Squirting the sugar substitute xylitol on infants' teeth could help prevent tooth decay, a disease that afflicts an estimated 28% of U.S. children ages 2 to 5, according to a new study.
Severe tooth decay occurs when bacteria such as Streptococcus mutans proliferate in the mouth and attack enamel. Largely preventable, it strikes poor children twice as often as wealthier ones. The problem is compounded because decay is more likely to go untreated in poorer communities.
Native American, Alaska Native, and indigenous Hawaiian and Pacific Island children are hit the hardest, due to diets high in sugar, inadequate access to fluoride in water and toothpaste, and subpar dental care.
The study, by researchers of the University of Washington in Seattle, was conducted in the Republic of the Marshall Islands, where early childhood tooth decay occurs at a rate of two to three times higher than that of the average U.S. mainland community. Just over half of all 2-year-olds have at least one decayed tooth.
Researchers instructed parents, aided by community healthcare workers, to give xylitol in a topical oral syrup to infants aged 9 months to 15 months over a period of about a year. The 94 children in the study were divided into three groups: One group received a single 2.67-gram dose of xylitol a day; another got eight grams a day delivered in two doses; the third got 8 grams in three doses.
Of the first group, 51.7% had some tooth decay. In the 2-dose-a-day and 3-dose-a-day groups, rates were 24.4% and 40.6%, respectively. In addition, the numbers of decayed teeth were significantly fewer in the latter two groups. No adverse effects of xylitol were reported.
The results, published in July in the Archives of Pediatrics & Adolescent Medicine, suggest that using an oral syrup with xylitol while baby teeth are growing could prevent as much as 70% of tooth decay, the authors said.
Xylitol is a naturally occurring sugar approved for use in foods since 1963. It can be found in chewing gum, gum drops and hard candy. It has been used effectively in chewing gum or lozenges in older children to prevent decay in permanent teeth.
The sugar reduces the number of decay-causing bacteria by impeding their ability to produce lactic acid, which damages teeth; or glycans, substances that allow bacteria to stick to teeth.
