Long-term effects of syrup medications for recurrent otitis media on the dental health of 6- to 8-year-old children.

The dental response to repeated antimicrobial and antihistamine medications was studied by comparing the dental health of 64 adenoidectomized children 5 years after surgery to that of 212 untreated controls. Annual dental recordings starting from the age of 3 years were obtained from health care centers. As expected, the proportion of children who had several (> or = 11) syrup medications was significantly higher (p < 0.001) in the adenoidectomized than in the control group. Sucrose-containing syrup medications were prescribed twice as often for the children of the adenoidectomized as for the control group (p < 0.001). However, the average amount of antimicrobial syrup medications prescribed was 19.2 +/- (SD) 13.0 per child for the adenoidectomized as compared to 8.5 +/- 8.3 for the control children (p < 0.001). The dmf value of the adenoidectomized children at the age of 3 years (mean +/- SEM: 0.5 +/- 0.1) was significantly (p < 0.005) lower than that of the controls (1.1 +/- 0.2). The difference was still significant (p < 0.01) at the age of 4 years, but disappeared thereafter. In conclusion, the antibacterial syrup medication seemed to be associated with a significant decline in dental caries at first. The simultaneous use of antihistamines was, however, thought to delay normal tooth maturation, so that after discontinuation of the antimicrobial medication, accelerated formation of new carious lesions took place.

Weekly variation in the acidogenic response of plaque.

The fall in plaque pH after sucrose rinsing was monitored once a week for 9 (8) weeks in succession, to measure the weekly variation in the magnitude of pH drop in the same subject. The plaque pH was measured with a touch electrode placed interdentally between the first and second premolar. The subject rinsed his mouth with 10% (w/v) sucrose solution, and the plaque pH was thereafter monitored for 40 min. The minimum plaque pH (pHmin), the change between starting and minimum pH (delta pH), and the resting pH value were determined. The pH values of the maxilla and mandible differed. No difference was seen between the right and left sides. As a rule, intraindividual variation was lower in terms of pHmin values than in terms of delta pH values. It was concluded that pH assessment with the touch electrode appeared to show a small weekly variation intraindividually and to be sensitive enough to test the acidogenic potential of foods, but only in the maxilla.

[Effect of Xylitol chewing gum on total saliva and dental plaque in caries-active persons]. / Die Wirkung ovn Xylitkaugummi auf den Gesamtspeichel und die Zahnplaque bei kariesaktiven Personen.

Total saliva and toothplaque values were investigated with caries active persons during the use of xylital containing chewing gum. 20 caries active individuals (DMFS 54.4) chewed 5 xylitol chewing gums per day over a period of 4 weeks. The most important result was the reduction in lacto-bacilli values. This may have occurred because of the inability of acid forming bacteria to metabolise xylitol.

Quantification of incipient approximal caries during fructose and sucrose consumption.

The purpose of this study was to quantify the changes in the size of approximal caries lesions during regular sucrose or fructose consumption. The material consisted of the subjects in the 2-year Turku Sugar Study, with an observation period of 19 months. Planimetric evaluation showed a highly significant increase in the approximal lesions of both groups. There was no difference between the groups in the rate of the increase in the sizes of the lesions. Initially, small lesions increased at a higher rate than initially large lesions in both groups. It is concluded that a fructose diet enhances the progression of carious lesions as much as a sucrose diet.

In vivo acid production from medicines in syrup form.

Syrup-form medicines have been shown to cause dental caries in chronically sick children. The acid production of 10 syrupy medicines sweetened with sucrose, fructose, sorbitol, xylitol and saccharin or with a combination of these was tested. The subjects consisted of 7 dental students with low buffering capacity and high levels of Streptococcus mutans. The subjects rinsed with sugar-based liquid medicines for 1 min, after which the plaque pH was measured with a Beetrode touch electrode at approximal sites until 40 min after the rinsing. The minimum pH, the delta pH, and the time under pH 5.7 were measured. From the results it can be concluded that xylitol, xylitol-saccharin and xylitol-sorbitol combinations used as sweeteners in syrup medicines are nonacidogenic, sorbitol is hypoacidogenic, and sucrose and fructose are highly acidogenic.

Correlation between caries incidence and frequency of chewing gum sweetened with sucrose or xylitol.

The effect on caries incidence of the daily consumption of chewing gum sweetened with sucrose or xylitol was measured in 100 subjects included in the 1-year chewing gum study (Scheinin et al. 1975, Turku sugar Studies XVIII). The subjects were divided retrospectively into groups consuming 2-8 chewing gum pieces per day and their caries incidence was compared. With chewing gum sweetened with sucrose, the caries incidence increased in relation to the daily consumption of gum. In contrast, chewing gum sweetened with xylitol reduced the incidence of caries with increasing consumption.

Changes in buccal white spots during 2-year consumption of dietary sucrose or xylitol.

The purpose of the present study was to quantitate changes in buccal white-spot lesions during sucrose and xylitol consumption. Standardized color macrophotographs of white-spot lesions were taken 7 months after the beginning and at the end of the 2-year study. The quantification was based on the planimetry of these photographs. The area of white-spot lesions decreased in the xylitol group in absolute values (p less than 0.01) and in percentages (p less than 0.001). In the sucrose group the area of white-spot lesions increased in absolute values (p less than 0.05) and in percentages (p less than 0.01) during the 17-month observation period. The stereomicroscopic evaluation gave a similar result; the ordinally quantified caries scores (CIS) increased in the sucrose group and decreased in the xylitol group, and the difference between the groups was highly significant (p less than 0.001). Thus the present findings showed that xylitol consumption caused remineralization of incipient white-spot lesions on buccal surfaces.

Comparative effects of xylitol- and sucrose-sweetened chew tablets and chewing gums on plaque quantity.

The effects of chewing gums and chew tablets sweetened with sucrose or xylitol on the quantity and adhesivity of dental plaque were studied with 14 volunteer dental students (mean age 23.2). The subjects participated in a four-phase study in which one of four different test products was used during each period. The 3-d periods were interspaced with 4-d normalization phases. The following four experimental products were tested: chewing gums (CG) and chew tablets (CT), sweetened with sucrose (s) or xylitol (x). The amount of plaque was determined through an automatic planimetric procedure on teeth treated with Dentotest. The total plaque areas before brushing were significantly larger in the CTs group compared with the CTx group. After brushing, the plaque areas remained larger in the CTs group. In the determination of the thick plaque areas, the use of CTx was associated with significantly smaller plaque scores than the use of CTs. In the adhesivity studies CGx consistently yielded the lowest plaque scores, but the differences between x and s were not significant. The comparison between CT and CG suggested that CTx produced significantly smaller plaque scores than CGx before brushing, but not after. This finding was considered to result from the differences involved in the texture and chemical composition between tablets and chewing gums. The present study showed that the use of CGx and CTx was associated with clinically more advantageous plaque effects than the use of corresponding products sweetened with sucrose.

Quantification of dental plaque through planimetric analysis.

The aim of this study was to develop a planimetric, automatic method for evaluation of the extension and volume of plaque. Series of color macrophotographs of stained plaque were analyzed with a digitizer entering Cartesian coordinate data from the graphic records in a calculator. Estimations were carried out on the reproducibility, discriminatory power, and time required for the planimetric analysis. In addition, the ratios between values obtained before and after reproducible cleansing were interpreted as measurement of the adhesion of plaque in vivo.

Some effects of sugar-flavored acid beverages on the biochemistry of human whole saliva and dental plaque.

An investigation was made of the effects on some biochemical characteristics of human whole saliva and dental plaque resulting from the daily consumption of three commercial, acid-containing beverages. The beverages tested were a cola beverage ("Coca-Cola"), a carbonated orange drink ("Jaffa") and single strength orange juice. Each of the three test beverages as well as non-fluoridated tap water as a control, were consumed during four two-week periods. The test group consisted of 39 dental students. The mean consumption frequency lay in the range from 5.3 to 5.7 times per day. Orange juice was found to stimulate the salivary secretion rate most. All test drinks decreased the salivary pH immediately after consumption, but the pH did not generally drotase-like activity in oral fluid. Changes were observed in calcium, phosphate and fluoride concentrations in oral fluid samples, but these were due to variations in salivary secretion rate. A significant decrease in redox potentials of whole saliva was, however, observed after consumption of the drinks. The present results indicate that in healthy persons with normal saliva flow rate and buffer capacity the moderate consumption of acidic beverages failed to induce any remarkable caries-promoting changes in oral cavity. However, in persons with low salivary flow rate erosion may be a consequence of regular consumption.

Xylitol binding in human dental plaque.

Human dental plaque and whole saliva sediment were tested for their ability to bind 14C-labeled sucrose, fructose, glucose, sorbitol, and xylitol. Sucrose, glucose, sorbitol, and fructose were bound to all materials tested, in this decreasing order. The binding was strongest with plaque given a five-second ultrasonic shock, and lowest with salivary sediment. Xylitol was only insignificantly bound, indicating that plaque microorganisms possess specific recognition sites for xylitol to a very restricted extent.

Turku sugar studies XXI. Xylitol, sorbitol-, fructose- and sucrose-induced physico-chemical changes in saliva.

The aim was to study eventual physico-chemical changes occurring in whole saliva due to sweetened and unsweetened stimulators. The assay was carried out in 10 female subjects with regard to changes of pH, buffering capacity and electrolytes in saliva as influenced by chewing of fructose, sucrose, sorbitol and xylitol gum, gum base and paraffin. The flow rate of saliva was measured in relation to use of xylitol and sucrose chewing gum and unsweetened gum base. These sweeteners increased significantly the salivary flow rate in comparison to the unsweetened gum base. Generally, xylitol and sorbitol on one hand, and sucrose and fructose on the other, behaved in an almost similar way. Increased buffering capacity and elevation of pH saliva was found in the presence of the polyols tested.