Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci: 6-year follow-up

Xylitol is effective as a noncariogenic or even cariostatic sugar substitut e. Habitual xylitol consumption appears to select for mutans streptococci ( MS) which shed easily into saliva from plaque. We have earlier shown that h abitual xylitol consumption of mothers was associated with a statistically significant reduction in the probability of mother-child transmission of MS assessed at 2 years of age. The aim of the present study was to assess the children's MS counts 1 and 4 years after the maternal xylitol consumption had been discontinued. At baseline, during pregnancy, all mothers (n = 195) showed high salivary levels of MS. The mothers were randomly assigned to x ylitol, fluoride IF) and chlorhexidine (CHX) groups. In the xylitol group, the mothers chewed xylitol-sweetened gum, for 21 months, starting 3 months after delivery. In the two control groups, the mothers received CHX or F va rnish treatments at 6, 12 and 18 months after delivery. At the 2-year exami nation, 169 mother-child pairs participated. At the 3-year and 6-year exami nations, there were 159 and 147 children in the study, respectively. For ch ildren's MS analyses, visible plaque was collected using tooth picks at the age of 3 and paraffin-stimulated saliva at the age of 6. The persons invol ved in the collection and analysis of the microbiological samples were blin ded as to the study design and group. Both the plaque and salivary MS were cultured on Mitis salivarius agars containing bacitracin. In all groups, th e colonization percentages increased during the follow-up. At the 3-year ex amination, the children's risk of having MS colonization was 2.3-fold in th e F group (95% CI 1.3-4.2) compared to the xylitol group. This difference w as statistically significant. Even at 6 years of age, the salivary MS level s were significantly lower in the xylitol group than in the other groups (A NOVA, p <0.001). in conclusion, the earlier demonstrated, xylitol-associate d reduction in the probability of mother-child transmission of MS was still found in the children's MS counts at the age of 3 and 6 years. Copyright ( C) 2001 S. Karger AG, Basel.