ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Alcohol Based Sugar Helps Prevent Carious Lesions
Clinical Question In individuals with high caries susceptibility, does exchanging sucrose for alcohol-based sugar (Xylitol) reduce their caries incidence?
Clinical Bottom Line The evidence suggests that in the pediatric population with high caries susceptibility using alcohol-based sugar helps reduce caries development in primary teeth. In clinical trials Xylitol, a sugar alcohol, was used per treatment protocol. The general trend was a reduction in caries development. In conclusion more research is needed to include the effects of Xylitol on permanent dentition.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22211678Vuokko Anttonen/2011306 children with primary teethDouble-blinded randomized controlled trial
Key resultsSurvival of primary teeth was greater in the xylitol group compared to the sucrose group. Exposure to sucrose regularly within a two-month period is enough of a stimulant to induce dental caries. For the xylitol group, two months was not enough time to demonstrate the protecting effect of xylitol among low-risk children but the group did have a reduced caries experience. More research must be done to be more conclusive. The survival times of the maxillary and mandibular first molars were shorter in the sucrose group and had a P-value of P=0.01 & P<0.001, respectively. For the 2nd molars P<0.001 & P=0.001, respectively and for the upper incisors P<0.001. The difference in caries onset between sucrose and xylitol groups were not significant and had a P-value that varied from 0.63 to 0.94.
#2) 19581542Milgrom/2009108 children of the Marshall IslandsDouble-blind randomized controlled trial
Key resultsThree groups were studied where groups received xylitol twice a day, three times a day, or once a day with two sorbitol dosages. Fewer decayed teeth were found in the groups who were administered xylitol compared to the control group that received one xylitol in a smaller dosage. The two groups that received xylitol twice or three times a day had significantly less decayed teeth. The group that received xylitol twice had a relative risk of 0.30, a 95% confidence interval of 0.13 to 0.66, and a P-value of 0.003, and the group that received xylitol three times a day had a relative risk of 0.50, a 95% confidence interval of 0.26 to 0.96, and a p-value of 0.037. However, there was no statistical difference (P=0.22) between the xylitol being distributed either twice or three times a day in regards to the extent of caries prevention.
Evidence Search "Dental Caries"[Mesh] AND ("Sugar Alcohols"[Mesh] OR ("xylitol"[MeSH Terms] OR "xylitol"[All Fields]))
Comments on
The Evidence
Reference #22211678: randomized clinical trial with similar start in groups with greater than 80% completing the trial. Groups were treated the same with adequate follow-up. Trial was double-blind and recall bias unlikely. Cannot tell from the article if there was adequate compliance from participants. There were no competing interests in reference #19581542: randomized clinical trial with similar start in groups with greater than 80% completing the trial. Groups were treated the same with adequate follow-up. Trial was double-blind with adequate compliance and recall bias unlikely. There were no competing interests.
Applicability Applies to children who are at a higher risk of developing a carious lesion with treatment applied quite feasible. Treatment in general benefited all the applicants in prevention of caries. Treatment cannot harm the patient, but only benefit.
Specialty/Discipline (General Dentistry) (Pediatric Dentistry)
Keywords Dental Caries; Caries Prevention; Xylitol
ID# 2255
Date of submission: 04/18/2012spacer
E-mail banksd@livemail.uthscsa.edu
Author Diane P. Banks
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana S. Gross, MPH
Faculty mentor/Co-author e-mail GROSSG@uthscsa.edu
Basic Science Rationale
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