Xylitol Chewing Gums and Caries Rates: A 40-month Cohort Study
dc.contributor.author | Makinen, Kauko K. | en_US |
dc.contributor.author | Bennett, C. A. | en_US |
dc.contributor.author | Hujoel, Philippe P. | en_US |
dc.contributor.author | Isokangas, Pauli | en_US |
dc.contributor.author | Isotupa, Kauko P. | en_US |
dc.contributor.author | Pape, H. R. | en_US |
dc.contributor.author | Makinen, Pirkko-Liisa | en_US |
dc.date.accessioned | 2010-04-13T20:14:36Z | |
dc.date.available | 2010-04-13T20:14:36Z | |
dc.date.issued | 1995 | en_US |
dc.identifier.citation | Makinen, K.K.; Bennett, C.A.; Hujoel, P.P.; Isokangas, P.J.; Isotupa, K.P.; Pape, H.R.; Makinen, PL (1995). "Xylitol Chewing Gums and Caries Rates: A 40-month Cohort Study." Journal of Dental Research 12(74): 1904-1913. <http://hdl.handle.net/2027.42/68231> | en_US |
dc.identifier.issn | 0022-0345 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/68231 | |
dc.description.abstract | Dental caries is a pandemic infectious disease which can affect the quality of life and consumes considerable health care resources. The chewing of xylitol, sorbitol, and even sugar gum has been suggested to reduce caries rates. No clinical study has simultaneously investigated the effectiveness of these gums when compared with a group receiving no chewing gum. A 40-month double-blind cohort study on the relationship between the use of chewing gum and dental caries was performed in 1989-1993 in Belize, Central America. One thousand two hundred and seventy-seven subjects (mean age, 10.2 years) were assigned to nine treatment groups: one control group (no supervised gum use), four xylitol groups (range of supervised xylitol consumption: 4.3 to 9.0 g/day), two xylitol-sorbitol groups (range of supervised consumption of total polyols: 8.0 to 9.7 g/day), one sorbitol group (supervised consumption: 9.0 g/day), and one sucrose group (9.0 g/day). The gum use during school hours was supervised. Four calibrated dentists performed the caries registrations by means of a modified WHO procedure. The primary endpoint was the development of an unequivocal caries lesion on a non-cavitated tooth surface. Compared with the no-gum group, sucrose gum usage resulted in a marginal increase in the caries rate (relative risk, 1.20; 95% confidence interval, 0.96 to 1.49; p = 0.1128). Sorbitol gum significantly reduced caries rates (relative risk, 0.74; 95% confidence interval, 0.6 to 0.92; p = 0.0074). The four xylitol gums were most effective in reducing caries rates, the most effective agent being a 100% xylitol pellet gum (relative risk, 0.27; 95% confidence interval, 0.20 to 0.36; p = 0.0001). This gum was superior to any other gum (p < 0.01). The xylitol-sorbitol mixtures were less effective than xylitol, but they still reduced caries rates significantly compared with the no-gum group. DMFS analyses were consistent with these conclusions. The results suggest that systematic usage of polyol-based chewing gums reduces caries rates in young subjects, with xylitol gums being more effective than sorbitol gums. | en_US |
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dc.format.extent | 1331607 bytes | |
dc.format.mimetype | text/plain | |
dc.format.mimetype | application/pdf | |
dc.publisher | SAGE Publications | en_US |
dc.subject.other | Xylitol | en_US |
dc.subject.other | Sorbitol | en_US |
dc.subject.other | Sugar | en_US |
dc.subject.other | Chewing Gum | en_US |
dc.subject.other | Caries Increments | en_US |
dc.title | Xylitol Chewing Gums and Caries Rates: A 40-month Cohort Study | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Dentistry | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078 | en_US |
dc.contributor.affiliationum | Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078 | en_US |
dc.contributor.affiliationum | Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078 | en_US |
dc.contributor.affiliationother | Belize City Hospital, Belize City, Belize | en_US |
dc.contributor.affiliationother | Department of Dental Public Health Sciences, University of Washington, Seattle | en_US |
dc.contributor.affiliationother | Ylivieska Health Center, Ylivieska, Finland | en_US |
dc.contributor.affiliationother | Institute of Dentistry, University of Turku, Turku, Finland | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/68231/2/10.1177_00220345950740121501.pdf | |
dc.identifier.doi | 10.1177/00220345950740121501 | en_US |
dc.identifier.citedreference | American Dental Association (1992). The 1991 survey of dental practice. General characteristics of dentists. Chicago, IL. Anderson S, Auquier A, Hauck WW, Oakes D, Vandaele W, Weisberg HI (1980). In: Statistical methods for comparative studies: techniques for bias reduction. New York: Wiley. Belize Ministry of Finance-Central Statistical Office (1991). 1991 Population census. Central Statistical Office. Government Printery, Belmopan, Belize. | en_US |
dc.identifier.citedreference | Bennett CA (1989). Clinical national oral health survey (Knowledge, attitude and practice survey; KAP survey), Ministry of Health, Belize, Belmopan. | en_US |
dc.identifier.citedreference | Birkhed D. (1994). Cariologic aspects of xylitol and its use in chewing gum: A review. Acta Odontol Scand 52:116-127. | en_US |
dc.identifier.citedreference | Breslow NE, Day NE (1980). Fundamental measures of disease occurrence and association. In: Statistical methods in cancer research. Vol. 1. The analysis of case-control studies. Lyon, France: International Agency for Research on Cancer. | en_US |
dc.identifier.citedreference | Brunelle JA (1989). Dental caries of United States children. The national survey of caries in U.S. schoolchildren: 1986-1987.National survey and regional findings.Washington, DC:US Dept. of Health and Human Services. NIH Pub No 89-2247, pp. 1-337. | en_US |
dc.identifier.citedreference | Burner ST, Waldo DR, Mc Kusick DR (1992). National health expenditures projections through 2030. Health Care Finan Rev 14:1-29. | en_US |
dc.identifier.citedreference | Burt BA (1986). Community-based methods for preventing dental caries and periodontal disease. In: Systematized prevention of oral disease: theory and practice. Granath L, Mc Hugh WD, editors. Boca Raton, FL: CRC Press, pp. 145-160. | en_US |
dc.identifier.citedreference | Charbeneau GT (1988). In: Principles and practice of operative dentistry. 3rd ed. Philadelphia: Lea and Febiger, pp. 26,27. Driscoll WS, Nowjack-Raymer R, Heifetz SB, Li S-H, Selwitz RH (1990). Evaluation of the comparative effectiveness of fluoride mouthrinsing, fluoride tablets, and both procedures in combination. Interim findings after five years. J Publ Health Dent 50:13-17. | en_US |
dc.identifier.citedreference | Glass RL (1981). Effects on dental caries incidence of frequent ingestion of small amounts of sugars and stannous EDTA in chewing gum. Caries Res 15:256-262. | en_US |
dc.identifier.citedreference | Glinsmann WH, Irausquin H., Park YK (1986). Evaluation of health aspects of sugars contained in carbohydrate sweeteners. J Nutr 116(Suppl 11):S1-S216. | en_US |
dc.identifier.citedreference | Hujoel PP, Isokangas PJ, Tiekso J., Davis S., Lamont RJ, De Rouen TA, et al. (1994). A re-analysis of caries onset rates in a preventive trial using Poisson regression models. J Dent Res 73:573-579. Imfeld T. (1977). Evaluation of the cariogenicity of confectionery by intra-oral wire-telemetry. Helv Odont Acta 21:1-28. | en_US |
dc.identifier.citedreference | Ismail AI, Burt BA, Eklund SA (1984). The cariogenicity of soft drinks in the United States. J Am Dent Assoc 109: 241-245. Isokangas P, Alanen P, Tiekso J, Makinen KK (1988). Xylitol chewing gum in caries prevention: a field study in children. J Am Dent Assoc 117:315-320. | en_US |
dc.identifier.citedreference | Kandelman D., Gagnon G. (1990). A 24-month clinical study of the incidence and progression of dental caries in relation to consumption of chewing gum containing xylitol in school preventive programs. J Dent Res 69:1771-1775. | en_US |
dc.identifier.citedreference | Kandelman D., Bar A., Hefti A. (1988). Collaborative WHO xylitol field study in French Polynesia. I. Baseline prevalence and 32-month caries increment. Caries Res 22:55-62. | en_US |
dc.identifier.citedreference | Karim MR, Zeger SL (1988). GEE: A SAS macro for longitudinal data analysis. Technical report #674. Department of Biostatistics. Baltimore, MD: The Johns Hopkins University. | en_US |
dc.identifier.citedreference | Landis JR, Koch GG (1977). The measurement of observer agreement for categorical data. Biometrics 33:159-174. | en_US |
dc.identifier.citedreference | Liang KY, Zeger SL (1986). Longitudinal data analysis using generalized linear models. Biometrika 73:13-22. | en_US |
dc.identifier.citedreference | Licht FO (1993). Sugar and sweetener yearbook. World sugar statistics. London: International Sugar Organization; Rome: Food and Agriculture Organization. | en_US |
dc.identifier.citedreference | Lilienfeld DE, Stolley PD (1994). Foundations of epidemiology. 3rd ed. New York: Oxford University Press. | en_US |
dc.identifier.citedreference | Loesche WJ (1986). Role of Streptococcus mutans in human dental decay. Microbiol Rev 50:353-380. | en_US |
dc.identifier.citedreference | Louis TA (1988). General methods for analyzing repeated measures. Statistics Med 7:29-45. | en_US |
dc.identifier.citedreference | Maclure M. (1990). Multivariate refutation of aetiological hypotheses in non-experimental epidemiology. Int J Epidemiol 19:782-787. Makinen KK (1989). Latest dental studies on xylitol and mechanism of action of xylitol in caries limitation. In: Progress in sweeteners. Grenby TH, editor. London: | en_US |
dc.identifier.citedreference | Elsevier, pp. 331-362. | en_US |
dc.identifier.citedreference | Mandel ID (1970). Effects of dietary modifications on caries in humans. J Dent Res 49(Spec Iss):1201-1211. | en_US |
dc.identifier.citedreference | Mc Cullagh P, Nelder JA (1989). Generalized linear models. 2nd ed. London and New York: Chapman and Hall. | en_US |
dc.identifier.citedreference | Miller AJ, Brunelle JA, Carlos JP, Brown LJ, Loe H. (1987). Oral health of United States adults. The national survey of oral health in U.S. employed adults and seniors: 1985-1986 national findings. Washington, DC: US Dept. of Health and Human Services, NIH Pub No 87-2868, pp. 1-168. | en_US |
dc.identifier.citedreference | Moller IJ, Poulsen S. (1973). The effect of sorbitol-containing chewing gum on the incidence of dental caries, plaque and gingivitis, in Danish school children. Community Dent Oral Epidemiol 1:58-67. Newbrun E (1989). Cariology. 3rd ed. Chicago: Quintessence Publishing Company, pp. 248-252. | en_US |
dc.identifier.citedreference | Pape HR Jr, Makinen KK (1994). Verification and maintenance of dental explorer sharpness. Oper Dent 19:221-223. | en_US |
dc.identifier.citedreference | Radike AW (1972). Criteria for diagnosis of dental caries. In: Proceedings of the conference on the clinical testing of cariostatic agents. Chicago, IL: American Dental Association, p. 87. | en_US |
dc.identifier.citedreference | Rugg-Gunn AJ (1983). Diet and dental caries. In: Prevention of dental disease. Murray JJ, editor. Oxford: Oxford University Press, pp. 3-82. | en_US |
dc.identifier.citedreference | Scheinin A., Makinen KK, Tammisalo E., Rekola M. (1975). Incidence of dental caries in relation to 1-year consumption of xylitol chewing gum. Acta Odontol Scand 33(Suppl 70):307-316. Scheinin A., Bánóczy J., Szoke J., Esztari I., Pienihakkinen K., Scheinin U., et al. (1985 a). Collaborative WHO xylitol field studies in Hungary. I. Three-year caries activity in institutionalized children. Acta Odontol Scand 43:327-347. | en_US |
dc.identifier.citedreference | Scheinin A., Pienihakkinen K., Tiekso J., Bánóczy J., Szoke J., Esztari I., et al. (1985b). Collaborative WHO xylitol field studies in Hungary. VII. Two-year caries incidence in 976 institutionalized children. Acta Odontol Scand 43:381-387. | en_US |
dc.identifier.citedreference | Shaw L., Murray JJ (1975). Inter-examiner and intra-examiner reproducibility in clinical and radiographic diagnosis. Int Dent J 25:280-288. | en_US |
dc.identifier.citedreference | Sreebny LM (1982). Sugar and human dental caries. World Rev Nutr Diet 40:19-65. | en_US |
dc.identifier.citedreference | Stephan RM (1944). Intra-oral hydrogen-ion concentrations associated with dental caries activity. J Dent Res 23: 257-266. Stephen KW (1993). Caries in young populations-worldwide. In: Cariology for the nineties. Bowen WH, Tabak LA, editors. Rochester: University of Rochester Press, pp. 37-50. Sturdevant CM (1995). In: The art and science of operative dentistry. 3rd ed. St. Louis: Mosby, pp. 89-97,203, 295. | en_US |
dc.identifier.citedreference | Tanzer JM (1993). Sweeteners and dental caries. Some emerging issues. In: Cariology in the nineties. Bowen W, Tabak LA, editors. Rochester: University of Rochester Press, pp. 383-396. Tanzer JM (1995). Xylitol chewing gum and dental caries. Int Dent J 45(Suppl 1):65-76. | en_US |
dc.identifier.citedreference | Woodward M., Walker ARP (1994). Sugar consumption and dental caries, evidence from 90 countries. Br Dent J 176:297-302. World Health Organization (1979). A guide to oral health epidemiological investigations. Geneva: WHO. | en_US |
dc.identifier.citedreference | World Health Organization (1984). Technical report series 713: Prevention methods and programmes for oral diseases. Geneva: WHO. | en_US |
dc.identifier.citedreference | World Health Organization (1989). Dental caries levels at 12 years (mimeograph of data from global data bank). Geneva: WHO. | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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