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Milk Sweetened with Xylitol: A Proof-of-Principle Caries Prevention Randomized Clinical Trial

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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.
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Keywords: CARIES PREVENTION; CHILDREN; MUTANS STREPTOCOCCI; RANDOMIZED CLINICAL TRIAL; SCHOOL-BASED INTERVENTIONS; XYLITOL

Document Type: Research Article

Affiliations: 1: Associate professor, Department of Oral Health Sciences, University of Washington, Seattle, Wash., USA;, Email: [email protected] 2: Professor, Department of Pediatric Dentistry, Universidad Alas Peruanas, Arequipa, Perú; 3: Professor, Department of Pediatric Dentistry, Universidad Católica de Santa Maria, Arequipa, Perú; 4: Affiliate assistant professor, Department of Oral Health Sciences, University of Washington, and a professor, Department of Stomatology for Children and Adolescents, Universidad Peruana Cayetano Heredia, Lima, Peru. 5: Professor, Department of Oral Health Sciences, University of Washington, Seattle, Wash., USA. 6: Professor, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Wash., USA. 7: Assistant professor, Department of Stomatology for Children and Adolescents, Universidad Peruana Cayetano Heredia, Lima, Peru. 8: Research associate professor, Department of Oral Health Sciences, University of Washington, Seattle, Wash., USA.

Publication date: 2016-09-01

More about this publication?
  • Acquired after the merger between the American Society of Dentistry for Children and the American Academy of Pediatric Dentistry in 2002, the Journal of Dentistry for Children (JDC) is an internationally renowned journal whose publishing dates back to 1934. Published three times a year, JDC promotes the practice, education and research specifically related to the specialty of pediatric dentistry. It covers a wide range of topics related to the clinical care of children, from clinical techniques of daily importance to the practitioner, to studies on child behavior and growth and development. JDC also provides information on the physical, psychological and emotional conditions of children as they relate to and affect their dental health.
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