title: Thirty-nine-month xylitol chewing-gum programme in initially 8-year-old school children: a feasibility study focusing on mutans streptococci and lactobacilli.
abstract: OBJECTIVE
  To investigate the use of xylitol-containing chewing-gums in public elementary schools as a means to affect the growth of salivary and plaque mutans streptococci and salivary lactobacilli.
  
  
  METHODS
  Over a period of 24 months, 750 8- to 9-year-old children chewed xylitol (X group; n = 255) or xylitol-sorbitol (XS group; n = 264) gum on school days (454 days over 2 years), or chewed no gum at all (C group; n = 231). Consumption of xylitol in the X and the XS groups was 6.6 and 5.4g per day, respectively. Use of gum took place at school in four daily episodes of which three were supervised by teachers. Following the 24-month chewing-gum period, the subjects were re-examined after 15 months (total follow-up period: 39 months) at which time an extraneous comparison group (ExC; n = 117) was also examined. The numbers of subjects examined after 39 months were: X, 239; XS, 248; C3 217.
  
  
  METHODS
  Salivary and plaque levels of mutans streptococci and the salivary levels of aerobically cultured aciduric bacteria (mostly representing lactobacilli) were determined using the Orion Diagnostica Dentocult SM and LB test kits, respectively.
  
  
  RESULTS
  There were statistically significant differences after 24 and 39 months between the two xylitol chewing-gum groups and the C group with regard to salivary and plaque mutans streptococci and salivary lactobacilli: the use of xylitol-containing chewing-gums significantly reduced these bacterial scores. The reductions were statistically more significant in the X group than in the XS group. The bacterial scores of groups C and ExC were similar.
  
  
  CONCLUSIONS
  Long-term use of xylitol-containing chewing-gum can reduce the growth of mutans streptococci in saliva and dental plaque, and lactobacilli-type bacteria in saliva, even if xylitol is used only on school days. The results also suggest that xylitol gum use can have a long-term, delayed growth-retarding effect on these micro-organisms, since reduced bacterial growth was still observed 15 months following the termination of xylitol use. The results indicate a close biochemical relationship between xylitol and mutans streptococci, and suggest that a similar relationship may exist regarding aerobically cultured aciduric bacteria present in saliva.
authors: Institute of Dentistry, University of Turku, Finland. kauko.makinen@uusikaupunki.fi
authors: Kauko K
authors: KK
authors: Mäkinen
authors: Pentti
authors: P
authors: Alanen
authors: Pauli
authors: P
authors: Isokangas
authors: Kauko
authors: K
authors: Isotupa
authors: Eva
authors: E
authors: Söderling
authors: Pirkko-Liisa
authors: PL
authors: Mäkinen
authors: Wang
authors: W
authors: Wenhui
authors: Wang
authors: W
authors: Weijian
authors: Chen
authors: C
authors: Xiaochi
authors: Wei
authors: W
authors: Yi
authors: Zhang
authors: Z
authors: Boxue
mesh_terms: D002638:Chewing Gum; D002648:Child; D002681:China; D015169:Colony Count, Microbial; D003773:Dental Plaque / Q000382:microbiology; D005240:Feasibility Studies; D006801:Humans; D007778:Lactobacillus / Q000187:drug effects*; D016015:Logistic Models; D011446:Prospective Studies; D012463:Saliva / Q000382:microbiology; D012571:School Dentistry; D013012:Sorbitol / Q000494:pharmacology; D018709:Statistics, Nonparametric; D013295:Streptococcus mutans / Q000187:drug effects*; D013549:Sweetening Agents / Q000494:pharmacology*; D014993:Xylitol / Q000494:pharmacology*
chemical_list: D002638:Chewing Gum; D013549:Sweetening Agents; D013012:Sorbitol; D014993:Xylitol