analogs & derivatives / Q000378:metabolism; D012463:Saliva / Q000378:metabolism / Q000382:microbiology*; D013012:Sorbitol / Q000378:metabolism; D013295:Streptococcus mutans / Q000187:drug effects / Q000378:metabolism*; D013402:Sugar Alcohols / Q000378:metabolism; D013549:Sweetening Agents / Q000378:metabolism* / Q000494:pharmacology; D014993:Xylitol / Q000378:metabolism* / Q000494:pharmacology
chemical_list: D002250:Carbon Radioisotopes; D002638:Chewing Gum; D013402:Sugar Alcohols; D013549:Sweetening Agents; D013012:Sorbitol; D008320:Maltose; C010745:maltitol; D014993:Xylitol