Clare Yates1, Brett Duane2. 1. Kent Community Health Foundation Trust, Faversham Kent. 2. Public Health England, County Hall North, Chart Way, Horsham, West Sussex, UK.
Abstract
DATA SOURCES: PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials databases and the ClinicalTrials.gov registry were searched with related articles'. Experts were contacted and a manual search of reference lists was undertaken. STUDY SELECTION: Randomised or quasi-randomised controlled trials that evaluated the maternal use of xylitol gum on Mutans Streptococci (MS) colonisation in infants. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers performed data extraction with a third reviewer asked to resolve any disagreements. Cochrane risk of bias tool was used to assess the quality of studies. Two reviewers independently appraised the methodological quality. The primary outcome measure was presence of MS in the saliva or plaque of infants, with the secondary outcome measure being occurrence of dental decay. RESULTS: 11 studies published between 2000 and 2012 involving a total of 601 patients were included. Sample sizes ranged from 60 to 195 and the daily dose of xylitol consumption ranged from 1.95g to 5.28g. Follow-up ranged from six months to 120 months. There was a significant difference between the two groups, with infants in the control group experiencing greater incidences of MS in their plaque or saliva. Risk ratios were 0.44 (95% CI: 0.08-2.40) at 6-9 months, 0.54 (95% CI: 0.39-0.73) at 12-18 months, 0.60 (95% CI: 0.34-1.08) at 24 months, 0.56 (95% CI: 0.40-0.79) at 36 months and 0.61 (95% CI: 0.48-0.76) at 60 months. Caries data could not be pooled. CONCLUSIONS: Xylitol consumption by mothers with high MS levels was associated with a significant reduction in the mother-to-child transmission of salivary MS. These findings are based on evidence that may have suffered from biases.
DATA SOURCES: PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials databases and the ClinicalTrials.gov registry were searched with related articles'. Experts were contacted and a manual search of reference lists was undertaken. STUDY SELECTION: Randomised or quasi-randomised controlled trials that evaluated the maternal use of xylitol gum on Mutans Streptococci (MS) colonisation in infants. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers performed data extraction with a third reviewer asked to resolve any disagreements. Cochrane risk of bias tool was used to assess the quality of studies. Two reviewers independently appraised the methodological quality. The primary outcome measure was presence of MS in the saliva or plaque of infants, with the secondary outcome measure being occurrence of dental decay. RESULTS: 11 studies published between 2000 and 2012 involving a total of 601 patients were included. Sample sizes ranged from 60 to 195 and the daily dose of xylitol consumption ranged from 1.95g to 5.28g. Follow-up ranged from six months to 120 months. There was a significant difference between the two groups, with infants in the control group experiencing greater incidences of MS in their plaque or saliva. Risk ratios were 0.44 (95% CI: 0.08-2.40) at 6-9 months, 0.54 (95% CI: 0.39-0.73) at 12-18 months, 0.60 (95% CI: 0.34-1.08) at 24 months, 0.56 (95% CI: 0.40-0.79) at 36 months and 0.61 (95% CI: 0.48-0.76) at 60 months. Caries data could not be pooled. CONCLUSIONS:Xylitol consumption by mothers with high MS levels was associated with a significant reduction in the mother-to-child transmission of salivary MS. These findings are based on evidence that may have suffered from biases.
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