Plaque and whole saliva samples were collected from initially 11- to 12-year-old children randomly chosen from two groups which participated in a 2- to 3-year field trial designed to test the efficacy of xylitol chewing gums in caries prevention. No initial differences were observed between the groups with regard to the plaque levels of Streptococcus mutans, but at the end of the 2-year xylitol gum regimen, the levels were smaller (p < 0.05) in children using xylitol gum than in control children. In a similar follow-up study on children who were considered to be at high risk with regard to dental caries and who continued the study over a 3rd year, the xylitol-consuming subjects showed at the end of the study significantly smaller (p < 0.004) salivary S. mutans counts than the control children. These effects were achieved after using up to 3 xylitol gums/day (daily xylitol dose per child was 7–10 g). Salivary flow rate and several salivary chemical parameters did not change.

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