G5 Article dissertation
Evaluation of xylitol use and bitewing radiographs among school-aged children in a low-caries level population
Authors: Hietala-LenkkeriAija-Maaria
Publisher: University of Turku
Publishing place: TURKU
Publication year: 2016
ISBN: ISBN 978-951-29-6626-4
eISBN: ISBN 978-951-29-6627-1
Web address : http://urn.fi/URN:ISBN:978-951-29-6627-1
Self-archived copy’s web address: https://www.doria.fi/handle/10024/125494
Abstract
The objective of the
present work was to study, in a low-caries level population, the
additional caries-preventive effect of xylitol/maltitol and
erythritol/maltitol lozenges delivered at school, in comparison with the
comprehensive routine prevention provided by the public dental health
care. Also the literature on xylitol, considering the caries level of
the population, as well as the in vitro mechanisms of action of xylitol
and erythritol were evaluated. Further, the additional value of bitewing
radiographic examination in the detection of caries was studied.
In a four-year, cluster-randomized, double-blinded clinical trial,
579 informed and consenting 10-year-olds were randomly assigned to
receive xylitol or erythritol lozenges (one or two years) in addition to
the comprehensive prevention, or to a control group receiving only
comprehensive prevention. In the cross-sectional study, 363 pairs of
radiographs obtained from these subjects at 14 years of age were
analyzed.
The use of the lozenges did not result in caries reduction. A strong
relationship between baseline caries level and the caries increment was
observed. The conducted systematic review revealed that
caries-preventive effect of xylitol was well shown in high-caries level
populations. Both xylitol and erythritol decreased the adherence of
polysaccharide-producing oral streptococci. Approximately half of the
subjects benefited from the radiographic examination.
In a population with low caries occurrence the size of the
caries-preventive effect of a polyol and the method required for
reliable caries detection according to the contemporary caries
management criteria seem to differ from those observed in a population
with a high caries level. The observations on erythritol call for
additional well-designed randomized clinical trials studying the
properties of erythritol in varying levels of caries occurrence.
It can be recommended that in public dental health care the
preventive methods used in addition to the comprehensive routine caries
prevention should be targeted at children with clinical signs of dental
caries or fillings.
The objective of the
present work was to study, in a low-caries level population, the
additional caries-preventive effect of xylitol/maltitol and
erythritol/maltitol lozenges delivered at school, in comparison with the
comprehensive routine prevention provided by the public dental health
care. Also the literature on xylitol, considering the caries level of
the population, as well as the in vitro mechanisms of action of xylitol
and erythritol were evaluated. Further, the additional value of bitewing
radiographic examination in the detection of caries was studied.
In a four-year, cluster-randomized, double-blinded clinical trial,
579 informed and consenting 10-year-olds were randomly assigned to
receive xylitol or erythritol lozenges (one or two years) in addition to
the comprehensive prevention, or to a control group receiving only
comprehensive prevention. In the cross-sectional study, 363 pairs of
radiographs obtained from these subjects at 14 years of age were
analyzed.
The use of the lozenges did not result in caries reduction. A strong
relationship between baseline caries level and the caries increment was
observed. The conducted systematic review revealed that
caries-preventive effect of xylitol was well shown in high-caries level
populations. Both xylitol and erythritol decreased the adherence of
polysaccharide-producing oral streptococci. Approximately half of the
subjects benefited from the radiographic examination.
In a population with low caries occurrence the size of the
caries-preventive effect of a polyol and the method required for
reliable caries detection according to the contemporary caries
management criteria seem to differ from those observed in a population
with a high caries level. The observations on erythritol call for
additional well-designed randomized clinical trials studying the
properties of erythritol in varying levels of caries occurrence.
It can be recommended that in public dental health care the
preventive methods used in addition to the comprehensive routine caries
prevention should be targeted at children with clinical signs of dental
caries or fillings.
UTU Research Portal