Clinical results after 12 months from a study of the incidence and progression of dental caries in relation to consumption of chewing-gum containing xylitol in school preventive programs.

This study was designed to evaluate the effect of chewing-gum containing xylitol on the incidence and the progression of dental caries. A sample of 433 children, aged 8 and 9 years, of low socio-economic status and high caries rate, was divided into two experimental groups (15% or 65% xylitol chewing-gum distributed three times a day at school) and one control group (without chewing-gum). The three groups were exposed to the same basic preventive program. Children who chewed gum had a significantly smaller DMF(S) increment over a 12-month period than did the control group. The former had increments of 1.58 surfaces, compared with 3.28 for the latter. No statistically significant difference, however, was demonstrated between the two experimental groups. The net progression of decay (progressions-reversals) showed a significant difference between the two experimental groups and the control group. In addition, 65% xylitol chewing-gum produced better results than did that containing 15% xylitol, suggesting a dose-response relationship. Chewing xylitol gum had a beneficial effect on the caries process for all types of tooth surfaces, but chewing gum with a higher xylitol content had an additional positive effect on buccolingual surfaces. A questionnaire asking the participants about stomach pain indicated that there was no difference between the experimental and control groups. The feasibility of such a preventive measure has been demonstrated by the excellent level of participation of both children and teachers. This activity could easily be integrated into existing preventive public health programs.