Xylitol gum gets thumbs up from dental experts

Dental experts in the US are recommending sugarfree chewing gum as a means of fighting tooth decay in high risk patients.

A multi-disciplinary expert panel, convened by the American Dental Association (ADA) Council on Scientific Affairs, issued a report this month containing clinical recommendations that sugarfree chewing gum, lozenges and sweets, including xylitol or polyol combinations, and a prescription varnish with chlorhexidine and thymol could be beneficial in preventing cavities.

These it recommended as adjuncts to a comprehensive cavity prevention programme which includes the use of fluoride-containing products.

The panel noted in its report that these non-fluoride options could provide an extra benefit to prevent cavities in patients at high risk for developing cavities when used in addition to products such as toothpaste, dental sealants and varnishes that contain fluoride as well as water fluoridation and good eating habits.

The full report is available on the ADA’s Center for Evidence-Based Dentistry (EBD) website. The executive summary of the report entitled, Non-fluoride Caries Preventive Agents, is published in the September issue of The Journal for the American Dental Association and is available on the EBD website (http://jada.ada.org/content/142/9/1065.full.pdf).

The clinical recommendations from the expert panel were reviewed and approved by the ADA’s Council on Scientific Affairs.

The ADA recommends that clinicians determine a patient’s risk for developing cavities by conducting a caries risk assessment, which includes completing a caries risk assessment form that can be used as a communications tool with their patients.

Non-fluoride agents
In addition to a comprehensive cavity-prevention program which includes the use of fluoride, the scientific panel recommended that clinicians consider applying a mixture of cholrhexidine-thymol varnish to the teeth of high-risk adults and the elderly every three months to reduce cavities developing in the root of the tooth.

The panel encouraged clinicians to consider advising parents and caregivers of healthy children older than five years who are at higher risk for cavities to chew sugarfree polyol gum after meals for 10 to 20 minutes to prevent cavities.

A polyol is a low-calorie sweetener such as xylitol, sorbitol or mannitol, which is not broken down by the bacteria in the mouth and therefore does not contribute to tooth decay.

The panel also recommended that sucking xylitol-containing sugarfree lozenges or hard sweets after meals may reduce cavities in children.

The panel’s recommendations are based on a review of evidence from 71 published articles that described 50 randomised controlled trials and 15 non-randomised studies to assess the effectiveness of various nonfluoride agents in preventing cavities. 

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