Effect of Xylitol and Sugar-Free Chewing Gums on Salivary Bacterial Count of Streptococcus Mutans and Lactobacilli in a Group of Egyptian School Children of Different Ages: A Randomized Clinical Trial

The purpose of this randomized clinical trial was to compare the effect of xylitol containing and sugar free brands of chewing gum on the salivary Colony Forming Unit (CFU) count of streptococcus mutans (SM) and lactobacilli (LB) cariogenic organisms in a group of Egyptian school children of different ages. This pragmatic randomized controlled trial (parallel group design) was approved by the Research Ethics Committee of the Faculty of Dentistry, Ain Shams University. 42 high caries risk children (DMFT/dmft/deft of 3 or more) were randomly allocated to either the xylitol or polyol group. Each main group was divided into three equal subgroups. Each subgroup comprised a block of seven children of the same age group as follows: Nursery group aging 3–6 years, junior primary school group aging 6–9 years and senior primary school group aging 9–12 years. Salivary analysis was carried out at baseline and after three weeks of daily gum chewing to all participating children by recording his/her stimulated salivary flow and salivary CFU counts of SM and LB bacteria. Compared to polyol gum, xylitol gum showed lower SM CFU counts. LB CFU counts were not affected by either gum types. However, there was no statistically significant difference between the two chewing gum groups in the different ages and regardless of age. Xylitol gum is more effective in decreasing SM count in saliva compared to polyol gum wheras both sugarless chewing gums show similar effect on LB species.