Title

Fluoride Is More Effective Than Xylitol At Preventing Caries

Clinical Question

In patients susceptible to dental caries, is fluoride more effective than xylitol at preventing caries?

Clinical Bottom Line

Fluoride is better than xylitol at preventing caries, but fluoride with xylitol is better than fluoride alone.

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
21712620	Rochel/2011	20 bovine samples	In Vitro Study of Bovine Teeth
Key results	Fluoride performed better at preventing enamel erosion than xylitol, but fluoride plus xylitol performed better than either component alone (P=.008).
21940519	Takahashi/2011	7 patients	Randomized Control Trials
Key results	Fluoride decreased acid production in vivo by inhibiting bacterial enolase. Xylitol did not affect acid production. P=.017
18341562	Stecksen-Blicks/2008	160 high caries risk 10-12 year old patients	Randomized Controlled Trials
Key results	Using lozenges with xylitol or both xylitol and fluoride did not affect the development of caries in high caries risk children. Also, there was no significant difference between the two groups (p>.05).

Evidence Search

("Fluorides"[Mesh]) AND "Xylitol"[Mesh]

Comments on
The Evidence

The studies listed seemed to have differing results in terms of effectiveness of fluoride versus xylitol. While it was shown that fluoride is better than xylitol at decreasing acid production, neither alone nor together did fluoride and xylitol reduce caries when given in a lozenge.

Applicability

These studies are representative of the patients one would see in a general practice. One study focused on bovine enamel in vitro but was treated with artificial saliva and should still be applicable.

Specialty

(Public Health) (Dental Hygiene)

Keywords

fluoride xylitol

ID#

2253

Date of submission

04/25/2012

E-mail

wallach@livemail.uthscsa.edu

Author

David Wallach

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Suman Challa, BDS, MS

Faculty mentor e-mail

Challas@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?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

None available