Subject: xylitol hazards, from PubMed

From: "echo" <[email-masked]>
Date: Mon, 28 Mar 2005 15:12:02 -0800

I have seen many reports of benefits from xylitol, including tooth remineralization, inhibition of tooth decay, and clearing of ear infection.

The other night I decided to search PubMed for experimental corroboration.  I found evidence of serious hazard if xylitol is used in quantities much greater than in chewing gum or nasal wash.  I was stirring the stuff into apricot puree and eating it as jam on toast to help combat a seasonal bug.  Beware of my example.

If you are one of the people to whom I sent this message earlier, please forgive me.  I somehow deleted the original and cannot check.

Connie

XYLITOL  RISKS

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15786825
 
Clin Nephrol. 2005 Mar;63(3):225-8.
 
Ethylene glycol intoxication and xylitol infusion--metabolic steps of oxalate-induced acute renal failure.
 
Meier M, Nitschke M, Perras B, Steinhoff J.
 
Department of Internal Medicine I, University of Lubeck, Germany.
[email-masked]
 
Acute renal failure is a major complication in patients with increased oxalate serum 
concentration. To describe the metabolic mechanisms of oxalate-induced glomerular and 
tubular damage, we report a case of ethylene glycol intoxication as well as a case of xylitol infusion in a patient with previously unknown primary hyperoxaluria type 1. Both patients 
presented with acute renal failure associated with histologically proven renal oxalate 
accumulation. This excessive oxalate overloading resulted from elimination and 
metabolization of ethylene glycol or xylitol. Thus, key enzymes in the elimination pathway 
of these substances represent targets for pharmacological treatment. Simultaneous 
hemodialysis is often necessary to reduce oxalate serum concentration. Whereas renal 
function of the ethylene glycol-poisoned patient recovered, the second patient who 
received xylitol infusion required chronic hemodialysis due to the unmasked hyperoxaluria 
type 1. Our cases demonstrate that patients with excessive endogenous oxalate generation are at high risk to develop acute renal failure. Therefore, to prevent end-stage renal failure in these patients, important clinical factors should be considered as indicators for the underlying cause: history of alcohol abuse and severe high anion gap acidosis for ethylene glycol intoxication or history of long-lasting parenteral nutrition for xylitol-associated acute renal failure.
 
PMID: 15786825 [PubMed - in process]
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14634832
 
Int J Legal Med. 2004 Apr;118(2):98-100. Epub 2003 Nov 22.
 
Fatal cerebro-renal oxalosis after appendectomy.
 
Pfeiffer H, Weiss FU, Karger B, Aghdassi A, Lerch MM, Brinkmann B.
 
Institute of Legal Medicine, Rontgenstrasse 23, 48149 Muenster, Germany.
[email-masked]
 
A case of a 24-year-old male with fatal cerebro-renal oxalosis assumed to be due to 
infusions of the sugar surrogate xylitol after appendectomy is reported. The diagnosis was 
established only after intensive histological investigations following the autopsy. The clinical picture was characterized by an acute seizure, coma and renal failure 2 days after the first xylitol infusion. Death occurred due to cerebral dysregulation as a very rare complication after parenteral administration of xylitol. Subendothelial double refractive calcium oxalate crystals were found in the walls of cerebral blood vessels, in particular in the stem ganglion regions and in the cortical renal tubules. The most common type of primary oxalosis was excluded by sequencing analysis. The young age, the minor surgical intervention and the otherwise unremarkable history are special features of this case. Since the genetic background of xylitol intolerance is still unclear, it is suggested that it should be banned as a sugar surrogate in clinical practice.
 
Publication Types:  Case Reports
 
PMID: 14634832 [PubMed - indexed for MEDLINE]
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11727161
 
Dtsch Med Wochenschr. 2001 Nov 30;126(48):1357-60.
                        
[Renal oxalosis with renal failure after infusion of xylitol]
 
[Article in German]
 
Leidig P, Gerding W, Arns W, Ortmann M.
 
Nephrologische Gemeinschaftspraxis Koln Ehrenfeld.
[email-masked]
 
HISTORY AND FINDINGS: Ten days after a complication-free operation for early gastric cancer a 61-year old man had a seizure and acute renal failure. INVESTIGATIONS: A percutaneous renal biopsy was performed to find the cause of the renal failure, which at times required several sessions of haemodialysis. TREATMENT AND COURSE: The seizure was thought to have been due to cerebrovascular deposits of oxalate crystals (renocerebral oxalosis). Parenteral xylitol had been given postoperatively, as a glucose substitute (total dose 1560g), together with other routine drugs. Primary oxalosis and other causes of secondary oxalosis had been excluded. CONCLUSION: Xylitol should not be used parenterally as a glucose substitute (banned in the USA).
 
Publication Types:  Case Reports
 
PMID: 11727161 [PubMed - indexed for MEDLINE]
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6438546

Neuroradiology. 1984;26(6):517-21.

Reno-cerebral oxalosis induced by xylitol.
 
Ludwig B, Schindler E, Bohl J, Pfeiffer J, Kremer G.
 
A 20-year-old man suffering from Crohn's disease developed coma and generalized seizures following ileocecal resection. During postoperative parenteral feeding he received xylitol in an unusually high concentration. CT examinations a few days before death showed intense hypodensity and swelling of brainstem and basal ganglia and increasing triventricular dilatation. Autopsy revealed, mainly in the brainstem and cerebellum, a destruction of intracerebral, intracerebellar and leptomeningeal vessel walls by birefringent crystals (probably calcium oxalate), an early inflammatory reaction and severe brain edema with final tonsillar herniation. The same crystalloid deposits were found in the kidneys.
 
 Publication Types:  Case Reports
 
 PMID: 6438546 [PubMed - indexed for MEDLINE] 
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6420342
 
Infusionsther Klin Ernahr. 1983 Dec;10(6):322-8.

[Acute kidney failure in secondary renal oxalosis. Additional indications for a causal connection to xylitol infusions]
 
[Article in German]
 
Schultze G, Pommer W, Offermann G, Molzahn M, Butz M, Krause PH, Lobeck H, Tschope W.
 
A 35 years old female developed a slowly progressive acute renal failure after surgical drainage of a pancreatic abscess. Due to the uncharacteristic course a renal biopsy was performed which revealed a severe obstructive renal oxalosis with concomitant interstitial nephritis. Primary oxalosis was excluded by determination of glyceric and glycolic acid in the urine. Since other preconditions for increased oxalate formation were not present it was considered as an adverse reaction to the parenteral application of xylitol. During 4 weeks of total parenteral nutrition the patient received this sugar alcohol in a dose of 3.0 g/kg/day (total dose 4480 g). In recognition of preceding autopsy studies and recent experimental investigations on the metabolic pathways from xylitol to oxalate the chances and conditions of renal deposition of calcium oxalate after administration of xylitol are discussed.
 
Publication Types:  Case Reports
 
PMID: 6420342 [PubMed - indexed for MEDLINE] 
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8345042
 
J Clin Endocrinol Metab. 1993 Aug;77(2):388-92.

Carbohydrate metabolism and urinary excretion of calcium and oxalate after ingestion of polyol sweeteners.
 
Nguyen NU, Dumoulin G, Henriet MT, Berthelay S, Regnard J.
 
Explorations Fonctionnelles Renales Metaboliques et Endocriniennes, Centre Hospitalier Universitaire, Besancon, France.
 
Polyols are widely used instead of glucose and sucrose in sweets and dietary products because they are barely cariogenic, and their energy value is lower. In addition, it has been shown that calciuria and oxaluria increase after an oral glucose (Glu) load. We, therefore, investigated the effects of a single polyol ingestion on carbohydrate, calcium, phosphate, and oxalate metabolism in 10 healthy subjects. On 5 experimental days, subjects ingested 20 g Glu, Lycasin (Lyc), Maltisorb (Mal), sorbitol (Sor), or xylitol (Xyl). Glu, Lyc, and Mal intake caused an increase in glycemia [respectively, +34% (P < 0.001), +15% (P < 0.001), and +15% (P < 0.001)], insulinemia [respectively, +358% (P < 0.001), +88% (P < 0.05), and +94% (P < 0.01)], and C-peptide level [respectively, +170% (P < 0.001), +15% (P < 0.01), and +15% (P < 0.001)]. Conversely, no change occurred in glycemia, insulinemia, or C-peptide levels after ingestion of Sor or Xyl. Urinary calcium increased after Glu (+64%; P < 0.01) and Xyl (+74%; P < 0.01) intake, and urinary phosphate increased after Xyl (+27%; P < 0.05), but decreased after a Glu load (-68%; P < 0.01). Only Xyl increased urinary excretion of oxalate (+53%; P < 0.05). Our results suggest that ingestion of polyols causes a much lesser pancreatic stimulation than Glu intake. Also, Lyc, Mal, and Sor sweeteners have no effect on urinary excretion of calcium and oxalate, whereas calciuria and oxaluria increase after Xyl ingestion.
 
PMID: 8345042 [PubMed - indexed for MEDLINE] 
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1905442
 
Z Gesamte Inn Med. 1991 Mar;46(4):101-6.

[Therapy-induced cerebro-renal oxalosis?]
 
[Article in German]
 
Bergmann M, Silling-Engelhardt G, Schnabel R, Gulotta F.
 
Institut fur Neuropathologie, Universitat Munster.
 
Report on three cases of a cerebro-renal oxalosis. The clinical picture was characterized by subacutely appearing coma and cerebral paroxysms. Death occurred due to break-down of cerebral regulation. In all three cases the post-mortem examination showed massive subendothelial depositions of double refractive crystals in the cerebral vessels, in particular in the stem ganglia regions and in the renal tubuli. The crystals showed several features typical for calcium oxalate. The clinical picture appears as an infrequent complication within intensive medicine, in connection with parenteral administration of xylit. Differential diagnosis, pathogenesis and possible cofactors are discussed.
 
Publication Types:  Case Reports
 
PMID: 1905442 [PubMed - indexed for MEDLINE] 
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1774401
 
Intensive Care Med. 1991;17(7):432-4.

Oxalate-induced encephalitis after infusions of sugar surrogates.
 
Heye N, Zimmer C, Terstegge K, Sirtl C, Cervos-Navarro J.
 
Neurological Clinic St. Josefs-Hospital, Universitat Bochum, FRG.
 
The case of a 55-year-old female with oxalate-induced lethal encephalitis following infusions of sugar surrogates is reported. Renal failure and subsequent central coma developed following the use of xylitol, fructose and sorbitol above the recommended dosages. The patient died due to raised intracranial pressure. Cerebral damage was caused by encephalitis due to calcium oxalate crystals. Oxalosis induced by sugar surrogates may be explained either by dose-dependent toxic effects or genetically fixed intolerance.
 
Publication Types: Case Reports
 
PMID: 1774401 [PubMed - indexed for MEDLINE] 

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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2208646
 
Clin Chem. 1990 Oct;36(10):1717-30.

The relation of clinical catastrophes, endogenous oxalate production, and urolithiasis.
 
Conyers RA, Bais R, Rofe AM.
 
Department of Biochemistry, Alfred Hospital, Prahran, Melbourne, Australia.
 
A dose-related toxicity syndrome of renal, cerebral, and liver dysfunction; metabolic acidosis; and deposition of calcium oxalate crystals in tissues is reported in association with various apparently unrelated treatments for a wide range of diseases. The parenteral emulsifiers (e.g., in vitamin E preparations), the anesthetic methoxyflurane, and possibly the experimental hypoglycemic agent dichloroacetate all produce a toxicity syndrome very similar to that of ethylene glycol poisoning. In long-term, high-dose oral toxicity studies with rodents, these or similar agents also produce calcium oxalate labeled agents in humans and animals and in vitro experiments with purified enzymes, tissue homogenates, and isolated hepatocytes have provided both strong circumstantial and direct evidence for the existence of minor pathways of carbohydrate metabolism and of oxidative dealkylation and dehalogenation reactions in drug biotransformations that link these agents to endogenous oxalate production. Because urinary oxalate is now considered to be a critical factor in stone formation and because it is increasingly accepted that 80-90% of urinary oxalate is produced endogenously, it is now possible to formulate pathways that link oxalate production with dietary macronutrients. Therapeutic modifications of diet, in vivo hormonal milieu, and intracellular metabolic controls in relation to endogenous oxalate production may provide new forms of treatment for urolithiasis.
 
Publication Types: 
    Review 
    Review, Tutorial 
 
PMID: 2208646 [PubMed - indexed for MEDLINE] 
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3594837
 
Clin Chem. 1987 Jul;33(7):1118-20.

Two-carbon oxalogenesis compared in recurrent calcium oxalate stone formers and normal subjects.
 
McWhinney BC, Nagel SL, Cowley DM, Brown JM, Chalmers AH.
 
We used a xylitol load to test the two-carbon pathway to oxalate production in humans. Use of this pentose sugar caused a fourfold increase in glycolate excretion, indicating its suitability as a dynamic function test of two-carbon metabolism. However, despite this increase in glycolate excretion in 10 recurrent stone formers and six normal subjects, there was no concomitant increase in oxalate excretion in either group. By comparison, a sucrose load produced no increase in excretion of either glycolate or oxalate. In addition, when we studied four recurrent calcium stone formers on successive diets with various fat content, we found no correlation between high fat intake and increased glycolate or oxalate excretion. In summary, there was no evidence of abnormal fluxes through the two-carbon pathway to oxalate in recurrent stone formers, nor of hyperoxaluria as related to increased intake of sucrose or fat.
 
PMID: 3594837 [PubMed - indexed for MEDLINE]
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3122459
 
Zentralbl Allg Pathol. 1987;133(4):369-76.

[Cerebrorenal oxalate formation--a metabolic abnormality following parenteral infusions of carbohydrate exchange substances]
 
[Article in German]
 
Frydl V.
 
Bezirkskrankenhauses Haar bei Munchen, BRD.
 
A 46 years old male alcoholic was admitted with an assumed alcohol withdrawal syndrome accompanied by tonic-clonic seizures. Parenteral nutrition with fructose, sorbitol, xylitol, dextran, hydroxyethylstarch, electrolytes, vitamins and amino acids was undertaken. He died 20 d later due to renal insufficiency and bronchopneumonia. Calcium-oxalate-monohydrate (whewellite) was found in the central nervous system, the kidneys, the testes, the epididymis, the cardiac muscle cells and the lungs. The presence of urate crystals was suspected. The pathogenesis of secondary oxalosis is discussed.
 
Publication Types: Case Reports
 
PMID: 3122459 [PubMed - indexed for MEDLINE] 
 
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XYLITOL - BENEFITS OR QUESTIONS

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15641497
 
Oral Health Prev Dent. 2003;1(3):195-9.
 
Effect of xylitol-containing chewing gums on lactic acid production in Dental plaque from caries active pre-school children.
 
Twetman S, Stecksen-Blicks C.
 
Department of Odontology/Paediatric Dentistry, Faculty of Medicine and Odontology, Umea University, Umea, Sweden. 
[email-masked]
 
PURPOSE: The aim of this study was to evaluate the lactic acid concentration in 
supragingival plaque from caries-active pre-school children after a short-term use of either 
xylitol- or sorbitol-containing chewing gums. MATERIAL AND METHODS: The investigation consisted of a prospective crossover design with 10 healthy children aged 2-4 years each 
with at least two caries lesions within the dentine (ds > or = 2). The children were instructed to chew 6 pieces of a test or a control gum every day for a 14-day period. The test gum contained 65% xylitol and the control gum was sweetened with sorbitol. At baseline and after 14 days, salivary mutans streptococci were enumerated with a chair-side test (Strip mutans) and dental plaque was collected from the upper maxillary incisors. After a washout period of 6 weeks, the same procedure was repeated with the corresponding test or control gum. Lactic acid was determined enzymatically in glucose-challenged plaque suspensions. RESULTS: The lactic acid concentration was significantly reduced (p<0.05) by 22% compared with baseline following the xylitol gum regimen but was unaltered after the control gum. The levels of salivary mutans streptococci were mainly unaffected by both chewing gums. CONCLUSION: A 14-day use of xylitol-containing chewing gums, corresponding to a daily amount of 5 grams of xylitol, could diminish glucose-initiated lactic acid formation in supragingival plaque in caries-active pre-school children.
 
Publication Types:
    Clinical Trial
    Randomized Controlled Trial
 
PMID: 15641497 [PubMed - indexed for MEDLINE]
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14700079
 
J Electron Microsc (Tokyo). 2003;52(5):471-6.
 
Remineralization effects of xylitol on demineralized enamel.
 
Miake Y, Saeki Y, Takahashi M, Yanagisawa T.
 
Department of Ultrastructural Science, Oral Health Science Center, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan.
[email-masked]
 
We morphologically determined the effects of xylitol on the remineralization of artificially 
demineralized enamel. The samples were demineralized and then immersed in a 
remineralizing solution with or without 20% xylitol at 37 degrees  C for 2 weeks. Samples 
were observed using contact microradiography, a multipurpose image processor (MIP) and a high-resolution electron microscope (HRTEM). Contact microradiography indicated that 
remineralization occurred in the surface and deep layers of samples immersed in a 
non-xylitol solution. Samples immersed in a xylitol solution demonstrated less 
mineralization in the outer 10 microm of the outermost surface layers, but more 
mineralization in the middle and deep layers, than was observed in the non-xylitol samples. The MIP evaluation indicated that remineralization was more prominent in layers at depths of 50-60 microm in the xylitol samples than in the non-xylitol samples. Observation of the xylitol samples by HRTEM revealed crystals of various sizes and irregular shapes with unclear crystal angles in the outermost surface layers. In the middle layers, they had thickened and angles of crystals are clear. These results indicate that xylitol can induce remineralization of deeper layers of demineralized enamel by facilitating Ca2+ movement and accessibility.
 
PMID: 14700079 [PubMed - indexed for MEDLINE]
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14693211
 
Arch Oral Biol. 2004 Feb;49(2):161-4.
 
Adaptation of salivary Lactobacillus strains to xylitol.
 
Badet C, Richard B, Castaing-Debat M, de Flaujac PM, Dorignac G.
 
Laboratoire Odontologique de Recherche, UFR d'Odontologie, 16 cours de la Marne, 
33082 Bordeaux Cedex, France. 
[email-masked]
 
OBJECTIVE: Acid production from sugars is one of the virulence factors of cariogenic 
bacteria. To eliminate this factor, many authors have suggested using sugar substitutes 
like xylitol, which is not fermented by most oral bacteria. The aim of this work was to 
investigate whether oral strains of lactobacilli unable to utilise xylitol could become able to 
utilise this polyol. DESIGN: Twenty-eight oral strains and six ATCC strains of lactobacilli 
were tested. None was initially able to produce acids from xylitol. Media containing only 
xylitol was used in order to see if an adaptation was possible. The acid production from 
xylitol was measured by recording the pH variations of the culture medium. The acids 
produced were identified by HPLC. RESULTS: After a 15-days culture, 10 strains produced acids. After a 40-days culture, 11 more strains produced acid. When acid production occurred, lactic, formic, acetic, propionic and butyric acids were the organic acids formed by all the strains. CONCLUSIONS: Adaptation of oral strains of lactobacilli to xylitol can occur in vitro.
 
PMID: 14693211 [PubMed - indexed for MEDLINE]
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12693818
 
J Calif Dent Assoc. 2003 Mar;31(3):205-9.
 
Xylitol and dental caries: an overview for clinicians.
 
Lynch H, Milgrom P.
 
Department of Dental Public Health Sciences, Northwest/Alaska Center to Reduce Oral 
Health Disparities, University of Washington, Seattle 98195-7475, USA.
 
An overview of studies about xylitol and dental caries suggests potential clinical dental 
applications for xylitol. Xylitol is a naturally occurring, low-calorie sugar substitute with 
anticariogenic properties. Data from recent studies indicate that xylitol can reduce the 
occurrence of dental caries in young children, schoolchildren, and mothers, and in children via their mothers. Xylitol, a sugar alcohol, is derived mainly from birch and other hardwood trees. Short-term consumption of xylitol is associated with decreased Streptococcus mutans levels in saliva and plaque. Aside from decreasing dental caries, xylitol may also decrease the transmission of S. mutans from mothers to children. Commercial xylitol-containing products may be used to help control rampant decay in primary dentition. Studies of schoolchildren in Belize and Estonia, along with data from the University of Washington, indicate that xylitol gum, candy, ice pops, cookies, puddings, etc., in combination with other dental therapies, are associated with the arrest of carious lesions. A prospective trial in Finland has demonstrated that children of mothers treated with xylitol had lower levels of S. mutans than children of mothers treated with chlorhexidine or fluoride varnish. Food products containing xylitol are available commercially and through specialized manufacturers, and have the potential to be widely accessible to consumers.
 
Publication Types:
    Review
    Review, Tutorial
 
PMID: 12693818 [PubMed - indexed for MEDLINE]
 
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12164990
 
J Am Geriatr Soc. 2002 Aug;50(8):1348-53.
 
Comment in:  J Am Geriatr Soc. 2002 Aug;50(8):1454-5.
 
The effect of medicated chewing gums on oral health in frail older people: a 1-year clinical trial.
 
Simons D, Brailsford SR, Kidd EA, Beighton D.
 
Dental Caries Research Group, Guy's, King's and St Thomas's Dental Institute, London, 
United Kingdom.
 
OBJECTIVES: To determine the effects of a medicated chewing gum on the oral health of 
frail older people. DESIGN: A controlled, double-blind trial using three groups based on 
random allocation of residential homes. SETTING: Sixteen residential homes in West 
Hertfordshire, England. PARTICIPANTS: One hundred eleven dentate subjects aged 60 
and older who completed the 12-month study. INTERVENTION: Subjects were assigned to a chlorhexidine acetate/xylitol gum (ACHX) group, a xylitol gum (X) group, or a no-gum (N) group. Subjects in the gum groups chewed two pellets for 15 minutes twice daily for 12 months. MEASUREMENTS: Primary outcome measures were salivary flow rate, denture debris score, prevalence of angular cheilitis, and denture stomatitis; secondary outcome 
measures were salivary levels of caries-associated microorganisms. A single examiner, who was blinded to group allocation, made all measurements at baseline before gum usage and at subsequent examinations after 3, 6, 9, and 12 months. Separate analyses were performed for subjects with dentures. RESULTS: Subjects in the three groups were similar in most of their baseline characteristics. The stimulated whole saliva flow rate +/- standard deviation increased significantly for the ACHX (1.4 +/- 0.7 mL/min) and X (1.6 +/- 0.9 mL/min) groups (P <.01) over baseline (ACHX = 0.9 +/- 0.6 mL/min, X = 0.8 +/- 0.6 mL/min) and N group levels (0.6 +/- 0.9 mL/min). The levels of mutans streptococci, lactobacilli, and yeasts significantly increased (P <.05) in the X and N groups. Denture debris status was significantly lower in the ACHX and X groups than at baseline or in the N group (P <.01). The reductions of 91% and 75% in denture stomatitis and angular cheilitis prevalence, respectively, that occurred in the ACHX group were significantly greater (P <.01) than the reductions in the X group (denture stomatitis 62%, angular cheilitis 43%). Prevalence of denture stomatitis and angular cheilitis were not significantly changed in the N group. CONCLUSION: The use of a medicated chewing gum significantly improved oral health in older occupants of residential homes. Chewing gums should be considered as a potential adjunct to other oral hygiene procedures in older subjects.
 
Publication Types:
    Clinical Trial
    Randomized Controlled Trial
 
PMID: 12164990 [PubMed - indexed for MEDLINE]