title: Long-term clinical and bacterial effects of xylitol on patients with fixed orthodontic appliances.
abstract: BACKGROUND
  The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of xylitol per day for 3 months on patients with full fixed orthodontic appliances.
  
  
  METHODS
  The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the different approaches at reducing the caries risk.
  
  
  RESULTS
  Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS counts than the control group nor did they have lower values at any of the time points. Chewing gum did not significantly increase the incidence of debonded brackets over the other groups.
  
  
  CONCLUSIONS
  Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial counts in patients with full fixed appliances regardless of whether or not xylitol was used.
authors.affiliation: Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, USA. Mohamed_Masoud@hsdm.harvard.edu.|Orthodontics Department, King Abdulaziz University, Jeddah, Saudi Arabia. Mohamed_Masoud@hsdm.harvard.edu.
authors.forename: Mohamed I
authors.initials: MI
authors.lastname: Masoud
authors.affiliation: Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. masoudortho@gmail.com.|Pediatric Dentistry, Armed Forces Hospital, Jeddah, Saudi Arabia. masoudortho@gmail.com.
authors.forename: Reem
authors.initials: R
authors.lastname: Allarakia
authors.affiliation: Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. nalamoudi2011@gmail.com.
authors.forename: Najlaa M
authors.initials: NM
authors.lastname: Alamoudi
authors.affiliation: College of Dentistry, University of Michigan at Ann Arbor, Ann Arbor, MI, USA. romesh.aus@gmail.com.
authors.forename: Romesh
authors.initials: R
authors.lastname: Nalliah
authors.affiliation: Department of Orthodontics, College of Dentistry, The University of Iowa, Iowa City, IA, 52242, USA. Veerasathpurush-Allareddy@uiowa.edu.
authors.forename: Veerasathpurush
authors.initials: V
authors.lastname: Allareddy
mesh_terms: D000293:Adolescent; D000328:Adult; D058491:Bacterial Load / Q000187:drug effects; D002327:Cariostatic Agents / Q000627:therapeutic use; D002638:Chewing Gum; D002648:Child; D003731:Dental Caries / Q000382:microbiology / Q000517:prevention & control; D003773:Dental Plaque / Q000382:microbiology / Q000517:prevention & control*; D003774:Dental Plaque Index; D003777:Dental Prophylaxis / Q000379:methods; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009910:Oral Hygiene / Q000193:education; D016910:Orthodontic Brackets / Q000382:microbiology*; D010865:Pilot Projects; D012463:Saliva / Q000187:drug effects / Q000382:microbiology; D013295:Streptococcus mutans / Q000187:drug effects*; D013607:Tablets; D014993:Xylitol / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D002327:Cariostatic Agents; D002638:Chewing Gum; D005460:Fluorides, Topical; D013607:Tablets; D014993:Xylitol
keywords: Bacterial counts; Fixed orthodontic appliances; Oral hygiene; Plaque; Xylitol