Sugar substitute may prevent cavities in toddlers

NEW YORK (Reuters Health) - Young children given syrup containing the naturally occurring sweetener xylitol may be less likely to develop decay in their baby teeth, results of a study hint.

Early childhood cavities, also called baby bottle tooth decay or nursing cavities, are characterized by severe tooth decay early in life and remain a problem, Dr. Peter Milgrom from the University of Washington in Seattle and colleagues note in a report published today. “Poor children experience rates twice as high as those of their more affluent peers, and their disease is more likely to be untreated,” they point out.

Xylitol, approved in the United States for use in food since 1963, has been shown to effectively prevent tooth decay by inhibiting the growth of bacteria that cause cavities. These previous studies have primarily involved chewing gum or lozenges used in school-age children with permanent teeth.

Milgrom’s team evaluated the effectiveness of using xylitol-containing syrup among 94 children, 9 to 15 months old, from the Republic of the Marshall Islands, where early childhood tooth decay is a serious health care problem.

“Our results suggest that exposure to xylitol (8 grams per day) in a twice-daily topical oral syrup during primary tooth eruption could prevent up to 70 percent of decayed teeth,” the investigators report.

After an average of 10.5 months, 8 of 33 children (24.2 percent) receiving two doses of xylitol per day and 13 of the 32 children (40.6 percent) receiving three doses of xylitol per day had tooth decay, compared with 15 of the 29 children (51.7 percent) in a control group.

The average numbers of decayed teeth were 0.6 in the two-dose xylitol group, one in the three-dose xylitol group and 1.9 in the control group.

“These results provide evidence for the first time (to our knowledge) that xylitol is effective for the prevention of decay in primary teeth of toddlers,” Milgrom and colleagues wrote.

“More research is needed to develop vehicles and strategies for optimal public health, but in populations with high rates of tooth decay, xylitol is likely to be a cost-effective preventive measure,” they conclude.

SOURCE: Archives of Pediatrics and Adolescent Medicine, July 2009.