RESUMO
Habitual xylitol gum-chewing may have a long-term preventive effect by reducing the caries risk for several years after the habitual chewing has ended. The goal of this report was (1) to determine if sorbitol and sorbitol/xylitol mixture provide a long-term benefit, and (2) to determine which teeth benefit most from two-year habitual gum-chewing - those erupting before, during, or after habitual gum-chewing. Children, on average 6 years old, chewing gums sweetened with xylitol, sorbitol, or xylitol/sorbitol mixture. There was a "no gum" control group. Five years after the two-year program of habitual gum-chewing ended, 288 children were re-examined. Compared with the no-gum group, sorbitol gums had no significant long-term effect (relative risk (RR), 0.65; 95 percent confidence interval [c.i]. 0.39 to 1.07; p < 0.18). Xylitol gums and, to a lesser extent, xylitol/sorbitol gum had a long-term preventive effect. During the 5 years after habitual gum-chewing ended, xylitol gums reduced the caries risk 59 percent (RR, 0.41; 95 percent c.i., 0.23 to 0.75; p < 0.0034). Xylitol-sorbitol gums reduced the caries risk 44 percent (RR, 0.56; 95 percent c.i., 0.36 to 0.89; p < 0.02). The long-term caries risk reduction associated with xylitol strongly depended on when teeth erupted (p < 0.02). Teeth that erupted after 1 year of gum-chewing or after the two-year habitual gum use ended had long-term caries risk reduction of 93 percent (p < 0.0054) and 88 percent (p < 0.0004), respectively. Teeth that erupted before the gum-chewing started had no significant long-term prevention (p < 0.30). We concluded that for long-term caries-preventive effects to be maximized, habitual xylitol gum-chewing should be started at least one year before permanent teeth erupt.(AU)
Assuntos
Criança , Feminino , Humanos , Masculino , Goma de Mascar , Cárie Dentária/prevenção & controle , Belize/epidemiologia , Goma de Mascar/estatística & dados numéricos , Distribuição de Qui-Quadrado , Estudos de Coortes , Cárie Dentária/epidemiologia , Índice CPO , Incidência , Estudos Longitudinais , Risco , Sorbitol/uso terapêutico , Fatores de Tempo , Erupção Dentária , Xilitol/uso terapêuticoRESUMO
Several independent clinical trials carried out during the past 25 years have shown that the consumption of xylitol (a natural carbohydrate sweetener of the pentitol type), is associated with significant reduction in the incidence of dental caries in young and adult subjects. These results generated the current widespread use of xylitol-containing confectionery and oral hygiene products especially in Scandinavian countries, and also elsewhere in Europe, Canada and the United States, Asia and the Far East. The use of xylitol in caries control has been endorsed by several national Dental Associations including the Belize Medical and Dental Association.(AU)