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The caries‐preventive effect of xylitol/maltitol and erythritol/maltitol lozenges: results of a double‐blinded, cluster‐randomized clinical trial in an area of natural fluoridation
Author(s) -
LENKKERI AIJAMAARIA HIETALA,
PIENIHÄKKINEN KAISU,
HURME SAIJA,
ALANEN PENTTI
Publication year - 2012
Publication title -
international journal of paediatric dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.183
H-Index - 62
eISSN - 1365-263X
pISSN - 0960-7439
DOI - 10.1111/j.1365-263x.2011.01182.x
Subject(s) - maltitol , xylitol , erythritol , medicine , dentistry , gingivitis , food science , chemistry , sugar , fermentation
International Journal of Paediatric Dentistry 2012; 22: 180–190 Objective. Xylitol studies suggest caries reductions in the order of 50%. Based on animal/microbial studies, erythritol potentially has caries‐preventive properties. However, clinical studies are required to confirm this.The aim of the study was to investigate the additional caries‐preventive effect of xylitol/maltitol and erythritol/maltitol lozenges delivered at school, relative to controls receiving comprehensive prevention, in a low‐caries prevalence population. Methods. A 4‐year, cluster‐randomized, double‐blinded clinical trial. Five hundred and seventy‐nine 10‐year‐old consenting subjects from 21 schools were randomly assigned to one of five groups. Four groups used the lozenges on school days, in three teacher‐supervised sessions daily, over 1 or 2 years. The daily amount was 4.7 g/4.6 g for xylitol/maltitol and 4.5 g/4.2 g for erythritol/maltitol. The groups received free examinations and care in the public health centre. Four hundred and ninety‐six children were analysed. The main outcome measure was dentin caries increment based on a clinical examination at 4 years since the start. The groups were compared in relation to the increment using hierarchical logistic regression to adjust for potential clustering. Results. Use of xylitol/maltitol or erythritol/maltitol lozenges did not result in caries reduction. A strong relationship between baseline caries prevalence and the 4‐year increment was observed (OR = 7.38; 95% CI: 3.78–14.41). Conclusions. The results suggest that in relatively low‐caries conditions the school‐based use of xylitol/maltitol or erythritol/maltitol lozenges would not have additional caries‐preventive effect when compared with comprehensive prevention.