Lingström Peter, Holm Anna-Karin, Mejàre Ingegerd, Twetman Svante, Söder Birgitta, Norlund Anders, Axelsson Susanna, Lagerlöf Folke, Nordenram Gunilla, Petersson Lars G, Dahlgren Helena, Källestål Carina
Department of Cariology, Faculty of Odontology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Acta Odontol Scand. 2003 Dec;61(6):331-40. doi: 10.1080/00016350310007798.
The aim of this study was, systematically, to evaluate the effect of dietary changes in the prevention of dental caries. A search and analysis strategy was followed, as suggested by the Swedish Council on Technology Assessment in Health Care (SBU). The search strategy for articles published in 1966-2003 was performed using electronic databases and reference lists of articles and selected textbooks. Out of 714 articles originally identified, 18 met the inclusion criteria for a randomized or controlled clinical trial--at least 2 years' follow-up and caries increment as a primary endpoint. This included the total or partial substitution of sucrose with sugar substitutes or the addition of protective foods to chewing gum. No study was found evaluating the effect of information designed to reduce sugar intake/frequency as a single preventive measure. It is suggested that the evidence for the use of sorbitol or xylitol in chewing gum, or for the use of invert sugar, is inconclusive. No caries-preventive effect was found from adding calcium phosphate or dicalcium phosphate dihydrate to chewing gums. The review dearly demonstrates the need for well-designed randomized clinical studies with adequate control groups and high compliance.
本研究旨在系统评估饮食变化对预防龋齿的效果。按照瑞典医疗技术评估委员会（SBU）的建议，遵循了检索与分析策略。针对1966年至2003年发表的文章，使用电子数据库、文章参考文献列表及选定的教科书进行检索。在最初识别出的714篇文章中，有18篇符合随机或对照临床试验的纳入标准——至少2年随访且以龋齿增量作为主要终点。这包括用糖替代品完全或部分替代蔗糖，或在口香糖中添加保护性食物。未发现有研究评估将旨在减少糖摄入量/摄入频率作为单一预防措施的信息的效果。有人认为，在口香糖中使用山梨醇或木糖醇，或使用转化糖的证据尚无定论。向口香糖中添加磷酸钙或二水磷酸二钙未发现有预防龋齿的效果。该综述明确表明需要设计良好、有适当对照组且依从性高的随机临床研究。
