Xponent Lemon Mints

Nutritional facts:		Percent Daily Values (DV) based on a 2000 calorie diet
Amount per serving	grams	%DV*
Serving size: 1 pc. (0.6g)
Servings per pack: 240
Calories 1.3
Calories from fat 0		0
.....Total Fat	0	0
....Saturated fat	0	0
Cholesterol	0	0
Sodium	0	0
Total Carbohydrate	0.55	1
....Sugars	0	0
....Xylitol	0.55	1
Protein	0	0

Ingredients:

Xylitol, ascorbic acid, magnesium stearate, gum arabic, flavors, glazing agents (beeswax).

This study applies to mints and lozenges as well.

	Age (Years) Isokangas, P. et al (2000) Journal of Dental Research 79(11): 1885 - 1889

A recent clinical study published in the Journal of Dental Research reported on an innovative new caries prevention method in which the chewing of xylitol-sweetened gum by mothers reduced their children's tooth decay by over 70%.

The aim of the study was to establish whether maternal use of sugar free chewing gum, sweetened with the naturally occurring sweetener xylitol, could reduce the transmission of harmful mutans streptococci (MS) bacteria from mother to child and thereby reduce the risk of dental caries in their children. Earlier published studies have demonstrated that prevention of colonization by these bacteria in early childhood can lead to reduction of dental decay and that mothers are the primary source of infection with mutans streptococci. These bacteria are passed from mother to child through everyday contacts such as kissing, and tasting of food.

The mothers were recruited for the study during pregnancy, and were assigned to one of three study groups. The xylitol group mothers chewed xylitol chewing gum approximately four times a day from 3 to 24 months after the child was born. The mothers in the two control groups received fluoride (which does not affect MS transmission, but strengthens tooth enamel), or chlorhexidine (which is supposed to reduce MS transmission) varnish treatments at 6, 12, and 18 months post delivery. Otherwise, normal dietary and oral hygiene practices were maintained.

The study measured the occurrence of tooth decay in the children at the age of five years: dental caries (dmft - decayed, missing, filled teeth) in the xylitol group was reduced by 71 - 74% as compared with the two control groups. Thus, the study concluded that the mothers' use of xylitol chewing gum prevented tooth decay in their children by significantly reducing the transmission of mutans streptococci from mother to child in early childhood.

The results of this study suggest that intervention against MS colonization by chewing xylitol-sweetened gum may lead to better caries prevention than traditional preventive measures that concentrate on increasing the resistance of the teeth, stated Dr. Eva Soderling from The University of Turku, Finland, one of the leading researchers of the Mother-Child study.

The results of this study indicate that mothers could substantially improve their children's dental health by the simple process of chewing sugar free gum sweetened with xylitol, alongside their normal oral hygiene measures. Xylitol is a naturally occurring sweetener; manufactured from natural sources such as birch wood, which has the same sweetness as sugar as well as unique dental benefits. It is widely used in sugar free chewing gum, confectionery and oral hygiene products.

The Belize Chewing Gum Study (1989-1993)
(40 month study of permanent dentition)
Ref: Makinen, K.K., Makinen, P.L., Pape, H.R. (Fr.), Allen, P., Bennett,
C.A., Isokangas, P.J., Isotupa, K.P.International Dental Journal 1995; 45: 93

Clinical evidence for the effectiveness of xylitol against caries

Non-cariogenic when used as a sugar substitute

In a-two year trial at the University of Turku in Finland, xylitol as clinically proven to be non-cariogenic. Group 1 ate food sweetened with sucrose, Group 2 with fructose and Group 3 with xylitol. At the end, the number of new caries registered as decayed (D), missing (M), or filled (F) tooth surfaces (i.e., the change in DMFS) was measured. While the sucrose and fructose groups had an average DMFS change of 7.2 and 3.8 respectively, virtually no new caries were seen in the xylitol group.

The Turku Sugar Study (1972-1974)

Ref: Turku Sugar Studies V. Scheinin, A., Makinen., K.K., Ylitalo, K.
Acta Ondontol. Scand. 1975; 33: 67

Reduces the number of new cavities when used as a partial sugar substitute

A three-year field study on 690 Hungarian school children used a control group with normal diet and oral hygiene, including fluoridated toothpaste. The xylitol group received in addition 20g per day of xylitol in the form of candies. For comparison, the third group received fluoridated milk. The results showed a lower caries increment for the xylitol group than the control and fluoride groups, and indicate that peroral xylitol has a cariostatic effect.

The WHO Hungarian Study (1981-1984)

Ref: Scheinin, A., Banoczy, J., Szoke, J., Esztari, I., Pienihakkin, K.,
Scheinen, U., Tieskso, J,. Zimmerman, P., & Hadas, E.
Aca Ondontol. Scand. 1985; 43: 321

Improves oral hygiene when given as chewing gum after meals

This study compared the effects on dental caries of regular use of sucrose- and xylitol -sweetened chewing gum respectively, in conjunction with a normal diet. After one year, the group using sucrose gum had a mean DMFS increase of 2.92, compared with
an actual decrease in the xylitol group. The xylitol group also had marked reductions in plaque formation and in the count of oral
micro-organisms.

The Turku Chewing Gum Study

Ref: Scheinin, A., Makinen., K.K., Tammisalo, E., & Maari, R.
Acta Ondontol. Scand. 1975; 33: 269

Reduction of caries related to frequency of xylitol use

In the Ylivieska study, 172 children (initially 11-12 years old) used one, two or three xylitol chewing gums daily (maximum dose 10g xylitol/day). In the children who used two and three gums a day, caries reductions of 30% and 60% respectively were achieved compared with 152 subjects who received no gum. In a sub-group with high caries activity, reductions of 50% and 80% were achieved with two and three gums a day.

Ylivieska Study - Two year results (all subjects)

Ref: Isokangas, P. Institute of Turku Academic Dissertation, 1987

The long term benefits

A follow up in 1989 to the original Ylivieska study demonstrated the longer term benefits of chewing xylitol containing gums. The overall advantage for the xylitol group had actually increased from 45% to greater than 75% a further 5 years after the end of the 2-year period during which xylitol gum was used. Whilst these figures relate to the better standards in total dentition, it is probably the additional protection afforded to newly erupted teeth of xylitol participants which accounts for the greater proportion of continued improvement.

Ylivieska Study - Five year follow up (11 - 12 year old girls)

Isokangus, P., Makinen, K.K., Tiesko, F., A Alanen, P.
Caries Research 1991; 27; 495

Adds to the benefits of a fluoridation programme

In the WHO and Ylivieska studies, it was demonstrated that the consumption of small quantities of xylitol in addition to a normal sucrose-containing diet enhanced the effects of an existing fluoridation programme, resulting in a reduction in new caries.
Similar trends are also observed when xylitol is applied topically, for example in a mouth rinse, resulting in a reduction in plaque weight.

Xylitol-sodium fluoride: Effect on plaque

Ref. Cobanera, A., Morrasso, A., White, E., Cuevas, R., Espinosa, R.,
Journal of Dental Research 1987; 66: 814

Furthermore, in a very large three-year study involving 2,630 initially 8-10 year old Costa Rican children, it was demonstrated that the inclusion of xylitol as well as fluoride in toothpaste achieved an additional 12.3% improvement over fluoride only treatment.

Addition of 10% xylitol enhances anti-caries effect of a sodium
fluoride/silica dentifrice (Comparative results after three years)

Addition of 10% xylitol enhances anti-caries effect of a sodium fluoride/silica dentifrice
(Comparative results after three years)

Cariostatic rather than non-cariogenic

A recent comprehensive clinical study involving 1,277 (initially 9-10 years old) Belize school children, has not only confirmed previous observations for the effectiveness of xylitol in reducing caries risk, but has also clearly demonstrated a cariostatic advantage for xylitol over the non cariogenic polyols, sorbitol. Children assigned to the xylitol chewing gum group showed a 50% lower caries risk than those in the sorbitol group.

Chewing of gum containing xylitol at various concentrations produced noticeably fewer caries onsets over the 40-month study period. For instance there was an average of only 1.4 caries onsets per child assigned 100% xylitol pellet gum compared to 6.2 caries onsets for the group using 100% sucrose gum.
The chewing of sucrose gum on a regular basis appeared to have no benefit in preventing dental caries when comparing the results for all chewing gum groups to the "no gum" baseline, as illustrated in the accompanying chart.

From these results there is also an apparent advantage for pellet gums coated with xylitol in addition to the benefits achieved with the familiar stick gum. This may be attributable to the higher initial concentration of xylitol making more effective contact with the affected areas in the oral cavity.

The Belize Chewing Gum Study 1989-1993

Ref: Makinen, K.K., Bennett, C.A., Hujoel, P.P., Isokangas, P.J., Isotupa, K.P., Pape, H.R.
(Fr.), Makinen, P.L. Journal of Dental Research 1995; 74(12): 1904