EFFECTS OF SHORT-TERM USE OF XYLITOL CHEWING GUM AND MOLTITOL ORAL SPRAY ON SALIVARY STREPTOCOCCUS MUTANS AND ORAL PLAQUE.

The purpose of this study was to investigate the short-term effects of xylitol chewing gum and maltitol spray on the concentration of salivary mutans streptococci (MS) and on the plaque index. Eighty-one second, third and fourth year dental and dental assistant students with a salivary MS concentration > 103 CFU/ml cultured on mitis salivarius bacitracin (MSB) agar were included in the study. The age range of subjects was 18-23 years. The participants were divided into 3 groups: control, xylitol chewing gum and maltitol spray groups. Each subject brushed their teeth with fluoridated toothpaste (1,000 ppm). Each subject in the xylitol chewing gum group was told to chew 2 pieces, 6 times a day (total xylitol dose=7.3 g/day) for 4 weeks. Each subject in the maltitol spray group was told to spray one puff twice daily (morning and evening) for 4 weeks. A dental examination and saliva samples to determine the salivary MS concentration were collected at baseline and at 2 and 4 weeks after experiment initiation. The nonparametric Mann–Whitney U test was used to analyze differences among groups. The mean ages in the control, xylitol chewing gum and maltitol spray groups were 22±1, 20±1 and 20±1 years, respectively. The mean MS concentrations at the beginning of the study and after 2 weeks in the control, and xylitol chewing gum and moltitol oral spray groups were not significantly different from each other. There was a significantly lower MS concentration in the moltitol oral spray group than in the control group by 4 weeks (p=0.045) but no significant difference between the control group and the xylitol gum group by 4 weeks. There were no significant differences in the mean plaque index at baseline among the control group, the xylitol chewing gum group and the moltitol oral spray group. The plaque index was significantly lower in the xylitol chewing gum group than the control group (p=0.003) at 2 weeks but not 4 weeks. There was no significant difference in the mean plaque index between the control group and the moltitol oral spray group at any time. Using the maltitol spray significantly reduced the MS level in the saliva by 4 weeks use but using the xylitol gum did not. However, using the xylitol chewing gum did reduce the mean plaque by 2 weeks use but the effect did not last; by 4 weeks there was no difference from control. The moltitol spray provided no benefit over the control in reducing the mean plaque index.