To Determine the Effect of Chewing Gum Containing Xylitol and Sorbitol on Mutans Streptococci and Lactobacilli Count in Saliva, Plaque, and Gingival Health and to Compare the Efficacy of Chewing Gums

Swapnil Oza, Kreta Patel, Satish Bhosale, Ruchi Mitra, Rupam Gupta, Divya Choudhary, Swapnil Oza, Kreta Patel, Satish Bhosale, Ruchi Mitra, Rupam Gupta, Divya Choudhary

Abstract

Aims and objective: The aim of the study is to determine the effect of chewing gum containing xylitol and sorbitol on mutans streptococci and Lactobacilli count in saliva, plaque, and gingival health and to compare the efficacy of chewing gums.

Materials and methods: The study was designed as a double-blinded randomized uncontrolled clinical trial with two parallel arms. A total of 80 students consented and completed the study. The test group (X) received corresponding pellets with xylitol and the control group (S) was given pellets containing sorbitol and maltitol three times daily for 30 days. Clinical scoring and saliva samples were collected at three different intervals, at baseline, 15th, and 30th day of the study. The outcome measure was plaque index score, gingival index score, salivary mutans streptococci, and Lactobacilli counts. Data collected were analyzed using Statistical Package for the Social Sciences (SPSS version 19.0).

Results: There was no statistically significant difference between the mean of mutans streptococci count of test and control group at baseline and 15th day, but there was statistically highly significant difference (P = 0.00) between the mean of mutans streptococci count in test and control group on the 30th day. The mean of Lactobacilli count, plaque index, and gingival index score between test and control group showed no statistically significant difference at baseline, 15th day, and 30th day.

Conclusion: The results suggest that only xylitol gum may interfere with the mutans streptococci composition and reduce it after continuous use of 30 days effectively as compared to sorbitol gum, but both the gums are equally effective on salivary Lactobacilli, plaque, and gingiva at different intervals.

Keywords: Dental plaque; Lactobacillus; Streptococcus mutans; gingiva; sorbitol; xylitol.

Conflict of interest statement

There are no conflicts of interest.

References

    1. Keijser BJ, van den Broek TJ, Slot DE, van Twillert L, Kool J, Thabuis C, et al. The impact of maltitol-sweetened chewing gum on the dental plaque biofilm microbiota composition. Front Microbiol. 2018;9:381.
    1. Shwetha R, Vivek S. Effect of dentifrices containing sorbitol, combination of xylitol and sorbitol on salivary Streptococcus mutans and Lactobacillus counts in 14-15-year-old children: A randomized trial. Int J Clin Trials. 2017;4:184–90.
    1. Dhingra S, Marya CM, Jnaneswar A, Kumar H, Dahiya N, Dahiya V, et al. Role of sugar free chewing gums in oral health. J Oral Health Comm Dent. 2015;9:35–9.
    1. Tuncer D, Onen A, Yazici AR. Effect of chewing gums with xylitol, sorbitol and xylitol-sorbitol on the remineralization and hardness of initial enamel lesions in situ. Dent Res J (Isfahan) 2014;11:537–43.
    1. Freire PL, Albuquerque AJ, Sampaio FC, Galembeck A, Flores MA, Stamford TC, et al. AgNPs: The new allies against S. mutans biofilm – A pilot clinical trial and microbiological assay. Braz Dent J. 2017;28:417–22.
    1. Wasfi R, Abd El-Rahman OA, Zafer MM, Ashour HM. Probiotic Lactobacillus sp. Inhibit growth, biofilm formation and gene expression of caries-inducing Streptococcus mutans. J Cell Mol Med. 2018;22:1972–83.
    1. Zhang J, Liu H, Liang X, Zhang M, Wang R, Peng G, et al. Investigation of salivary function and oral microbiota of radiation caries-free people with nasopharyngeal carcinoma. PLoS One. 2015;10:e0123137.
    1. Hemalatha N, Syamala N. Efficacy of dip slide test in assessing the asymptomatic bacteriuria in pregnancy. Int J Res Med Sci. 2016;4:1921–5.
    1. Migliorati M, Isaia L, Cassaro A, Rivetti A, Silvestrini-Biavati F, Gastaldo L, et al. Efficacy of professional hygiene and prophylaxis on preventing plaque increase in orthodontic patients with multibracket appliances: A systematic review. Eur J Orthod. 2015;37:297–307.
    1. Park SH, Cho SH, Han JY. Effective professional intraoral tooth brushing instruction using the modified plaque score: A randomized clinical trial. J Periodontal Implant Sci. 2018;48:22–33.
    1. Milgrom P, Ly KA, Roberts MC, Rothen M, Mueller G, Yamaguchi DK, et al. Mutans streptococci dose response to xylitol chewing gum. J Dent Res. 2006;85:177–81.
    1. Holgerson PL, Sjöström I, Stecksén-Blicks C, Twetman S. Dental plaque formation and salivary Mutans streptococci in schoolchildren after use of xylitol-containing chewing gum. Int J Paediatr Dent. 2007;17:79–85.
    1. Nayak PA, Nayak UA, Khandelwal V. The effect of xylitol on dental caries and oral flora. Clin Cosmet Investig Dent. 2014;6:89–94.
    1. Decker EM, Klein C, Schwindt D, von Ohle C. Metabolic activity of Streptococcus mutans biofilms and gene expression during exposure to xylitol and sucrose. Int J Oral Sci. 2014;6:195–204.
    1. Krzyściak W, Jurczak A, Kościelniak D, Bystrowska B, Skalniak A. The virulence of Streptococcus mutans and the ability to form biofilms. Eur J Clin Microbiol Infect Dis. 2014;33:499–515.
    1. Söderling E, Mäkinen KK, Chen CY, Pape HR, Jr, Loesche W, Mäkinen PL, et al. Effect of sorbitol, xylitol, and xylitol/sorbitol chewing gums on dental plaque. Caries Res. 1989;23:378–84.
    1. Philip N, Suneja B, Walsh LJ. Ecological approaches to dental caries prevention: Paradigm shift or shibboleth? Caries Res. 2018;52:153–65.
    1. Birkhed D, Edwardsson S, Ahldén ML, Frostell G. Effects of 3 months frequent consumption of hydrogenated starch hydrolysate (Lycasin), maltitol, sorbitol and xylitol on human dental plaque. Acta Odontol Scand. 1979;37:103–15.
    1. Lyn O’Brien N, editor. Sorbitol and Mannitol. 3rd ed. Switzerland: Marcel Dekker AG; 2017. Alternative sweeteners; p. 317.
    1. Loesche WJ, Grossman NS, Earnest R, Corpron R. The effect of chewing xylitol gum on the plaque and saliva levels of Streptococcus mutans. J Am Dent Assoc. 1984;108:587–92.
    1. Birkhed D, Edwardsson S, Svensater G. Frequent sorbitol consumption and dental caries – A longitudinal clinical and bacteriological study. J Dent Res. 1981;60:1261–7.
    1. Liu C, Niu Y, Zhou X, Zheng X, Wang S, Guo Q, et al. Streptococcus mutans copes with heat stress by multiple transcriptional regulons modulating virulence and energy metabolism. Sci Rep. 2015;5:12929.
    1. Krzysciak W, Jurezak A, Koscielniak D, Bystrowska B, Skalniak A. The virulence of streptococcus mutans and the ability to form biofilms. Eur J Clin Microbiol Infect Dis. 2014;33:499–515.

Source: PubMed

3
Iratkozz fel