Mothers’ xylitol chewing gum use protects their children from dental caries
The mother-child study started in the early 1990’s is the first clinical study on the effect of the use of xylitol by mothers on the colonization of their children with Streptococcus mutans and subsequent dental health. The study was designed and carried out by Doctors Eva Söderling , docent at the University of Turku, Institute of Dentistry, and Pauli Isokangas of the Health Care Centre in Ylivieska
The study confirmed that maternal xylitol chewing gum consumption reduced the strep mutans transmission
5-fold as compared to the control group receiving fluoride-varnish treatments.
Xylitol both reduces the numbers of mutans streptococci as well their transmission properties, which is proposed to explain the results.
Dental caries is an infectious disease
The earlier the primary teeth are colonized with Streptococcus mutans, the higher the risk of future caries. The risk of colonization is highest in children aged about two years. It is usually the mother who inadvertently passes the infection to the child. Frequent saliva contacts through food-tasting or pacifier-cleaning are the most likely routes of passing the infection from mother to child.
Mothers used xylitol gum daily for two years
The joint project of the Institute of Dentistry, University of Turku and the Ylivieska Health Care Centre started in early 1990’s. The aim of the study was to explore whether mothers’ habitual xylitol consumption could prevent the mother-child transmission of S. mutans, and how the result would be reflected in caries occurrence in the children.
Altogether 195 pregnant women with high salivary mutans streptococci levels were invited to the study. In the xylitolgroup, the mothers chewed xylitol chewing gum approximately four times a day for about two years. The use of the xylitol gum was started before the first primary teeth erupted to ensure that the “xylitol-effect” on the oral flora was established.
In the two control groups, the mothers received either fluoride (F; no effect on transmission of S. mutans ) or chlorhexidine (CHX; supposed to reduce transmission of S. mutans ) varnish applications, 6, 12 and 18 months after delivery. All interventions discontinued when the child was two years old. Both saliva and plaque samples were collected from the mothers and their children during the study. The Streptococcus mutans levels of the samples were determined both using plate culturing and a strip test.
Xylitol gum efficiently prevented the transmission of Streptococcus mutans
169 mother-child pairs, with the child at the age of two, participated in the study. In the xylitol group only 10% (see table) of the children became colonized with mutans streptococci bacteria, even though the salivary bacteria levels of their mothers were not reduced during the xylitol consumption period. The researchers emphasize that xylitol did thus not reduce the children’s colonization by reducing that of their mothers, but rather by affecting the transmission properties of the mutans streptococci.
In the Xylitol group, only 10 % of the children became colonized withStreptococcus mutans. The corresponding results in the control groups were: In the F-varnish group, the colonization percentage was 49% and, in the CHX group, 29 %.
The first two years in a child’s life are the most important in caries prevention. The study results indicate that, in future, intervention against mutans streptococci colonization may lead to better caries prevention than the traditional caries measures concentrating on increasing the resistance of the teeth
Söderling E, Isokangas P, Pienihäkkinen K, Tenovuo J. Influence of Maternal Xylitol Consumption on Acquisition of Mutans Streptococci by Infants. J Dent Res, 79: 882-887, 2000.