Kovari · Acta odontologica Scandinavica 2003 · cluster-randomized trial · n=1191

Use of xylitol chewing gum in daycare centers: a follow-up study in Savonlinna, Finland.

Cited 44 times in the scientific literature.

Level 2 - randomized trial

Cluster-randomized community trial (daycare centers randomized to xylitol gum vs. brushing)

PubMed 14960009 · doi:10.1080/00016350310007806 · record verified 2026-08-28

What was done

A community trial in Savonlinna, Finland evaluated the caries-preventive effect of xylitol chewing gum compared to toothbrushing. A total of 921 children across daycare centers were cluster-randomized to either a xylitol chewing gum group or a toothbrushing group. An additional external reference group of 270 children not attending daycare centers was recruited later to evaluate whether the daycare sample was representative of local children.

What was found

The authors reported a statistically significant but clinically small difference in oral health status favoring the xylitol chewing gum group over the brushing group. The abstract reports no numerical data, caries incidence rates, effect sizes, confidence intervals, or p-values.

Why it matters

Xylitol chewing gum may serve as a practical substitute for oral hygiene in preschool or daycare environments where supervised toothbrushing is difficult to manage or carries infection-control concerns.

Limits

The abstract reports no numerical outcomes or effect sizes. Family mobility, irregular daycare attendance, and changing employment led to high turnover and non-optimal intervention continuity. Randomization was cluster-based at the center level, and home oral hygiene practices or dietary co-interventions were not reported.

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