The aim of this study was to assess the use of xylitol chewing gum on dental plaque, saliva flow and saliva buffer capacity in youngster. Fifteen dental students were randomly assigned to a study and control group, the first received a xylitol chewing gum while the second a placebo chewing gum, provided 4 times per day for 21 days. Dental plaque, saliva flow and saliva ph were measures at day 0, 7, 14 and 21st. The use of xylitol chewing gum helps to reduce dental plaque, increase saliva flow and ph, like the placebo chewing gum, but a larger study is needed to properly assess if xylitol has an additional benefit on the studied variables. Over the last years, preventive dentistry has become an important issue among professionals, especially by the development of new methods to prevent plaque.
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The aim of this study was to assess the use of xylitol chewing gum on dental plaque, saliva flow and saliva buffer capacity in youngster. Fifteen dental students were randomly assigned to a study and control group, the first received a xylitol chewing gum while the second a placebo chewing gum, provided 4 times per day for 21 days.
Dental plaque, saliva flow and saliva ph were measures at day 0, 7, 14 and 21st. The use of xylitol chewing gum helps to reduce dental plaque, increase saliva flow and ph, like the placebo chewing gum, but a larger study is needed to properly assess if xylitol has an additional benefit on the studied variables. Over the last years, preventive dentistry has become an important issue among professionals, especially by the development of new methods to prevent plaque.
Among them, the use of chewing gum containing sugar alcohols is being practiced more often Ribelles Llop et al. All sugar alcohols, like xylitol, sorbitol and mannitol, have been tested for fermentation by oral bacteria and can be classified as hypo- or non-acidogenic, therefore low or non-cariogenic van Loveren, Anderson stated that xylitol produces an unfavorable environment for the Streptococcus mutans, reducing the adherence to oral tissues therefore affecting its capacity to form dental plaque.
Other authors concluded that xylitol penetrates into the bacterial cytoplasm, interferes with glycolysis and results in cell growth inhibition van Loveren; Fraga et al. This anti caries property may also be related to the fact that chewing gum produces a stimulation and increment in saliva production, therefore increasing the buffer capacity of it as well Ribelles Llop; Fraga et al.
The use of chewing gum and lozenges for oral care purposes is a practical method and easy to disseminate in the community Borhan-Mojabi et al. Holgerson et al. With all this Information gathered, children would benefit significantly In reducing dental plaque formation if xylitol chewing gum is used, but there is few information about its use in young patients.
The objective of the study was to assess the use of xylitol chewing gum on dental plaque, saliva flow and saliva buffer capacity in Chilean youngsters. Fifteen subjects, out of 61, voluntarily participated in this simple blind, randomized pilot study.
Subjects eligible for study inclusion had to be studying fifth year of dentistry at the Universidad Del Desarrollo and consented to study acceptance. A random assignment was performed to build the study and control group. Dental plaque was measured using the O'Leary index, which indicates the proportion of stained dental surfaces. After that, chewing gums were provided according a protocol described by Manton et al.
The chewing gums were provided in an unlabeled plastic bag. All subjects attended a control at days 7, 14, and They were asked not to change the usual diet or the hygiene habits during such period. Using a disposable test tube, 1 ml of saliva was placed in a different tube to be mixed with 0. All the procedures followed the ethical norms set by the Helsinki declaration and sanitary protocols. To determine significant differences through the time in the O'Leary index, saliva flow and saliva buffer capacity, a repetitive measures analysis was performed.
Six female and nine male participated in this randomized pilot study. All the subjects attended the control sessions and comply with the study protocols.
Table I shows the general data. The O'Leary index average was reduced from The saliva flow Fig. Table I. O'Leary index, saliva flow and saliva buffer pH initial and final.
Treatment Tx 1 chewing gum, and treatment 0 to sorbitol chewing gum. The subjects Ss average age was corresponds to xylitol 23 years. Initial saliva pH average of study and control group at days 0, 7, 14 and 21st. Final saliva pH average of study and control group at days 0, 7, 14 and 21st. The purpose of the study was to assess the use of xylitol chewing gum on dental plaque, saliva flow and saliva buffer capacity in Chilean youngsters.
The study confirms what other researchers have shown related to the effect of xylitol chewing gum in reducing plaque Anderson; Borhan-Mojabi et al. Dental plaque was reduced in the study and control group between day 0 and 21st. Besides the effect of the use of xylitol and the mechanical action of chewing gum on the dental plaque the researchers believe there was a personal interest of each participant to demonstrate a better O'Leary index since they were dental students.
It was noticeable the interest of each participant to know the index record at each control and compare it with the previous. The researchers believe they changed the hygiene behavior even when they were told to maintain their usual habit and unconsciously they placed more attention to toothbrushing.
Like the study of Holgerson et al. Saliva flow increased in both groups but it was greater in the control group. This could be an indication that sorbitol is more effective in producing saliva flow than xylitol. This differs from the study of Manton et al. Future studies should include an additional group consuming a chewing gum without alcoholic sugar to test if the increment of saliva flow is due to the sugar alcohols of only due to the act of chewing Machiulskiene et al.
The saliva ph increased in both groups and no significant differences were found among them. This may indicate that buffer capacity is favored by chewing process itself Machiulskiene et al.
It can be concluded that the use of xylitol chewing gum associated to oral hygiene could be a good prevention scheme to control dental plaque and reduce the risk of caries, in youngsters and children Borhan-Mojabi et al.
However, xylitol can be administered by other vehicles like sweets, which have a good acceptance by children and have a similar effect than chewing gum Antonio et al. This study could also be used as an initial work to test a greater sample of individuals, using sugar free chewing gums and exploring the existence of significant differences among the groups studied.
Finally, according to the results, it is concluded that the use of xylitol chewing gum reduces dental plaque, increases saliva flow and reinforces saliva buffer capacity; but no significant differences were found when compared to the control group. Anderson, M. Chlorhexidine and xylitol gum in caries prevention. Care Dentist. Antonio, A. Caries preventive effects of xylitol-based candies and lozenges: a systematic review.
Public Health Dent. Borhan Mojabi, K. Effect of chewing xylitol gum on plaque accumulation on teeth surfaces. Sci, 8 4 , Fraga, C. Oral Res. Holgerson, P. Dental plaque formation and salivary mutans streptococci in schoolchildren after use of xylitol- containing chewing gum.
Machiulskiene, V. Caries preventive effect of sugar-substituted chewing gum. Community Dent. Oral Epidemiol. Manton, D. Remineralization of enamel subsurface lesions in situ by the use of three commercially available sugar-free gums. Ribelles Llop, M. Effects of xylitol chewing gum on salivary flow rate, pH, buffering capacity and presence of Streptococcus mutans in saliva. Caries Res. Wennerholm, K. Effect of xylitol and sorbitol in chewing-gums on mutans streptococci, plaque pH and mineral loss of enamel.
Email: manuelvelasquez udd. Received: Accepted: Servicios Personalizados Revista.
2003, Número 1
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