 |
| 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) 22211678 | Vuokko Anttonen/2011 | 306 children with primary teeth | Double-blinded randomized controlled trial | | Key results | Survival 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) 19581542 | Milgrom/2009 | 108 children of the Marshall Islands | Double-blind randomized controlled trial | | Key results | Three 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: |
04/18/2012 |
| 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
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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