Gummy bear candies, not traditionally seen as a first line of defence in battling tooth decay, may play some role in providing oral health care to children when containing some sugar alcohols, according to a new clinical trial in the US.
The study, published online in the journal BMC Oral Health, evaluated the impact of incorporating xylitol, already linked to fighting the harmful Mutans streptococci (MS) bacteria, in the traditional confectionery product.
Head researcher Kiet Ly of the University of Washington said that controlled doses of xylitol-containing gummy bears could be a more ideal solution than chewing gum for delivering the sugar alcohol to children as part of a potential oral health programme.
"For xylitol to be successfully used in oral health promotion programmes amongst primary-school children, an effective means [of delivery] must be identified," he stated.
A spokesperson for UK-based charity the British Dental Association (BDA) said that despite the findings, it believes educating children on restricting their consumption of sugary foods, while ensuring a consistent dental hygiene regime was a more effective solution.
Sugar alcohol caution
According to the study's researchers, although gummy bears could provide an effective means of providing xylitol to children, some caution was needed in interpreting the results impact on use in dental hygiene.
Testing on reducing mutans streptococci also indicated that malitol, another sugar alcohol not linked to causing tooth decay, was also found to fight plaque, the study stated.Researchers said that apart from xylitol, studies into other sugar alcohols like sorbitol had found little evidence that they provide similar benefits.
Xylitol is a cariostatic bulk sweetener, which was approved by the US Food and for use in food products back in the 1960s.
It has since experienced remarkable growth following its commercialisation in the early 1970s, particularly due to its inclusion as a key ingredient in sugar free chewing gum due to its taste profile and dental benefits.
The prospective double-blind randomized trial split its participants, taken from fifth grade children from two schools in Washingon State, into three different groups with each subjected to a different gummy bear formulation.
Each group was bound to daily consuming a formulation consisting of either:
- Gummy bears containing 15.6g of xylitol
- Gummy bears containing 11.7g of xylitol
- Gummy bears containing 44.7g of malitol
Malitol had been chosen for the study as a null-comparison due to its slowly fermentable nature and the inability of MS in plaque to adapt to it compared to sorbitol and sucrose, researchers said.
Over a six week period, plaque levels were measured both at the beginning and end of the study by trained research staff, with no special instructions being given on the collection days regarding tooth brushing. Of the respondents, 97 per cent participated in plaque sampling with 77 per cent of the allotted gummy bears being consumed.
The gummy bear snacks used within the testing were provided by Santa Cruz nutritionals, though are not currently available on the market, the researchers concluded.
According to the study, after a six week testing period, significant reductions in MS was found in respondents. The level of these reductions were not found to be statistically different between the three different product formulations.
At the conclusion of the study, thirty-eight children were found to have gone from having detectable levels of MS to non-detectable levels. However, two children from each of the two xylitol groups went from having non-detectable to detectable levels of the bacteria, the study said.
In direct comparison of the xylitol groups, the higher dose 15.6g group recorded an overall higher reduction in MS levels in respondents, though not in any significant manner. The researchers claim that a plateau effect is therefore attributable to higher xylitol doses.
The study said that this pattern did not change when taking into account unconsumed gummy bear levels through the testing.
Source: journal BMC Oral Healthdoi:10.1186/1472-6831-8-5"Xylitol gummy bear snacks: a school-based randomizedclinical trial"Authors: Kiet Ly, Christine Riedy, Peter Milgrom et al.