Maarit Rekola

Turku sugar studies XVIII: Incidence of dental caries in relation to 1-year consumption of xylitol chewing gum

A longitudinal study was carried out in order to evaluate the caries incidence as affected by partial substitution of dietary sucrose (S) with xylitol (X), the effects of S- or X-containing chewing gums being compared during one year. The material comprised initially 102 young adults, predominantly dental and medical students, divided randomly into S- and X-groups. During the study 2 subjects were excluded, one due to lack of cooperation, the other not being allowed to enter the assigned S-group due to excessive caries prevalence. The subjects consumed 4.0 chewing gums per day in the S-group and 4.5 in the X-group. The frequency of sucrose intake was 4.2 times per day in the S-group, and 4.9 in the X-group. The caries incidence, assessed independently by clinical and radiographical means, expressed as the mean increment of decayed, missed and filled tooth surfaces, was 2.92 in the S-group, and --1.04 in the X-group. The corresponding values, when considering additionally the secondary caries reverals, were 3.76 in the S-group, and 0.33 in the X-group. The caries incidence was also expressed in combined quantitative and qualitative terms by considering in addition to the above parameters, also the changes in lesion size. The caries activity index thus calculated was 4.96 in the S-group, and 0.88 in the X-group. The results show a profound difference in the caries increment rate between the two experimental groups. The findings clearly indicate a therapeutic, caries inhibitory effect of xylitol.

In vivo acid production from medicines in syrup form.

Syrup-form medicines have been shown to cause dental caries in chronically sick children. The acid production of 10 syrupy medicines sweetened with sucrose, fructose, sorbitol, xylitol and saccharin or with a combination of these was tested. The subjects consisted of 7 dental students with low buffering capacity and high levels of Streptococcus mutans. The subjects rinsed with sugar-based liquid medicines for 1 min, after which the plaque pH was measured with a Beetrode touch electrode at approximal sites until 40 min after the rinsing. The minimum pH, the delta pH, and the time under pH 5.7 were measured. From the results it can be concluded that xylitol, xylitol-saccharin and xylitol-sorbitol combinations used as sweeteners in syrup medicines are nonacidogenic, sorbitol is hypoacidogenic, and sucrose and fructose are highly acidogenic.

Approximal Caries Development during 2-Year Total Substitution of Dietary Sucrose with Xylitol

The purpose of the present study was to quantify changes in the size of approximal carious lesions in order to find out the effect of sucrose or xylitol consumption on the rate of caries progression. The projections of approximal lesions on bite-wing radiographs were analysed planimetrically. Evaluation of the data showed a highly significant increase of approximal lesion size in the sucrose group; in the xylitol group lesion sizes remained unchanged. The corresponding difference in lesion size between the xylitol and sucrose groups after the 2-year study period was highly significant (p

Long-Term Effects of Syrup Medications for Recurrent Otitis media on the Dental Health of 6- to 8-Year-Old Children

The dental response to repeated antimicrobial and antihistamine medications was studied by comparing the dental health of 64 adenoidectomized children 5 years after surgery to that of 212 untreated controls. Annual dental recordings starting from the age of 3 years were obtained from health care centers. As expected, the proportion of children who had several (> or = 11) syrup medications was significantly higher (p < 0.001) in the adenoidectomized than in the control group. Sucrose-containing syrup medications were prescribed twice as often for the children of the adenoidectomized as for the control group (p < 0.001). However, the average amount of antimicrobial syrup medications prescribed was 19.2 +/- (SD) 13.0 per child for the adenoidectomized as compared to 8.5 +/- 8.3 for the control children (p < 0.001). The dmf value of the adenoidectomized children at the age of 3 years (mean +/- SEM: 0.5 +/- 0.1) was significantly (p < 0.005) lower than that of the controls (1.1 +/- 0.2). The difference was still significant (p < 0.01) at the age of 4 years, but disappeared thereafter. In conclusion, the antibacterial syrup medication seemed to be associated with a significant decline in dental caries at first. The simultaneous use of antihistamines was, however, thought to delay normal tooth maturation, so that after discontinuation of the antimicrobial medication, accelerated formation of new carious lesions took place.

Changes in buccal white spots during 2-year consumption of dietary sucrose or xylitol

The purpose of the present study was to quantitate changes in buccal white-spot lesions during sucrose and xylitol consumption. Standardized color macrophotographs of white-spot lesions were taken 7 months after the beginning and at the end of the 2-year study. The quantification was based on the planimetry of these photographs. The area of white-spot lesions decreased in the xylitol group in absolute values (p less than 0.01) and in percentages (p less than 0.001). In the sucrose group the area of white-spot lesions increased in absolute values (p less than 0.05) and in percentages (p less than 0.01) during the 17-month observation period. The stereomicroscopic evaluation gave a similar result; the ordinally quantified caries scores (CIS) increased in the sucrose group and decreased in the xylitol group, and the difference between the groups was highly significant (p less than 0.001). Thus the present findings showed that xylitol consumption caused remineralization of incipient white-spot lesions on buccal surfaces.

Turku sugar studies XXI: Xylitol-, sorbitol-, fructose- and sucrose-induced physico-chemical changes in saliva

The aim was to study eventual physico-chemical changes occurring in whole saliva due to sweetened and unsweetened stimulators. The assay was carried out in 10 female subjects with regard to changes of pH, buffering capacity and electrolytes in saliva as influenced by chewing of fructose, sucrose, sorbitol and xylitol gum, gum base and paraffin. The flow rate of saliva was measured in relation to use of xylitol and sucrose chewing gum and unsweetened gum base. These sweeteners increased significantly the salivary flow rate in comparison to the unsweetened gum base. Generally, xylitol and sorbitol on one hand, and sucrose and fructose on the other, behaved in an almost similar way. Increased buffering capacity and elevation of pH saliva was found in the presence of the polyols tested.

Weekly variation in the acidogenic response of plaque

The fall in plaque pH after sucrose rinsing was monitored once a week for 9 (8) weeks in succession, to measure the weekly variation in the magnitude of pH drop in the same subject. The plaque pH was measured with a touch electrode placed interdentally between the first and second premolar. The subject rinsed his mouth with 10% (w/v) sucrose solution, and the plaque pH was thereafter monitored for 40 min. The minimum plaque pH (pHmin), the change between starting and minimum pH (delta pH), and the resting pH value were determined. The pH values of the maxilla and mandible differed. No difference was seen between the right and left sides. As a rule, intraindividual variation was lower in terms of pHmin values than in terms of delta pH values. It was concluded that pH assessment with the touch electrode appeared to show a small weekly variation intraindividually and to be sensitive enough to test the acidogenic potential of foods, but only in the maxilla.

Xylitol Binding in Human Dental Plaque

Human dental plaque and whole saliva sediment were tested for their ability to bind 14C-labeled sucrose, fructose, glucose, sorbitol, and xylitol. Sucrose, glucose, sorbitol, and fructose were bound to all materials tested, in this decreasing order. The binding was strongest with plaque given a five-second ultrasonic shock, and lowest with salivary sediment. Xylitol was only insignificantly bound, indicating that plaque microorganisms possess specific recognition sites for xylitol to a very restricted extent.

Comparison Between Sucrose and Lactulose in a Suspended Salivary System

Lactulose (1,4-f3-gal meric form of lacto Dairy Sci 44: 1375-13 in the small intestin an insignificant exte the colon convert it results in a drop o increase of the osn Gut 11: 1043-1048, BOSKI, Biochim Biop RUTTHOFF ET AL, Nai MAN ET AL, Klin Wo Lactulose has been u increased defecation NH3-NH4+ from tiss the effects of lactul4 system. Human whole sali paraffin stimulation persons (20 to 40 yea in the morning afte: hygiene. The sampl

Quantification of incipient approximal caries during fructose and sucrose consumption

The purpose of this study was to quantify the changes in the size of approximal caries lesions during regular sucrose or fructose consumption. The material consisted of the subjects in the 2-year Turku Sugar Study, with an observation period of 19 months. Planimetric evaluation showed a highly significant increase in the approximal lesions of both groups. There was no difference between the groups in the rate of the increase in the sizes of the lesions. Initially, small lesions increased at a higher rate than initially large lesions in both groups. It is concluded that a fructose diet enhances the progression of carious lesions as much as a sucrose diet.