The effect of maltitol sweetened chewing gum on the oral microbiology -RCT-

This metgenomic study is based on the Marsh¡¯s theory ( Marsh et al 2006, BMC oral health). This theory consist in considering that the bacteria of dental plaque belong to a dynamic equilibrium where various factors can be deleterious. Indeed environment( diet health status) can let or not some pathogenic bacteria colonizing dental plaque. The equilibrium can move form a ¡¯¡¯healthy state¡¯¡¯ to a ¡¯¡¯sick state¡¯¡¯. Sugar alcohols, a class of polyols, are commonly added to foods because of their lower calorific content compared to sugars. Maltitol, sorbitol, xylitol, erythritol are often used as sweetner in chewing gum because they are not broken down by bacteria in the mouth or metabolized to acids, and thus do not contribute to tooth decay. Importantly, polyol sugars promote tooth mineralization by increasing the flow of saliva. Xylitol and sorbitol have been demonstrated in vivo and in vitro to inhibit growth of a number of cariogenic bacterial species, including mutans streptococci, most prominently Streptococcus mutans and Streptococcus sobrinus. The exact mechanism of action of xylitol on mutans streptococci (MS) is not fully known but habitual xylitol consumption, at high enough doses reduces counts of MS, apparently making plaque and mutans streptococci less adhesive to teeth. Loesche et al showed that consumption of 5−7 g of xylitol in chewing gum reduced MS in both plaque and saliva but not counts of S. sanguis. Very little is actually known about the effects of the polyole sugars on the oral microbiota. This study aims to establish the effects of frequent consumption of chewing gum (sweetened with maltitol or the use of gum base) during 28 days on the oral microbiome composition, and to relate to effects to microbial risk factors for gingivitis and caries. Also, the prolonged effects of chewing gum (sweetened with maltitol or the use of gum base) consumtion are examined after 2 weeks. The study can contribute to effective dosage of gum consumption and improve our understanding on the level of the dental plaque ecosystem.

What is the effect of the use of a maltitol sweetened chewing gum compared to a gum base and no gum in during a 28 days on the composition of the supragingival plaque microbiome in healthy non dental students ≥ 18 years old.

Screening

Visit 1: baseline

Visit 2: day 28

Visit 3: day 42

Intervention: maltitol sweetened chewing gum
Placebo: gum base
Control: no gum