PREVENTION OF DENTAL CARIES BY XYLITOL GUM IN PRE-SCHOOL CHILDREN DURING 12-MONTHS

자일리톨 껌 저작에 의한 유치 우식증 예방효과 비교분석

The effect of xylitol and sorbitol chewing gums on dental caries levels among 5-year old kindergarteners was investigated. Three kindergartens the operations of which were partly subsidized by municipal government of Daegu city, Korea, were chosen as the study sites. The child base of the kindergartens were considered demographically and ethnically similar, representing middle-income families. The subjects were examined at their own kindergarten by the two dentists. Participation in the program was voluntary. Over 12 months, 123 participants chewed xylitol chewing gums(X group; 42 subjects), sorbitol chewing gum(S group; 42 subjects), or did not receive chewing gum as a control group(C group; 39 subjects). Consumption of xylitol and sorbitol was 4.5 to 5.0 g/day/subject, consumed in five daily chewing episodes of 5 min. Oral examination, Dentocult-SM test and interproximal dental plaque collection were completed at baseline and 12 months later. The dmfs of group C increased 59.2%, but group S increased 33.4% and group X increased only 31.3% during 12 months study period. The caries prevention ratio was 47.1% at group X and 43.6% at group S. There also appeared the reduction of caries activity at group X(1.39), group S(1.50) than control group(1.79). Compared with groups S and C, there was a statistically significant reduction of S. mutans in interproximal plaque in group X. The results suggest that xylitol chewing gum can prevent dental caries of deciduous dentition, and may be a little more effective than a sorbitol-containing product in controlling some caries-associated parameters in kindergarten-age subjects.

자일리톨 껌 저작에 의해 어린이들의 유치우식증 예방효과를 평가하기 위하여 3개 어린이집에서 만 $5{\sim}6$세 어린이 123명을 최종 선정하였다. 자일리톨 껌을 씹는 군(42명), 솔비톨 껌을 씹는 군(42명) 그리고 아무런 조치도 취하지 않은 대조군(39명)으로 나누어 12개월 동안 하루 5회씩 껌을 저작하게 한 다음 구강검사와 우식활성 검사를 통해 유치우식증 예방효과를 비교 분석 하였다. 12개월 동안 대조군 어린이들에서는 dfs index가 5.19개면 증가하였고 솔비톨 군에서는 2.96개면이 증가한 반면 자일리톨 군에서는 2.62개면이 증가하여 대조군에 비해 자일리톨 군은 47.1%가 감소하였고 솔비톨 군에서는 43.6%가 감소한 것으로 나타났다. Dentocult-SM strip 검사 및 site strip 검사 결과 모두에서 대조군에 비해 자일리톨 껌과 솔비톨 껌을 씹은 군의 아동들에서 우식활성도가 공히 감소되었다 따라서 본 연구와 같은 집중적인 자일리톨 껌의 저작 사업은 대상자들과 부모들의 사업에 대한 호응도가 높았고, 사업 시행이 다른 국책 구강보건사업에 비해 용이하였으며 특히 유치우식증 예방적인 측면에서 효과적인 것으로 나타났다.