ABSTRACT

Purpose: To evaluate the effectiveness of xylitol wipes on caries prevention in high-risk infants.

Methods: In a double-blinded randomized controlled clinical trial, 44 mother-infant pairs were randomized into xylitol-wipe or placebo-wipe groups (n=22 per group). Guardians were instructed to use wipes on their infants 3-4 times daily and to brush the infants teeth with fluoride toothpaste twice daily. Saliva samples for mutans streptococci (MS) and lactobacilli (LB) enumeration (CFU/ml) and DMFS/dmfs scores were collected from mother-infant pairs at baseline and 1 year.

Results: Eighteen (xylitol-wipe group) and 11 (placebo-wipe group) pairs completed the study. Five dropout subjects from the placebo group returned at 1 year. The mean±SE logMS counts in infants at 1 year were 2.7±0.6 for the xylitol-wipe group, 2.8±0.8 for the placebo-wipe group, and 5.0±1.2 for the dropout group with logLB levels as 0.1±0.1, 0.1±0.1, and 1.4±0.9 respectively. Only the dropout group had significantly higher logLB at 1 year compared to the 2 wipe groups (ANOVA, p < 0.05). Children in the xylitol-wipe group had significantly fewer new decayed surfaces at 1 year (mean new ds±SE=0.06±0.06, p < 0.05) than the placebo-wipe (mean new ds±SE=0.45±0.20) and the dropout group (mean new ds±SE=0.75±0.47).

Conclusions: Although xylitol-wipe use did not significantly reduce MS and LB levels in infants, the development of new caries was significantly reduced by the use of xylitol wipes in infants daily. Wipe-use alone may help reduce cariogenic bacteria in infants. The daily use of xylitol wipes in infants in conjunction with brushing with fluoride toothpaste may be a very successful caries preventive regimen for infants.