Efecto de una Pasta Dental Comercial Conteniendo Xilitol Sobre el Recuento de Streptococcus Mutans en Saliva de Gestantes: Ensayo Clínico Controlado Aleatorizado / Effect of a Commercial Toothpaste Containing Xylitol on the Count of Streptococcus Mutans in Saliva of Pregnant Women: Randomized Controlled Clinical Trial

RESUMEN: El objetivo del presente trabajo fue determinar el efecto de una pasta dental comercial conteniendo xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes. El presente fue un ensayo clínico, a doble ciego, que se realizó en el Centro de Salud "José Olaya" (Chiclayo Perú), en enero de 2017. Se trabajó con una población muestral de 50 gestantes en el segundo trimestre que cumplieron con los criterios establecidos, distribuyéndolas en dos grupos: 25 gestantes usaron pasta dental con 10 % de xilitol y 25 gestantes usaron pasta dental sin xilitol. Se les tomó y procesó microbiológicamente una muestra de saliva antes del inicio del estudio y 14 días después del uso de las respectivas pastas. Se realizó el recuento de unidades formadoras de colonias (UFC) de Streptococcus mutans en saliva con una confiabilidad altamente significativa mediante el Coeficiente de Correlación Intraclase, calibración intra e interexaminador (1,000 y 0,999, respectivamente). El análisis de los datos se realizó mediante la prueba U de Mann-Whitney, considerando un nivel de significancia del 5 %. No se encontró diferencia entre las gestantes que emplearon pasta dental con xilitol en comparación con las que utilizaron pasta sin xilitol (p=0,062). Se concluyó que el efecto de la pasta dental comercial conteniendo xilitol es similar a una pasta sin xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes.

ABSTRACT: The objective of the present study was to determine the effect of a commercial toothpaste containing xylitol on the counts of Streptococcus mutans in saliva of pregnant women. The present was a double-blind clinical trial performed at the "José Olaya" health Centre (Chiclayo Peru) in January 2017. We worked with a sample population of 50 pregnant in the second trimester that met the established criteria, distributing in two groups: 25 pregnant women used toothpaste with 10 % xylitol and 25 pregnant used toothpaste without xylitol. They were taken and microbiologically processed a sample of saliva before the start of the study and 14 days after the use of the respective toothpastes. The Colony-forming units (CFU) of Streptococcus mutans in saliva were counted with a highly significant reliability through the intraclass correlation coefficient, Intra-and Interexaminer calibration (1.000 and 0.999, respectively). Data analysis was performed using the Mann-Whitney U test, considering a 5 % significance level. No difference was found among the pregnant women who used xylitol toothpaste compared to those who used toothpaste without xylitol (p = 0,062). It was concluded that the effect of xylitol containing commercial toothpaste is similar to a toothpaste without xylitol on the count of Streptococcus mutans in the saliva of pregnant women.

Efeito de diferentes gomas de mascar sobre o pH salivar de crianças / Effect of different chewing gum brands on the salivary pH of children

Objetivo: avaliar o efeito de diferentes gomas de mascar sobre o pH salivar de crianças em dentadura decídua.Métodos: foram selecionadas 40 crianças e divididas em quatro grupos: controle (sem goma de mascar), goma de mascar sem açúcar, goma demascar com fosfopeptídeo de caseína û fosfato de cálcio amorfo e goma de mascar com xilitol. Após a escovação dentária supervisionada para estabilização do pH bucal foi realizada a primeira coleta de saliva. Após isso, todas as crianças foram instruídas a beberem lentamente 100 mL de refrigerante à base de cola (Coca-Cola®), e após 10 min foi realizada nova coleta. Logo após, cada grupo fez uso de sua goma de mascar durante 5 min e a descartou, sendo coletada saliva novamente em intervalos de 5, 10 e 15 min após o início do uso da goma. Os métodos utilizados para leitura do pH salivar foram fitas colorimétricas e pH-metro digital. O tratamento estatístico dos dados foi feito por meio da Análise de Variância (Anova) e teste de Tukey com nível de significância de 95%. Resultados: o uso de gomas de mascar acelerou a elevação do pH salivar em níveis bastante alcalinos após o consumo de bebida ácida, principalmente nos primeiros minutos. Os níveis mais elevados foram encontrados nos grupos que utilizaram gomas contendo xilitol e fosfopeptídeo de caseína û fosfato de cálcio amorfo. Conclusão: o uso de gomas de mascar após a ingestão de bebida ácida elevou o pH salivar, sendo que os grupos que utilizaram gomas com fosfopeptídeo de caseína û fosfato de cálcio amorfo e xilitol em sua composição apresentaram os melhores resultados...

Objective: To evaluate the effect of different chewing gum brands on the salivary pH of children with primary dentition. Method: Forty children were selected and assigned to four groups: control (no chewing gum); sugarless chewing gum; chewing gum with casein phosphopeptide-amorphous calcium phosphate; and chewing gum with xylitol. The first saliva collection was made after supervised tooth brushing for stabilization of the oral pH. Next, all children were instructed to drink slowly 100 mL of a cola-based soft drink (Coca-Cola®) and a new saliva collection was made 10 min later. Then, each group chewed on the chewing gum for 5 min and discarded it after this time. Saliva was collected again at 5, 10 and 15 min intervals after start using the chewing gum. Measurement of salivary pH was made with colorimetric test papers and a digital pH-meter. Data were analyzed statistically by analysis of variance and Tukey?s test at a 5% significance level. Results: The use of chewing gums accelerated the increase of salivary pH to considerably alkaline levels after consumption of an acidic beverage, especially within the first minutes. The highest levels were obtained in the groups of children that used chewing gums containing xylitol and casein phosphopeptide-amorphous calcium phosphate. Conclusion: Children that used the chewing gums after ingestion of an acidic soft drink presented an increase in salivary pH, with the best results in the groups that used chewing gums containing casein phosphopeptide-amorphous calcium phosphate and xylitol...

Use of chewing gum containing 15 percent of xylitol and reduction in mutans streptococci salivary levels

Frequent use of Xylitol may decrease the S. mutans levels. However, very little is known about whether this effect on the levels of cariogenic bacteria is maintained after the interruption of short-term usage of xylitol. This study aimed at evaluating changes in mutans streptococci (MS) salivary levels after using a chewing gum containing xylitol. Twelve volunteers harboring > 10(5) CFU MS/ml saliva levels were asked to chew Happydent-xylit® for 5 minutes, 5 X/day, for 30 days. Saliva samples were collected at baseline, at 30 days after xylitol usage began, and at 30 days beyond its interruption. MS salivary levels were estimated. The average salivary levels of MS in the ten subjects who completed the study were 13.17 (NL-CFU) at baseline (A). After the 30 days experimental period (B), this average decreased to 9.45 (NL-CFU). Nine of ten subjects studied showed a reduction in MS salivary levels in relation to baseline, whereas salivary levels were maintained in the remaining subject. At thirty days beyond the interruption of xylitol usage (C), the average levels of MS were still reduced to 10.31 (NL-CFU). Multiple sample comparison using the Bonferroni test revealed that the decrease in MS levels observed from baseline (A) to the time immediately after 30 days of xylitol usage (B) was statistically significant (p < 0.05), and those levels were still decreased between baseline and 30 days beyond the interruption of xylitol usage (C). So, the use of xylitol induced a reduction in MS salivary levels after a short period of usage which persisted beyond its interruption.

The effect of xylitol chewing gum on mutans streptococci in saliva and dental plaque.

Dental caries are one of the most common infectious diseases occurred in Thai children. The chewing of xylitol, sorbitol, and even sugar gum has been suggested to reduce caries rates. The aim of the present investigation was to evaluate the effect of xylitol chewing gum on mutans streptococci (MS) in saliva and dental plaque. Ninety-one children, aged 10-12 years, with more than 1 x 10(5) MS per milliliter of saliva were included in this study. They were divided into three groups balanced according to their MS counts at baseline: one control group (no supervised gum use), and two xylitol groups (supervised 55% and 100% xylitol gum use). Whole saliva and pooled plaque samples were obtained after 90 school days. When comparing the MS counts between the groups, those chewing 100% and 55% xylitol gum showed significant reductions (p < 0.025), but a dose response effect was not demonstrated. Chewing 100% xylitol gum caused significant reductions on salivary MS scores (p < 0.025) which was little different from the 55% xylitol group. The results suggest that the use of xylitol chewing gum can reduce the levels of MS in plaque and saliva.

Açäo da goma de mascar com xilitol sobre o pH da placa bacteriana após ingestäo de sobremesa à base de sacarose / Effect of xylitol chewing-gum on dental plaque pH after the consumption of a sucrose-containing dessert

O papel da sacarose no estabelecimento da cárie dentária já está bastante consolidado na literatura odontológica. No experimento de Stephan, na década de 40, a evoluçäo do pH da placa em funçäo do tempo por ocasiäo da ingestäo de carboidrato fermentável mostrou uma curva característica, com uma queda inicial e uma lenta recuperaçäo, ficando conhecida como "Curva de Stephan". Desde entäo, usualmente, é analisada a curva provocada por determinado alimento, para determinaçäo da cariogenicidade deste, basicamente a partir da estimativa da área formada pela curva. Tem sido relatado por alguns autores que a goma de mascar restaura o pH da placa, diminuído pela açäo de carboidratos, de uma forma bastante significativa. O objetivo deste trabalho foi verificar a açäo de uma goma de mascar à base de xilitol na Curva de Stephan provocada por uma sobremesa típica brasileira, o doce de leite. O experimento foi realizado em duas fases em 5 indivíduos: na primeira, consumiu-se somente doce de leite e, na segunda, consumiu-se o doce e, em seguida, a goma de mascar. Em ambas, o pH da placa foi monitorado ao longo de 25 minutos, em intervalos de 5 minutos. Foi utilizada a técnica da "amostra da placa" para a leitura do pH e a análise foi feita a partir da comparaçäo das áreas formadas pelas curvas em cada fase. Observou-se que o uso da goma de mascar após ingestäo do doce proporcionou uma área da curva significativamente menor (8,31 ñ 2,25) do que quando somente o doce era ingerido (18,25 ñ 2,96), podendo-se concluir que o uso de goma de mascar à base de xilitol após ingestäo de alimento com sacarose diminui a acidogenicidade deste