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Background. Although caries is prevalent in adults, investigators have tested few preventive therapies in adult populations. In a randomized controlled trial, the authors evaluated the effectiveness of xylitol lozenges in preventing caries in adults at elevated risk of developing caries. Methods. The Xylitol for Adult Caries Trial (X-ACT) was a three-site placebo-controlled randomized trial. Participants (n = 691) aged 21 through 80 years consumed five 1.0-gram xylitol or placebo lozenges daily for 33 months. They underwent clinical examinations at baseline and at 12, 24 and 33 months. Results. Xylitol lozenges reduced the caries increment 10 percent. This reduction, which represented less than one-third of a surface per year, was not statistically significant. There was no indication of a dose-response effect. Conclusions. Daily use of xylitol lozenges did not result in a statistically or clinically significant reduction in 33-month caries increment among adults at an elevated risk of developing caries. Clinical Implications. These results suggest that xylitol used as a supplement in adults does not reduce their caries experience significantly. [ABSTRACT FROM AUTHOR]

The article presents information on a project that developed a mechanism which enables school nurses to identify adolescents with gingivitis using a visual screening instrument. In San Antonio, Texas, there is a high prevalence of severe gingival inflammation. School-based interventions were used because of its effectiveness in promoting oral health. The interventions developed were focused on the identification of the health problem and referral for diagnosis and treatment. A training was conducted for both the dentist and the nurse. After that training, the nurses screened each student using penlight and tongue depressor.

Background: Dental caries incidence in adults is similar to that in children and adolescents, but few caries preventive agents have been evaluated for effectiveness in adults populations. In addition, dentists direct fewer preventive services to their adult patients. Xylitol, an over-the-counter sweetener, has shown some potential as a caries preventive agent, but the evidence for its effectiveness is not yet conclusive and is based largely on studies in child populations., Methods/design: X-ACT is a three-year, multi-center, placebo controlled, double-blind, randomized clinical trial that tests the effects of daily use of xylitol lozenges versus placebo lozenges on the prevention of adult caries. The trial has randomized 691 participants (ages 21-80) to the two arms. The primary outcome is the increment of cavitated lesions., Discussion: This trial should help resolve the overall issue of the effectiveness of xylitol in preventing caries by contributing evidence with a low risk of bias. Just as importantly, the trial will provide much-needed information about the effectiveness of a promising caries prevention agent in adults. An effective xylitol-based caries prevention intervention would represent an easily disseminated method to extend caries prevention to individuals not receiving caries preventive treatment in the dental office., Trial Registration: ClinicalTrials.Gov NCT00393055.

Purpose: The purpose of this study was to compare the prevalence of caries between children whose parents had previously participated in an infant oral health educational program (IOHEP) at a WIC clinic with those children whose parents had not participated previously., Methods: One hundred and twenty children aged 1 to 5 years participated in the study. A single examiner previously standardized using the WHO diagnostic criteria for caries examined the children., Results: One hundred and sixteen children were Hispanic (97%). Forty-one of the parents (34%) had previously participated in the IOHEP. Previous participation of the parents in the IOHEP was highly associated with fewer enamel carious lesions (P=.005) and lower dft (P=.043) scores. Children whose parents reported brushing their child's teeth with fluoride toothpaste had significantly lower prevalence of caries (P=.007)., Conclusions: Infant oral health educational programs directed to parents at WIC can have a positive impact on caries prevention.