Donald L Chi1, Graciela Zegarra2, Elsa C Vasquez Huerta3, Jorge L Castillo4, Peter Milgrom5, Marilyn C Roberts6, Ailin R Cabrera-Matta7, Ana P Merino7. 1. Department of Oral Health Sciences, University of Washington, Seattle, Wash., USA. dchi@uw.edu. 2. Department of Pediatric Dentistry, Universidad Alas Peruanas, Arequipa, Perú. 3. Department of Pediatric Dentistry, Universidad Católica de Santa Maria, Arequipa, Perú. 4. Department of Oral Health Sciences, University of Washington, Seattle, Wash., USA; Department of Stomatology for Children and Adolescents, Universidad Peruana Cayetano Heredia, Lima, Peru. 5. Department of Oral Health Sciences, University of Washington, Seattle, Wash., USA. 6. Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Wash., USA. 7. Department of Stomatology for Children and Adolescents, Universidad Peruana Cayetano Heredia, Lima, Peru.
Abstract
PURPOSE: To evaluate the efficacy of xylitol-sweetened milk as a caries-preventive strategy. METHODS: In this nine-month prospective proof-of-principle trial, Peruvian schoolchildren were randomized to one of five different milk groups: (1) eight g of xylitol per 200 mL milk once per day; (2) four g of xylitol per 100 mL milk twice per day; (3) eight g of sorbitol per 200 mL milk once per day; (4) four g of sorbitol per 100 mL milk twice per day; or (5) eight g of sucrose per 200 mL milk once per day. The primary outcome was plaque mutans streptococci (MS) at nine months. A secondary outcome was caries incidence. We hypothesized that children in the xylitol groups would have a greater MS decline and lower caries incidence. RESULTS:One hundred fifty-three children were randomized in the intent-to-treat analyses. Children receiving xylitol had a greater decline in MS than children receiving sucrose (P=0.02) but were not different from children receiving sorbitol (P=0.07). Dental caries incidence for xylitol once per day or twice per day was 5.3±3.4 and 4.3±4.0 surfaces, respectively, compared to sorbitol once per day, sorbitol twice per day, or sucrose (4.1±2.8, 3.7±4.2, and 3.2±3.4 surfaces, respectively). There were no differences in caries incidence between xylitol and sucrose (rate ratio [RR] = 1.51; 95 percent confidence interval [CI] = 0.88, 2.59; P=0.13) or between xylitol and sorbitol (RR = 1.28; 95 percent CI = 0.90, 1.83; P=0.16). CONCLUSION:Xylitol-sweetened milk significantly reduced mutans streptococci levels compared to sucrose-sweetened milk, but differences in caries incidence were not detected.
RCT Entities:
PURPOSE: To evaluate the efficacy of xylitol-sweetened milk as a caries-preventive strategy. METHODS: In this nine-month prospective proof-of-principle trial, Peruvian schoolchildren were randomized to one of five different milk groups: (1) eight g of xylitol per 200 mL milk once per day; (2) four g of xylitol per 100 mL milk twice per day; (3) eight g of sorbitol per 200 mL milk once per day; (4) four g of sorbitol per 100 mL milk twice per day; or (5) eight g of sucrose per 200 mL milk once per day. The primary outcome was plaque mutans streptococci (MS) at nine months. A secondary outcome was caries incidence. We hypothesized that children in the xylitol groups would have a greater MS decline and lower caries incidence. RESULTS: One hundred fifty-three children were randomized in the intent-to-treat analyses. Children receiving xylitol had a greater decline in MS than children receiving sucrose (P=0.02) but were not different from children receiving sorbitol (P=0.07). Dental caries incidence for xylitol once per day or twice per day was 5.3±3.4 and 4.3±4.0 surfaces, respectively, compared to sorbitol once per day, sorbitol twice per day, or sucrose (4.1±2.8, 3.7±4.2, and 3.2±3.4 surfaces, respectively). There were no differences in caries incidence between xylitol and sucrose (rate ratio [RR] = 1.51; 95 percent confidence interval [CI] = 0.88, 2.59; P=0.13) or between xylitol and sorbitol (RR = 1.28; 95 percent CI = 0.90, 1.83; P=0.16). CONCLUSION:Xylitol-sweetened milk significantly reduced mutans streptococci levels compared to sucrose-sweetened milk, but differences in caries incidence were not detected.
Authors: Peter von Philipsborn; Jan M Stratil; Jacob Burns; Laura K Busert; Lisa M Pfadenhauer; Stephanie Polus; Christina Holzapfel; Hans Hauner; Eva Rehfuess Journal: Cochrane Database Syst Rev Date: 2019-06-12