The effect of chlorhexidine/xylitol chewing-gum on cariogenic salivary microflora: a clinical trial in elderly patients

Abstract

The effects of 14-day use of either a chlorhexidine/xylitol or a xylitol chewing gum on salivary levels of mutans streptococci, lactobacilli, and yeasts were determined for 53 subjects (mean age 79.49 +/- 7.7 years) participating in this randomised, double-blind, placebo-controlled trial. Salivary flow rates and enamel staining were measured and the attitudes of the subjects to gum chewing were evaluated by the use of structured questionnaires. The chlorhexidine/xylitol gum significantly reduced the salivary levels of mutans streptococci (p < 0.0001) lactobacilli (p < 0.05) and yeasts (p < 0.05) while the xylitol placebo gum produced significant reductions in mutans streptococci (p < 0.01) only. The study population found chewing gum twice per day for 10 min an acceptable method of receiving medication and improving oral health. Prior to gum use participants recognised persistent symptoms of dry mouth and their subjective evaluation of dry mouth was significantly (p < 0.001) related to the number of prescribed medications with xerostomic side-effects. The desire to continue gum use was significantly related to the subjects' evaluation of their oral dryness at baseline and to their perceived oral health gain from gum usage. Only those participants with stained enamel at baseline exhibited increased enamel staining following chlorhexidine/xylitol gum usage.