Sugar-free lollies, non-fluoride varnishes help prevent cavities

A multi-disciplinary expert panel, convened by the American Dental Association (ADA) Council on Scientific Affairs, issued a report this month containing clinical recommendations that sugar-free chewing gum, lozenges and hard candy including xylitol or polyol combinations, and a professionally applied varnish with chlorhexidine and thymol could be beneficial in preventing cavities when used as adjuncts to a comprehensive cavity prevention program which includes the use of fluoride-containing products.

The panel noted in its report that these nonfluoride options could provide an extra benefit to prevent cavities in patients at high risk for developing cavities when used in addition to products such as toothpaste, dental sealants and varnishes that contain fluoride as well as community water fluoridation and good eating habits.

The full report is available on the ADA's Center for Evidence-Based Dentistry (EBD) website. The executive summary of the report entitled, "Nonfluoride Caries Preventive Agents," is published in the September issue of The Journal of the American Dental Association and is available on the EBD website. The clinical recommendations from the expert panel were reviewed and approved by the ADA's Council on Scientific Affairs.

The ADA recommends that clinicians determine a patient's risk for developing cavities by conducting a caries risk assessment, which includes completing a caries risk assessment form that can be used as a communications tool with their patients. The Caries Form (Patients Ages 0–6 Years) and the Caries Form (Patients Over 6 Years) are available on ADA.org.

Nonfluoride agents
In addition to a comprehensive cavity-prevention program which includes the use of fluoride, the scientific panel recommended that clinicians consider applying a mixture of cholrhexidine-thymol varnish to the teeth of high-risk adults and the elderly every three months to reduce cavities developing in the root of the tooth.

The panel encouraged clinicians to consider advising parents and caregivers of healthy children older than 5 years who are at higher risk for cavities to chew sugar-free polyol gum after meals for 10 to 20 minutes to prevent cavities.

A polyol is a low-calorie sweetener such as xylitol, sorbitol or mannitol, which is not broken down by the bacteria in the mouth and therefore does not contribute to tooth decay. The panel also recommended that sucking xylitol-containing sugar-free lozenges or hard candy after meals may reduce cavities in children.

The panel's recommendations are based on a review of evidence from 71 published articles that described 50 randomised controlled trials and 15 nonrandomised studies to assess the effectiveness of various nonfluoride agents in preventing cavities.

(Source: American Dental Association (ADA): The Journal of the American Dental Association)

More information

For more information on dental health in children, including teething, hygiene and nutrition for good teeth, as well as the importance of dental check-ups, see Dental Health in Children.

For more information on nutrition, including information on types and composition of food, nutrition and people, conditions related to nutrition, and diets and recipes, as well as some useful videos and tools, see Nutrition.