Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 10765964 · doi:10.1177/00220345000790031601
What was done
A two-year randomized trial investigated whether maternal xylitol consumption could prevent mother-child transmission of mutans streptococci (MS). The study included 169 mother-child pairs in which mothers had high salivary MS levels during pregnancy. Mothers were assigned to: xylitol-sweetened gum (65% w/w) chewed at least 2 to 3 times daily starting 3 months postpartum (n = 106), chlorhexidine varnish at 6, 12, and 18 months postpartum (n = 30), or fluoride varnish at 6, 12, and 18 months postpartum (n = 33). Children received no gum or varnish. MS levels were cultured from maternal saliva semi-annually and from child plaque at 1 and 2 years of age using Mitis salivarius bacitracin agar.
What was found
Maternal salivary MS levels remained high and were not significantly different among the three groups throughout the study. At 2 years of age, detectable MS was present in 9.7% of children in the xylitol group, 28.6% in the chlorhexidine group, and 48.5% in the fluoride varnish group, representing a statistically significant reduction in transmission probability for the xylitol group.
Why it matters
Habitual maternal xylitol consumption during early infancy offers an effective, non-invasive method to suppress vertical transmission of cariogenic bacteria, outperforming periodic chlorhexidine or fluoride varnish applications.
Limits
Allocation between groups was substantially unbalanced (106 in the xylitol group vs 30 and 33 in the comparator groups). The abstract does not report exact p-values, confidence intervals, or adherence rates. Outcomes were limited to bacterial colonization rather than long-term clinical caries development, and the population was restricted to mothers with high baseline MS counts.
Cited by
- context In Finland, preschool programs give xylitol to children to encourage beneficial bacterial colonization of newly erupting permanent molars.