title: The caries preventive effect of 1-year use of low-dose xylitol chewing gum. A randomized placebo-controlled clinical trial in high-caries-risk adults.
abstract: OBJECTIVE
  The caries preventive effect of long-term use (1 year) of low-dosage (2.5 g/die) of xylitol chewing gum in a high-caries-risk adult population was evaluated.
  
  
  METHODS
  In this randomized clinical trial, 179 high-caries-risk adults were assigned to two experimental groups, xylitol and polyols. Caries status, salivary mutans streptococci (MS), and plaque pH were re-evaluated after 2 years from baseline in 66 xylitol and 64 polyol subjects. Outcomes (the net caries increment for initial, moderate, and extensive caries lesions and for the caries experience) were evaluated using the nonparametric Mann-Whitney U test.
  
  
  RESULTS
  The total caries experience increment was 1.25 ± 1.26 in the xylitol group and 1.80 ± 2.33 in the polyol group (p = 0.01). Subjects treated with xylitol chewing gums had a reduction of risk rate at tooth level of 23% with respect to those treated with polyols with a number needed to treat of 55 teeth. The area under the curve at pH 5.7 was statistically significantly lower (p = 0.02) during the experimental period in the xylitol group. A decrease of the concentration of salivary MS was noted in the xylitol group (p < 0.01).
  
  
  CONCLUSIONS
  Subjects using the low-dose xylitol chewing gum showed a significantly lower increment of initial and extensive caries lesions and overall a lower increment of caries experience.
  
  
  CONCLUSIONS
  One-year use of chewing gums provides an effective means for the prevention of caries disease.
  
  
  BACKGROUND
  NCT02310308.
authors.affiliation: Department of Surgery, Microsurgery and Medical Sciences-School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy.|WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Cocco
authors.affiliation: Department of Surgery, Microsurgery and Medical Sciences-School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Carta
authors.affiliation: WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.|Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Cagetti
authors.affiliation: WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.|Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Strohmenger
authors.affiliation: Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Lingström
authors.affiliation: Department of Surgery, Microsurgery and Medical Sciences-School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy. gcampus@uniss.it.|WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, Milan, Italy. gcampus@uniss.it.
authors.forename: Guglielmo
authors.identifier: http://orcid.org/0000-0002-8573-485X
authors.initials: G
authors.lastname: Campus
mesh_terms: D000328:Adult; D002638:Chewing Gum; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000382:microbiology; D013402:Sugar Alcohols / Q000008:administration & dosage / Q000627:therapeutic use; D013549:Sweetening Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014993:Xylitol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D002638:Chewing Gum; D013402:Sugar Alcohols; D013549:Sweetening Agents; D014993:Xylitol
keywords: Chewing gums; Dental caries; Preventive medicine; RCT; Xylitol