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Scientific Panel Issues Evidence-Based Clinical Recommendations: Sugar-Free Polyol Gum, Lozenges and Hard Candy, Nonfluoride Varnishes Help Prevent Cavities

Recommended in conjunction with fluoride for patients at high-risk for developing cavities

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CHICAGO, Sept. 12, 2011 – 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 randomized controlled trials and 15 nonrandomized studies to assess the effectiveness of various nonfluoride agents in preventing cavities. 

ADA expert panels, Evidence-Based Dentistry
The clinical recommendations, developed by expert multidisciplinary panels convened by the ADA Council on Scientific Affairs, assessed available scientific evidence and developed practice-oriented recommendations through a comprehensive evidence-based process.
 
Evidence-based clinical recommendations are intended to provide dentists and other health professionals with a review of the latest scientific evidence on particular topics and are not considered a standard of care. Rather, health care professionals can consider clinical recommendations, patient preference and their own clinical judgment when diagnosing and treating patients. 

Evidence-based clinical recommendations are a product of the Center for Evidence-Based Dentistry (EBD). The ADA created the Center for EBD to connect the latest research findings with the daily practice of dentistry. The EBD website provides on-demand access to systematic reviews, summaries and clinical recommendations that translate the latest scholarly findings into a user-friendly format that dentists can use with their patients.

About The ADA Center for Evidence-based Dentistry

The ADA Center for Evidence-Based Dentistry is headquartered in the ADA Division of Science, under the advisement of the Council on Scientific Affairs. Established in 2007, the Center develops resources to help dentists integrate clinically relevant scientific evidence at the point of care. The Center facilitates access to the best available scientific information related to oral health care, and develops evidence-based resources for use in clinical practice. The Center's mission is to assist practitioners and improve the oral health of the public by collaborating with other interested parties to enhance the evidence base and its integration in clinical practice; appraising and disseminating the best available scientific evidence on oral health care; and helping practitioners understand and apply the best available evidence in their clinical decision-making. For more information, visit the EBD Website at http://ebd.ada.org 

About the American Dental Association

The not-for-profit ADA is the nation's largest dental association, representing 157,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit www.ada.org. For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA’s consumer website www.MouthHealthy.org.