Dental Caries Clinical Trial
— WIPEOfficial title:
Effectiveness of Xylitol Wipes on Infants in Reducing Bacterial Transmission and Colonization From Mother to Child
Mutans streptococci (MS) and lactobacillus species (LB) are the two groups of infectious
cariogenic (caries-causing) bacteria most strongly associated with dental caries (dental
decay). Infants acquire cariogenic bacteria from their mothers early in development via
saliva. There have been several studies that have demonstrated a significant reduction in
dental caries associated with consumption of the food additive known as xylitol in children
and adults. Xylitol is a non-toxic 5 carbon polyol, approved as a food additive by the FDA,
that tastes like and behaves like sucrose in humans. Xylitol is used as a sugar substitute
to reduce dental caries as it is not fermentable by the caries causing bacteria. In
addition, an observed positive beneficial side effect of this sugar substitute is that
xylitol has been shown to reduce mother to child bacterial transfer when used by the mother.
It is commonly recommended to wipe infants' teeth and gums with a soft cloth to reduce the
formation of dental bacterial plaque. Recently wipes have been marketed that contain xylitol
to provide a safe sweet sensation for the infant during this cleaning procedure. However, no
study has been conducted that assesses the biological effect of applying xylitol directly to
the teeth and gums of infants. This study will be conducted to test whether xylitol applied
by swab directly to the infant's teeth and gums will effectively reduce bacterial transfer
from mother to child. Children age up to two years old whose mothers have high cariogenic
bacterial counts will be recruited to use xylitol wipes 3-4 times daily in addition to their
normal preventive regimen. This will be a randomized double blinded study where the control
group will receive placebo wipes (with no xylitol) and the experimental group will receive
the xylitol wipes. The mother-child pair MS and LB bacterial counts and caries score of the
children will be measured at baseline, 3 months, 6 months and 1 year. We will contact all
patients that were recruited into the study to inquire whether they are willing to return
for further follow-up visits at 1, 2, 3, and 4 years post-wipe treatment completion. If
successful, this study will support the use of a simple caries preventive measure that could
be easily and safely implemented in young children. Ten MS isolates and unique LB colonies
will be isolated from each saliva samples to study their genetic diversities and virulence
factors.
The investigators will also investigate whether specific MS genes relate to ECC prevention
effect of daily xylitol-wipe application using genomic sequencing of MS isolated from
current study when the active intervention was applied.
| Status | Completed |
| Enrollment | 88 |
| Est. completion date | January 2008 |
| Est. primary completion date | January 2008 |
| Accepts healthy volunteers | Accepts Healthy Volunteers |
| Gender | Both |
| Age group | 6 Months to 35 Months |
| Eligibility |
Inclusion Criteria: 1. mothers presenting with active dental decay or restorations within the past year (high caries risk) 2. mothers who are the primary caregivers for their child 3. healthy children without systemic disease aged 6 months to two years 4. Infants younger than 6 months who have one or more teeth present Exclusion Criteria: 1. mother or child with systemic disease 2. antibiotics or medications taken within the previous 3 months that may alter oral flora and saliva flow for mother or child 3. children who primarily receive care in a daycare center or by a caregiver other than the mother |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
| Country | Name | City | State |
|---|---|---|---|
| United States | University of California, San Francisco | San Francisco | California |
| Lead Sponsor | Collaborator |
|---|---|
| University of California, San Francisco |
United States,
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | new decayed surfaces | 1 year | No | |
| Secondary | salivary levels of Mutans Streptococci | 3 month, 6 month, 1 year | No | |
| Secondary | levels of lactobacilli | 3 month, 6 month, and one year | No |
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