Mäkinen K K, Hujoel P P, Bennett C A, Isotupa K P, Mäkinen P L, Allen P
Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, USA.
Caries Res. 1996;30(6):408-17. doi: 10.1159/000262352.
The effect of 2-year chewing-gum use on the caries rates of primary teeth was studied in a combined school and home program in a sample of 510 initially 6-year-old subjects with high caries experience, low availability of fluoride, and difficult access to dental care. The gum, formed into either sticks or pellets, comprised either xylitol, sorbitol, or mixtures thereof. The gum was chewed for 5 min under supervision five times a day during the school year, and for variable times during nonschool days. Seven groups were studied. One group received no gum; two xylitol gum groups received either pellet or stick gum as did, two sorbitol gum groups, and two groups received either of two types of xylitol/sorbitol pellet gum. The response variable was the development of a frank carious lesion detectable by physical loss of enamel and probable extension to the dentin for those surfaces of primary teeth that were not cavitated at baseline. Caries rates associated with the use of each of the gum types were compared to the caries rates in the no-gum group. The usage of all polyol gums resulted in a significant decrease of the caries onset rate (p < 0.05). The caries onset risk for a primary surface in the xylitol pellet and the sorbitol pellet groups was 35 and 44% of that in the no-gum group (relative risk, 0.35; 95% confidence interval, 0.21-0.59; relative risk, 0.44; 95% confidence interval, 0.30-0.63, respectively). The caries onset risk in the xylitol stick gum group was 53% of that in the no-gum group (relative risk, 0.53; 95% confidence interval, 0.39-0.72), which was marginally (p = 0.1520) lower than in the sorbitol stick gum group (relative risk, 0.70; 95% confidence interval, 0.52-0.94). The usage of both xylitol/sorbitol mixtures in pellet form was associated with a caries onset rate comparable with the usage of the xylitol stick gum. The largest caries risk reduction was observed in the group receiving xylitol pellet gum.
在一项学校与家庭联合项目中，对510名最初6岁、患龋经历丰富、氟化物供应不足且难以获得牙科护理的受试者进行了研究，以探讨两年嚼口香糖对乳牙龋患率的影响。口香糖制成棒状或粒状，包含木糖醇、山梨醇或其混合物。在学年期间，口香糖在监督下每天咀嚼5分钟，共5次，非上学日咀嚼时间不定。研究了七组。一组不接受口香糖；两个木糖醇口香糖组分别接受粒状或棒状口香糖，两个山梨醇口香糖组也是如此，还有两组接受两种类型的木糖醇/山梨醇粒状口香糖中的一种。反应变量是在基线时未出现龋洞的乳牙表面出现明显龋损的情况，可通过牙釉质的物理缺损以及可能延伸至牙本质来检测。将使用每种口香糖类型的龋患率与不使用口香糖组的龋患率进行比较。所有多元醇口香糖的使用均导致龋病发病率显著降低（p<0.05）。木糖醇粒状组和山梨醇粒状组中乳牙表面的龋病发病风险分别为不使用口香糖组的35%和44%（相对风险，0.35；95%置信区间，0.21 - 0.59；相对风险，0.44；95%置信区间，0.30 - 0.63）。木糖醇棒状口香糖组的龋病发病风险为不使用口香糖组的53%（相对风险，0.53；95%置信区间，0.39 - 0.72），略低于山梨醇棒状口香糖组（相对风险，0.70；95%置信区间，0.52 - 0.94）（p = 0.1520）。两种粒状木糖醇/山梨醇混合物的使用与木糖醇棒状口香糖的使用所导致的龋病发病率相当。在接受木糖醇粒状口香糖的组中观察到最大的龋病风险降低。
