A prospective longitudinal cohort study of the effectiveness of 25% xylitol toothpaste on mutans streptococci in high caries-risk young children

Aim To compare the prevalence of mutans streptococci (SM) prevalence and categorical distribution in the saliva of high caries-risk children after their 24 months exposure to 25% xylitol toothpaste applied twice a day. To also examine the early caries susceptibility at baseline.Study design An observational design with two times of collection. A total of 270 mother-infant dyads (mean age of infant 6.7 months) were initially recruited. At baseline, a dental exam looked for any early clinical signs of caries, and saliva collections were performed to assess SM prevalence. Two years later, other saliva collections were performed on a residual sample of 102 young children at the endpoint.Method Two hundred four saliva samples were analysed with Dentocult, a commercial kit estimating in four categories, the SM distribution, expressed as the number of colonies forming units per milliliter of saliva (CFU/ml). The dental exam used the ICDAS system to include initial carious lesions (d1-2). The dentist administrated a maternal socio-economic questionnaire as the study collector.Results The dramatic sample attrition between the two collection timepoints was likely caused by the fact that the first saliva collection made the children cry.ICDAS system applications initially found that 14.4% of the infants aged 6.7 months experienced a total of 216 carious lesions, with 161 being initial and 55 being cavitated.A statistically significant (0.001) difference in SM prevalence and distribution was found between the two collection times. The most impacting categories showed optimal benefits: bacteria-free increased (from 27% to 44%) and SM>105 decreased (from 17% to 5%).Conclusion A domestic strategy using a natural toothpaste containing 25% of xylitol as a vehicle, and tooth brushing as a habit, showed a promising antibacterial cariogenic effect. This approach could be a relevant alternative to in-home care to prevent ECC and early SM contamination