Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci: 6-year follow-up.
Level 2 - randomized trial
Individual randomized controlled trial with blinded laboratory follow-up.
PubMed 11385196 · doi:10.1159/000047452
What was done
195 pregnant mothers with high salivary mutans streptococci (MS) levels were randomized to xylitol gum, chlorhexidine (CHX) varnish, or fluoride (F) varnish groups. Xylitol mothers chewed gum for 21 months beginning 3 months postpartum; CHX and F groups received varnish at 6, 12, and 18 months postpartum. Children were assessed for MS at age 2 (n = 169 pairs), age 3 (n = 159; plaque via toothpicks), and age 6 (n = 147; paraffin-stimulated saliva), corresponding to 1 and 4 years post-intervention. Sample collectors and laboratory analysts were blinded to group allocation.
What was found
Colonization percentages increased across all groups during follow-up. At age 3, the risk of child MS colonization was 2.3-fold higher in the F group compared to the xylitol group (95% CI 1.3-4.2). At age 6, salivary MS levels remained significantly lower in the xylitol group than in the CHX and F groups (ANOVA, p < 0.001).
Why it matters
Habitual maternal xylitol consumption during early infancy creates a durable, multi-year reduction in child mutans streptococci acquisition that persists years after maternal treatment stops.
Limits
Attrition reduced the evaluable cohort from 195 mothers at baseline to 147 children at 6 years. The abstract does not report clinical caries incidence (dmft/DMFT), absolute bacterial counts, or specific risk estimates comparing xylitol to chlorhexidine at age 3.
Cited by
- context In Finland, preschool programs give xylitol to children to encourage beneficial bacterial colonization of newly erupting permanent molars.