Guideline on Xylitol Use in Caries Prevention

Council on Clinical Affairs. Guideline on xylitol use in caries prevention. Chicago (IL): American Academy of Pediatric Dentistry (AAPD); 2011. 4 p. [51 references]

Recommendations

Clinicians may consider recommending xylitol use to moderate or high caries risk patients. Those recommending xylitol should be familiar with the product labeling and recommend age-appropriate products. They should routinely reassess (not less than once every 6 months) a patient for changes in caries-risk status and adjust recommendations accordingly.

Dosage

There is accumulating evidence that total daily doses of 3 to 8 grams of xylitol are required for a clinical effect with the currently available delivery methods of syrup, chewing gum, and lozenges. Dosing frequency should be a minimum of 2 times a day, not to exceed 8 grams per day. Although tables of clinically effective xylitol containing products have recently been published, the products are continually changing.

Modality

Chewing gum has been the predominant modality for xylitol delivery in clinical studies. Studies that have utilized xylitol-containing mints and hard candies have shown them to be as effective as xylitol-containing chewing gum. The American Academy of Pediatrics (AAP) does not recommend use of chewing gum, mints, or hard candy by children less than 4 years of age due to the risk of choking. A randomized trial of xylitol syrup (8 g/day) reduced early childhood caries by 50 to 70 percent in children 15 to 25 months of age. Another study showed that gum or lozenges consumed by children at 5 grams total dose per day at about age 10 resulted in 35 to 60 percent reductions of tooth decay, with no differences between the delivery methods. Xylitol containing gummy bears, other confections, and even milk have been studied as delivery vehicles, but they are neither well established scientifically nor available commercially at present. A pacifier with a pouch containing slow release xylitol in tablet form, not yet available in the United States, has shown high salivary xylitol concentrations and may be a potential delivery vehicle for infants. Currently, xylitol-containing chewing gum, mints, energy bars and foods, nasal sprays, and oral hygiene products (e.g., mouth rinse, gels, wipes, floss) are commercially available through retail or online venues. However, they may not contain the necessary therapeutic level, xylitol as the only sweetener, or adequate labeling.

Studies using toothpaste formulations with 10% xylitol (dose of 0.1 g/brushing) have shown reduction in m

Guideline on Infant Oral Health Care

Clinical Affairs Committee - Infant Oral Health Subcommittee, Council on Clinical Affairs. Guideline on infant oral health care. Chicago (IL): American Academy of Pediatric Dentistry (AAPD); 2011. 5 p. [80 references]Purpose

The American Academy of Pediatric Dentistry (AAPD) recognizes that infant oral health is one of the foundations upon which preventive education and dental care must be built to enhance the opportunity for a lifetime free from preventable oral disease. The AAPD proposes recommendations for preventive strategies, oral health risk assessment, anticipatory guidance, and therapeutic interventions to be followed by dental, 

medical, nursing, and allied health professional programs

Autism. Recognition, referral and diagnosis of children and young people on the autism spectrum.

National Institute for Health and Clinical Excellence (NICE). Autism. Recognition, referral and diagnosis of children and young people on the autism spectrum. London (UK): National Institute for Health and Clinical Excellence (NICE); 2011 Sep. 51 p. (Clinical guideline; no. 128). This guideline covers the recognition, referral and diagnosis of autism in children and young people from birth up to 19 years. 'The term autism describes qualitative differences and impairments in reciprocal social interaction and social communication, combined with restricted interests and rigid and repetitive behaviours. Autism spectrum disorders are diagnosed in children, young people and adults if these behaviours meet the criteria defined in the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders DSM-IV Fourth Edition (DSM-IV) and have a significant impact on function. The over-arching category term used in ICD-10 and DSM-IV is pervasive developmental disorder (PDD), a term now used synonymously with autism spectrum disorder (excluding Rett's syndrome); it is a behaviourally defined group of disorders, which is heterogeneous in both cause and manifestation. The guideline development group recognised that individuals and groups prefer a variety of terms, including autism spectrum disorder, autistic spectrum condition, autistic spectrum difference and neuro-diversity. For clarity and consistency, in this guideline the term 'autism' is used throughout, in keeping with the use of 'autism' in recent Department of Health[1], National Audit Office and Public Accounts Committee documents. However in this guideline 'autism' refers to 'autism spectrum disorders'.

Evidence-Based Clinical Recommendations on the Prescription of Dietary Fluoride Supplements for Caries Prevention

A Report of the American Dental Association Council on Scientific Affairs

This article presents evidence-based clinical recommendations for the prescription of dietary fluoride supplements. The recommendations were developed by an expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs (CSA). The panel addressed the following questions: when and for whom should fluoride supplements be prescribed, and what should be the recommended dosage schedule for dietary fluoride supplements?

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