| 1. |
- Cagar, E, et al.
(författare)
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Effect of chewing gums containing xylitol or probiotic bacteria on salivary mutans streptococci and lactobacilli
- 2007
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Ingår i: Clinical Oral Investigations. - Berlin : Springer. - 1432-6981 .- 1436-3771. ; 11:4, s. 425-429
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to evaluate the effect of xylitol and probiotic chewing gums on salivary mutans streptococci (MS) and lactobacilli (LB). The material consisted of 80 healthy young adults (21-24 years) who volunteered after informed consent. They were assigned by random into one of four parallel study groups: A, probiotic gum group; B, xylitol gum group; C, probiotic + xylitol gum group; and D, placebo gum group. The gums were taken three times daily after meals, and the intervention period was 3 weeks. The probiotic gums contained two strains of Lactobacilli reuteri (ATCC 55730 at a dose of 1 x 10(8) CFU/gum and ATCC PTA 5289 at a dose of 1 x 10(8) CFU/gum), and each pellet of the xylitol gum contained approximately 1.0 g xylitol as single sweetener. Pretreatment and posttreatment samples of stimulated whole saliva were collected and quantified for MS and LB with chair-side kits. A statistically significant reduction (p < 0.05) of salivary MS was displayed in group A and B after the intervention when compared with baseline. A similar but nonsignificant tendency was seen in group C. No alterations of salivary LB was demonstrated in any group. In conclusion, daily chewing on gums containing probiotic bacteria or xylitol reduced the levels of salivary MS in a significant way. However, a combination of probiotic and xylitol gums did not seem to enhance this effect.
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| 2. |
- Holgerson, Pernilla Lif, et al.
(författare)
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Decreased salivary uptake of [14C]-xylitol after a four-week xylitol chewing gum regimen.
- 2007
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Ingår i: Oral health and preventive dentistry. - 1602-1622. ; 5:4, s. 313-319
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: 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. MATERIALS AND 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. CONCLUSION: A relatively high daily dose of xylitol could alter salivary microbial composition during the intervention period but no long-term impact was observed.
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| 3. |
- Holgerson, Pernilla Lif, et al.
(författare)
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Validation of an age-modified caries risk assessment program (Cariogram) in preschool children.
- 2009
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 67:2, s. 106-112
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. (i) To validate caries risk profiles assessed with a computer program against actual caries development in preschool children, (ii) to study the possible impact of a preventive program on the risk profiles, and (iii) to compare the individual risk profiles longitudinally. Material and methods. Caries risk was assessed in 125 two-year-old children invited to participate in a 2-year caries-preventive trial with xylitol tablets. At 7 years of age, 103 were available for follow-up, 48 from the former intervention group and 55 from the control group. At baseline and after 5 years, 7 variables associated with caries were collected through clinical examinations and questionnaires, and scored and computed with a risk assessment program (Cariogram). Results. Children assessed as having a "low chance (0-20%) of avoiding caries" had significantly higher caries at 7 years of age compared to children with a lower risk in the control group (p<0.05) but not in the intervention group. Overall predictive accuracy and precision, however, were moderate in both groups. Less than half of the children remained in the same risk category at both ages, despite a largely unchanged consumption pattern of sugar. The majority of the children who changed category displayed a lowered risk at 7 years. The intervention program seemed to impair the predictive abilities of Cariogram. Conclusion. A modified Cariogram applied on preschool children was not particularly useful in identifying high caries risk patients in a low-caries community.
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| 4. |
- Lif Holgerson, Pernilla, et al.
(författare)
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Effect of xylitol-containing chewing gums on interdental plaque-pH in habitual xylitol consumers.
- 2005
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 63:4, s. 233-238
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Tidskriftsartikel (refereegranskat)abstract
- Abstract. The aim was to investigate the effect of high and low amounts of xylitol on the interdental plaque-pH, directly and after sucrose challenge in schoolchildren with a habitual consumption. The study group consisted of 11 healthy children (10-15 years) with low caries risk and the experiment had a single-blind crossover (Latin square) design. After a 2-week run-in period with a daily 4.0 g xylitol intake, the children were subjected to single-dose exposures of chewing gums with i) paraffin (CTR; no xylitol), ii) low dose xylitol (LX; 2.0g xylitol), and iii) high dose xylitol (HX; 6.0g xylitol) in a randomised order separated by a wash-out period of one week. Samples of chewing-stimulated whole saliva were collected prior to and after the experimental period for determination of bacterial counts. The outcome measures were in situ plaque-pH (micro-touch method) and area under the curve (AUC) above pH 6.0. The AUC was significantly greater (p<0.05) in the HX group compared to the LX and control groups during the first 5 minutes after chewing. After a 10% sucrose rinse, the interdental plaque-pH dropped in all groups but the HX regimen displayed significantly less reduction 0-5 min after chewing (p<0.05). No significant alterations of the total viable counts or mutans streptococci levels in saliva were disclosed during the 4-week experimental period. The present results suggested that a high single dose of xylitol had a short and limited beneficial effect on interdental plaque-pH in habitual xylitol consumers while a low single dose, resembling a normal chewing gum use, did not differ from the control.
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| 5. |
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| 6. |
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| 7. |
- Lif Holgerson, Pernilla, 1972-
(författare)
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Xylitol and its effect on oral ecology : clinical studies in children and adolescents
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Xylitol, classified as a natural sugar substitute, has for about 35 years been known as an agent that may act against caries. The mechanism of action; how it inhibits mutans streptococci (MS) and the clinical dose-response relationship are not however fully investigated. The general aim of the investigations was to evaluate the effect of xylitol on oral ecology in children and adolescents. A series of experimental and controlled clinical trials were performed in which samples of saliva and plaque was collected and analysed with respect to xylitol content, pH, microbial composition and lactic acid production. In paper I, significantly reduced proportions of xylitol-sensitive MS in saliva were demonstrated after 18 weeks of regular use of two dose regimens of xylitol-containing tablets (1.7g and 3.4g xylitol/day) but the acidogenicity in dental plaque was not affected. In paper II, the effect on interdental plaque-pH of two different single dose intakes (2.0g and 6.0g) of xylitol was evaluated. The higher xylitol dose counteracted the pH-drop significantly (p<0.05) when the chewing was followed by a sucrose rinse while the lower dose did not differ from the control. In paper III, the xylitol concentrations in saliva after use of different common xylitol-containing products (0.1g-1.3g) were investigated. Statistically significant elevations of salivary xylitol levels were demonstrated for all products during the first 8-16 min when compared with baseline (p<0.05) but the individual variation was considerable. In samples of supragingival dental plaque, a high dose rinse (6.0g) increased the xylitol concentrations for a longer period (>30 min) than a low dose rinse (2.0g). In paper IV, it was demonstrated that 6.0g of xylitol in chewing gums, every day in 4 weeks, gave significantly less visible plaque and a significantly reduced sucrose-induced lactic acid formation (p<0.05) in saliva. Furthermore, the proportion of MS decreased significantly (p<0.05) compared to baseline. In paper V, the salivary uptake of [14C]-xylitol was compared with a specific assay determining xylitol-sensitive MS and a fair positive correlation (p<0.05) between the two assays was found. In a controlled trial, the proportions of MS and the salivary xylitol uptake decreased significantly (p<0.05) in the xylitol gum test group after 4 weeks compared to baseline which was in contrast to the control gum group. No serious adverse effects were reported in any of the investigations. The main conclusions from this thesis were: a) various xylitol-containing products increased the xylitol levels in saliva and plaque, b) 6.0g of xylitol could counteract the interdental pH-drop after sugar consumption and reduce lactic acid formation in saliva c) a daily dose of 6.0g xylitol reduced the amount of visible plaque and altered the salivary microbial composition, d) a transient shift of MS strains in saliva was demonstrated during periods of regular intake of xylitol products but no long-term impact was found after its termination. The relatively high amount of xylitol needed for a beneficial effect on the oral ecology calls for a further development of effective and safe routes for administration.
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| 8. |
- Lif Holgerson, Pernilla, et al.
(författare)
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Xylitol concentration in saliva and dental plaque after use of various xylitol-containing products
- 2006
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Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 40:5, s. 393-397
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Tidskriftsartikel (refereegranskat)abstract
- The study consisted of two sets of experiments, one in saliva and one in dental plaque. The xylitol concentration in saliva was determined enzymatically in 12 children (mean age 11.5 years) after a standardised use of various xylitol products: (A) chewing gums (1.3 g xylitol), (B) sucking tablets (0.8 g xylitol), (C) candy tablets (1.1 g xylitol), (D) toothpaste (0.1 g xylitol), (E) rinse (1.0 g xylitol), and (F) a non-xylitol paraffin. Unstimulated saliva was sampled 1, 3, 8, 16 and 30 min after use. The concentration in dental plaque was determined after mouthrinses with contrasting amounts of xylitol (LX = 2.0 g, HX = 6.0 g, and control) and supragingival plaque was collected and pooled after 5, 15 and 30 min. The mean xylitol concentration in saliva at baseline was approximately 0.1 mg/ml. All xylitol-containing products resulted in significantly increased levels (p < 0.05) immediately after intake and remained elevated for 8-16 min in the different groups. The highest mean value in saliva was obtained immediately after use of chewing gums (33.7 +/- 16.4 mg/ml) and the lowest was demonstrated after using toothpaste (8.2 +/- 4.9 mg/ml). No significant differences were demonstrated between chewing gums (A), sucking tablets (B), candy (C) and rinses (E). In dental plaque, the mean values were 8.6 +/- 5.4 and 5.1 +/- 4.0 mg/ml 5 min after HX and LX rinses. Concerning the higher concentration, the values remained significantly elevated (p < 0.05) during the entire 30-min follow-up. In conclusion, commonly advocated xylitol-containing products gave elevated concentrations of xylitol in unstimulated whole saliva and dental plaque for at least 8 min after intake. Copyright 2006 S. Karger AG, Basel.
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| 9. |
- Oscarson, Per, et al.
(författare)
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Influence of a low xylitol-dose on mutans streptococci colonisation and caries development in preschool children.
- 2006
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Ingår i: European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry. - 1818-6300. ; 7:3, s. 142-7
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate the effect of xylitol-containing tablets on mutans streptococci colonisation and caries development in preschool children. STUDY DESIGN: Randomised single-blind prospective design. METHODS: The material consisted of 132 healthy 2-year-old children, 71 boys and 61 girls and they were assigned to a xylitol tablet (test) group or a non-intervention control group. The mean age was 2 years + 1 month in both groups. The drop-out rate was 10.6% during the 2-year trial. The test group was given 1-2 xylitol tablets (0.5-1g) per day during 1.5 years. Mutans streptococci (MS) enumeration was performed at baseline and semi-annually in the children and at baseline or shortly after in the mothers with a chair-side technique. Caries prevalence was scored at baseline and the age of 4 years. RESULTS: No statistically significant differences in MS colonisation were disclosed between the test and control groups at baseline or any of the designated follow-ups. A statistically significant positive relationship was found between the maternal salivary MS levels and the colonisation of the children in the control group at 2.5 years, 3 years and 3.5 years (r=0.39, r=0.35; r=0.30; p<0.01, p<0.01 and p<0.05) but not in the xylitol tablet group (p<0.05). The mean caries prevalence was lower in the test group compared with the control group at 4 years of age (dmfs 0.38 +/-1.05 vs. 0.80 +/-2.60) but the difference was not statistically significant. CONCLUSION: The findings do not support a low-dose xylitol tablet program for caries prevention in preschool children.
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| 10. |
- Oscarson, Per, et al.
(författare)
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Influence of xylitol-containing tablets on mutans streptococci colonisation
- 2006
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Ingår i: European Archives of Paediatric Dentistry. ; 7:3, s. 142-147
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the effect of xylitol-containing tablets on mutans streptococci colonisation and caries development in preschool children. Study design: Randomised single-blind prospective design. Methods: The material consisted of 132 healthy 2-year-old children that were assigned to a xylitol tablet (test) group or a non-intervention control group. The test group was given 1-2 xylitol tablets (0.5-1g) per day during 1.5 years. Mutans streptococci enumeration was performed at baseline and semi-annually with a chair-side technique. Caries prevalence was scored at baseline and the age of 4 years. Results: No statistically significant differences in mutans streptococci colonisation were disclosed between the test and control groups at baseline or any of the designated follow-ups. A statistically significant positive relationship was found between the maternal salivary mutans streptococci levels and the colonisation of the children in the control group (r=0.35; p<0.05) but not in the xylitol tablet group. The mean caries prevalence was lower in the test group compared with the control group at 4 years of age (dmfs 0.38 ±1.05 vs. 0.80 ±2.60) but the difference was not statistically significant. Conclusion: The findings do not support a low-dose xylitol tablet program for caries prevention in preschool children.
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| 11. |
- Stecksen-Blicks, Christina, et al.
(författare)
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Caries risk profiles in two-year-old children from northern Sweden
- 2007
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Ingår i: Oral health & preventive dentistry. - New Malden, Surry : Quintessence. - 1602-1622. ; 5:3, s. 215-221
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate existing caries risk factors in preschool children and to illustrate their caries risk profiles graphically with aid of a computer-based program.Materials and Methods: All 2-year-old children from a small town in northern Sweden were invited and 87% (n = 125) accepted to participate. Data was collected with a questionnaire concerning the child’s normal diet and sugar consumption. Special care was taken to note the intake of sweet drinks and sugary between-meal products. Questions on general health and medication, toothbrushing frequency with parental help and use of fluorides were also included. The caries prevalence was recorded with mirror and probe and the level of oral mutans streptococci was enumerated with a chair-side technique. The obtained data were computerised in a risk assessment program (Cariogram) and a graphical profile of each child was constructed.Results: The caries prevalence was 6%, and 18% had detectable levels of oral mutans streptococci. The sugar consumption was strikingly high with 82% and 97% having ice cream and sweets once a week or more often. In 22% of the families, toothbrushing with parental help was not a daily routine. Of the children, 51% displayed a low chance (0–20%) of avoiding caries in the future. The frequency of sugar consumption was the most pertinent factor in the children’s caries risk profiles.Conclusions: Half of the subjects exhibited a low chance of avoiding caries in the near future and the strongest single factor was frequent sugar consumption. Thus efforts to limit and reduce the sugar intake in young children are important measures for primary caries prevention.
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| 12. |
- Stecksen-Blicks, Christina, et al.
(författare)
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Effect of xylitol and xylitol-fluoride lozenges on approximal caries development in high-caries-risk children
- 2008
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Ingår i: International Journal of Paediatric Dentistry. - Oxford : Blackwell Scientific Publications. - 0960-7439 .- 1365-263X. ; 18:3, s. 170-177
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the effect of xylitol- and xylitol/fluoride-containing lozenges on approximal caries development in young adolescents with high caries risk. Study design: A 2-year double-blind trial with two parallel arms and a nonrandomized reference group. Material and methods: One hundred and sixty healthy 10- to 12-year-old children with high caries risk were selected. After informed consent, they were randomly assigned into a xylitol and a xylitol/fluoride group. They were instructed to take two tablets three times a day (total xylitol and fluoride dose 2.5 g and 1.5 mg, respectively). The compliance was checked continuously and scored as good, fair, or poor. A reference no-tablet group was also selected (n = 70) for group comparison. The outcome measure was approximal caries incidence. Results: The dropout rate was 28%, and 41% exhibited a good compliance with the study protocol. No statistically significant differences in caries incidence could be found between the study groups (P > 0.05). Among a subgroup of children who demonstrated good compliance, the mean DeltaDMFSa value was significantly lower in the xylitol/fluoride group compared to the xylitol group, 1.0 +/- 2.3 vs. 3.3 +/- 4.6 (P < 0.05), while no difference could be displayed between any of the study groups and the reference group (P > 0.05). Conclusions: The results from this 2-year trial did not support a self-administered regimen of xylitol- or xylitol/fluoride-containing lozenges for the prevention of approximal caries in young adolescents with high caries risk.
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| 13. |
- Öhlund, Inger, 1954-, et al.
(författare)
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Diet intake and caries prevalence in four-year-old children living in a low-prevalence country.
- 2007
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Ingår i: Caries Research. - Basel : S. Karger AG. - 0008-6568 .- 1421-976X. ; 41:1, s. 26-33
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Tidskriftsartikel (refereegranskat)abstract
- Preventive measures have dramatically decreased the prevalence of dental caries in children. However, risk factors for the disease in children living in low-prevalence areas remain elusive. In the present study we evaluated associations between dental caries, saliva levels of mutans streptococci and lactobacilli, and diet with special emphasis on the intake of fermentable carbohydrates and dairy products in 4-year-old children living in an area where the overall caries prevalence was low. Dietary intake was recorded in 234 infants as part of the Study of Infant Nutrition in Umea, Sweden (SINUS). Of these the parents of 124 children gave consent to participate in a follow-up at 4 years of age. Dietary intake, height and weight, dental caries, oral hygiene, including tooth brushing habits, presence of plaque and gingival inflammation, fluoride habits and numbers of mutans streptococci and lactobacilli in saliva were recorded. Using multivariate stepwise logistic regression, caries experience was negatively associated with intake frequency of cheese (OR = 0.67; 95% CI = 0.44-0.98) and positively associated with the salivary level of mutans streptococci (OR = 1.57; 95% CI = 1.21-2.03). Caries experience was not correlated with intake frequency or amounts of carbohydrate-containing foods, with any other particular food, or with daily intake of energy, carbohydrate or any other macro- or micronutrient. We conclude that cheese intake may have a caries-protective effect in childhood populations where the overall caries prevalence and caries experience are low and the children are regularly exposed to fluoride from toothpaste.
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