Polyol-combinant saliva stimulants: a 4-month pilot study in young adults

Several studies indicate that xylitol (X) consumption is associated with certain biochemical changes in dental plaque and whole saliva. In making X-containing saliva stimulants more cost-effective and palatable, manufacturers may use maltitol syrup (MS, which normally contains some sorbitol and higher polyols) or polydextrose (PD, a polysaccharide molecule with a mass > 22 kDa) as bulking agents. Combinations of X with MS and PD have not been tested regarding their salivary effects. One hundred and eighty-eight young subjects (mean age, 22 years) of both sexes were divided into three groups of equal size for a 4-month study. The subjects in one group used X-MS dragees (in 7 daily episodes; 8 g X per day), while the subjects in another group used X-PD dragées in as many daily episodes (8 g X per day). Subjects in the third (comparison) group did not receive saliva stimulants. Paraffin-stimulated whole saliva samples were collected at baseline, after 2 months, and at endpoint. The usage of X-MS was associated with a significant (P < 0.05) reduction in the salivary sucrase activity. After 4 months, the activity of enzymes hydrolyzing N(alpha)-benzoyl-DL-arginyl-p-nitroaniline was significantly reduced in all groups, while the levels of free sialic acid were reduced in group X-PD only (P < 0.05). These salivary changes most likely reflected microbial shifts in the oral cavity and suggest that information from saliva studies may be of avail when deciding which bulking agents should be used in xylitol-based saliva stimulants.