Original Articles
Effect of polyol gums on dental plaque in orthodontic patients

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Abstract

Sixty 11- to 15-year-old children wearing fixed orthodontic appliances were given chewing gums containing polyol for daily use after meals and snacks, to study whether the chewing of gums that contained slowly fermentable polyols (xylitol and sorbitol) affects the amount of dental plaque and the number of mutans streptococci present in plaque and saliva. The 60 subjects were randomly divided into four groups, each of which was provided with a supply of 1.35 gm pellet-shaped gums for a period of 1 month, as follows: (1) xylitol; (2) sorbitol; (3) xylitol-sorbitol mixture I (3:2); and (4) xylitol-sorbitol mixture 11 (4:1). In each group, two pellets with a total initial gum mass of 2.7 gm (maximum polyol dose per day: 10.5 gm), were used six times a day. The fresh and dry weight of dental plaque, collected at baseline and 28 days later from incisors, canines, and premolars from the area between gingival margin and the bracket, reduced in all groups, but most significantly (by 43% to 47%) in children receiving xylitol gum. The plaque and saliva levels of mutans streptococci did not change in the sorbitol group, but was significantly (in most cases) reduced by 13% to 33% in groups that received gum containing xylitol. Provided that the quantity of dental plaque and the plaque and salivary levels of mutans streptococci can be regarded as risk factors in dental caries, these results suggest that regular use of polyol gum—and especially gum that contains xylitol as the predominant sweetener—can reduce the caries risk in young patients wearing fixed orthodontic appliances. (AM J ORTHOD DENTOFAC ORTHOP 1995;107:497-504.)

Section snippets

Subjects

The subjects of this study were 11- to 15-year-old orthodontic patients of The University of Michigan Dental School who wore fixed orthodontic appliances. On the initial interview with the children, it was ascertained that the participants were not diabetic, had no history of acute or chronic disease with potential oral manifestations, displayed no sensitization to oral hygiene products and flavoring agents, and had not used antibiotics within the last 2 weeks. None of the subjects had an

General observations

Neither the subjects nor their parents/guardians reported any adverse experiences as a result of the use of polyol gums. The subjects did not report any excessive or harmful sticking of the gum to orthodontic appliances. Gum chewing was not found to damage the orthodontic arches. No brackets and bands came loose. Before gum use, bleeding gingivae were observed in one subject who began to use xylitol-sorbitol mixture II. Four weeks later, bleeding gingivae were observed in one (but not in the

Discussion

This study investigated the impact of 1-month consumption of polyol gums on two properties of dental plaque that have been regarded as risk factors of dental caries: plaque quantity and oral levels of mutans streptococci. It is possible that gum chewing could significantly reduce caries risk in subjects who temporarily loose their ability to brush their teeth (after arm fracture and other accidents). The tooth areas from which plaque was collected were relatively accurately defined, i.e., the

Acknowledgements

We are grateful to Mrs. Inez Klein, Kitty Blatt, and Evelyn Blackburn for technical assistance. Mr. Sheldon Siegel, vice president, Research and Development, Leaf Group (Amsterdam, The Netherlands) and Mr. Sakari Taskinen, director, Development, Huhtamäki Oy Leaf, (Turku, Finland) are offered special thanks for providing the clinical supplies requested.

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