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Clin Oral Investig. 2013 Apr;17(3):785-91. doi: 10.1007/s00784-012-0774-5. Epub 2012 Jul 13.

Six months of high-dose xylitol in high-risk caries subjects--a 2-year randomised, clinical trial.

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Department of Surgery, Microsurgery, Medical Sciences, Dental School, University of Sassari, Viale San Pietro 43/C, 07100, Sassari, Italy.



The hypothesis was that the daily use of a high dose of a xylitol chewing gum for 6 months would reduce the increment of decayed permanent first molar surfaces (ΔD6S) in high-risk schoolchildren after 2 years.


In this randomised, clinical trial, 204 schoolchildren with a high caries risk were assigned to two experimental groups, xylitol and non-xylitol. Caries status, salivary mutans streptococci, and lactobacilli were re-evaluated 2 years later in 74 xylitol-treated and 83 non-xylitol-treated schoolchildren. Differences in mean ∆D6S between groups registered at baseline and at follow-up were evaluated using the nonparametric Mann-Whitney U test.


Outcome was the development of detectable carious lesions initial (D1-D2) and manifest (D3) in the permanent first molars. In the xylitol group, the difference in proportion of children with decayed first permanent molars at baseline and follow-up was 1.43% for manifest lesion and 2.86% for initial lesions; while in the non-xylitol group was 10.26% (p < 0.01) and 16.66% (p < 0.01), respectively. A statistically significant difference regarding means was also observed in the non-xylitol group: the ∆D6S for manifest lesion was 0.18 (p = 0.03) and 0.67 (p = 0.02) for initial lesion.


The use of a chewing gum containing a high dose of xylitol for a period of 6 months has been shown to produce a long-term effect on caries development in high caries-risk children.


A school-based preventive programme based on 6 months' administration of a high dose of xylitol via chewing gum proved to be efficacious in controlling caries increment in high-risk children.

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