Clinical Studies

Oral Health Prev Dent. 2012;10(4):319-26.

Effectiveness of tooth wipes in removing babies' dental biofilm.

Abanto J1Rezende KMCarvalho TSCorrea FNVilela TBönecker MSalete MCorrea NP.

Author information:

University of Sao Paulo, Brazil. 



To assess the effectiveness of tooth wipes in removing dental biofilm from babies' anterior teeth, as well as to evaluate the babies' behaviour and the guardians' preference concerning hygiene methods.


In this random blind cross-over study, 50 high caries risk babies, from 8 to 15 months old, were divided into two groups: babies with oral hygiene performed by caregivers (n = 25) or by their mothers (n = 25). The caregivers and mothers removed biofilm using three methods of oral hygiene (tooth wipes, toothbrushes and gauze), one in each experimental phase. Professional cleaning was done before each phase, which had 2 days of biofilm accumulation and 1 experimental day, when caregivers and mothers used one method to remove biofilm. Examiners blinded to the study design assessed the biofilm index at baseline, prior to and following biofilm removal using each method. The babies' behaviour and the mothers'/caregivers' preference were assessed.


The tooth wipes, toothbrushes and gauze significantly reduced the amount of biofilm (P < 0.001). The mothers' group removed more biofilm than the caregivers' group, using toothbrushes or tooth wipes (P < 0.05). Babies in the mothers' group had better behaviour using tooth wipes than toothbrushes (P < 0.05). Mothers and caregivers preferred to use tooth wipes.


Tooth wipes are effective in removing biofilm from babies' anterior teeth and are the method best accepted by mothers, caregivers and babies.

PMID: 23301232 [Indexed for MEDLINE] 


J Dent Res. 2012 Jul;91(7 Suppl):85S-90S.

Effects of xylitol wipes on cariogenic bacteria and caries in young children.

Zhan L1Cheng JChang PNgo MDenbesten PKHoover CIFeatherstone JD.

Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, Box 0758, 707 Parnassus Ave, San Francisco, CA 94143, USA. 


The aim of the study was to investigate the efficacy of the use of xylitol-containing tooth-wipes in preventing dental caries in young children. In a double-blinded randomized controlled clinical trial, 44 mothers with active caries and their 6- to 35-month-old children were randomized to xylitol-wipe or placebo-wipe groups. The children's caries scores were recorded at baseline and 1 year. Salivary levels of mutans streptococci and lactobacilli were enumerated at baseline, 3, 6, and 12 months. Data were analyzed by intent-to-treat modeling with imputation for caries lesions and a linear mixed-effect model for bacterial levels. Significantly fewer children in the xylitol-wipe group had new caries lesions at 1 year compared with those in the placebo-wipe group (P < 0.05). No significant differences between the two groups were observed in levels of mutans streptococci and lactobacilli at all time-points. Daily xylitol-wipe application significantly reduced the caries incidence in young children as compared with wipes without xylitol, suggesting that the use of xylitol wipes may be a useful adjunct for caries control in infants ( registration number CT01468727).


PMCID: PMC3383105 Free PMC Article

PMID: 22699675 [Indexed for MEDLINE]


Arch Pediatr Adolesc Med. 2009 Jul;163(7):601-7. doi: 10.1001/archpediatrics.2009.77.

Xylitol pediatric topical oral syrup to prevent dental caries: a double-blind randomized clinical trial of efficacy.

Milgrom P1Ly KATut OKMancl LRoberts MCBriand KGancio MJ.

Northwest Center to Reduce Oral Health Disparities, Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle, WA 98195-7475, USA. 

OBJECTIVES: To evaluate the effectiveness of a xylitol pediatric topical oral syrup to reduce the incidence of dental caries among very young children and to evaluate the effect of xylitol in reducing acute otitis media in a subsequent study.

DESIGN: Double-blind randomized controlled trial.

SETTING: Communities in the Republic of the Marshall Islands.

PARTICIPANTS: One hundred eight children aged 9 to 15 months were screened, and 100 were enrolled. Intervention Children were randomized to receive xylitol topical oral syrup (administered by their parents) twice a day (2 xylitol [4.00-g] doses and 1 sorbitol dose) (Xyl-2 x group) or thrice per day (3 xylitol [2.67-g] doses) (Xyl-3x group) vs a control syrup (1 xylitol [2.67-g] dose and 2 sorbitol doses) (control group).

MAIN OUTCOME MEASURES: The primary outcome end point of the study was the number of decayed primary teeth. A secondary outcome end point was the incidence of acute otitis media for reporting in a subsequent report.

RESULTS: Ninety-four children (mean [SD] age, 15.0 [2.7] months at randomization) with at least 1 follow-up examination were included in the intent-to-treat analysis. The mean (SD) follow-up period was 10.5 (2.2) months. Fifteen of 29 of the children in the control group (51.7%) had tooth decay compared with 13 of 32 children in the Xyl-3x group (40.6%) and eight of 33 children in the Xyl-2x group (24.2%). The mean (SD) numbers of decayed teeth were 1.9 (2.4) in the control group, 1.0 (1.4) in the Xyl-3x group, and 0.6 (1.1) in the Xyl-2x group. Compared with the control group, there were significantly fewer decayed teeth in the Xyl-2x group (relative risk, 0.30; 95% confidence interval, 0.13-0.66; P = .003) and in the Xyl-3x group (0.50; 0.26-0.96; P = .04). No statistical difference was noted between the 2 xylitol treatment groups (P = .22).

CONCLUSION: Xylitol oral syrup administered topically 2 or 3 times daily at a total daily dose of 8 g was effective in preventing early childhood caries.

PMCID: PMC2722805 Free PMC Article

PMID: 19581542 [Indexed for MEDLINE]


Pediatr Dent. 2007 Jul-Aug;29(4):337-42.

The effectiveness of a novel infant tooth wipe in high caries-risk babies 8 to15 months old.

Galganny-Almeida A1Queiroz MCLeite AJ.

Pediatrics Department, Federal University of Ceará. Fortaleza, Brazil. 



The purpose of this study was to assess baby and parental satisfaction and plaque-removal efficacy of a novel infant tooth wipe (Spiffies) in high caries-risk babies.


Thirty-five healthy and caries-free infants were selected. Babies had never had their teeth cleaned and no primary molars were yet present. Subjects were identified with the risk factor of nightly feeding behaviors. Pre- and post-cleaning oral hygiene plaque measurements were recorded and then analyzed by a blinded examiner. A manual toothbrush (Ultra Kids) was used as the control method. Infants' caregivers used their randomly assigned cleaning method without instruction. Babies returned to the clinic after a 48- to 72-hour washout period, and the procedures were repeated before and after use of the alternate method. Parental satisfaction and baby-perceived acceptance were evaluated by a questionnaire and were analyzed at the time of the visit and at bedtime.


Both the infant tooth wipe and conventional brushing significantly reduced plaque levels (P < .001). Parents were more satisfied with the wipes when compared to toothbrushing, particularly after nightly feeding habits (P < .001). Similarly, infant's acceptance was higher with the wipes at daytime and significantly higher at night-time (P = .002).


The novel infant tooth wipe provides an effective method of plaque removal before the eruption of primary molars.


Biol Blood Marrow Transplant. 2020 Sep;26(9):1704-1710.

 doi: 10.1016/j.bbmt.2020.05.019. Epub 2020 Jun 4.

Improving Oral Health and Modulating the Oral Microbiome to Reduce Bloodstream Infections from Oral Organisms in Pediatric and Young Adult Hematopoietic Stem Cell Transplantation Recipients: A Randomized Controlled Trial

Priscila Badia 1Heidi Andersen 2David Haslam 2Adam S Nelson 2Abigail R Pate 3Sara Golkari 4Ashley Teusink-Cross 3Laura Flesch 3Ashely Bedel 3Victoria Hickey 3Kathi Kramer 3Adam Lane 3Stella M Davies 5Sarat Thikkurissy 4Christopher E Dandoy 5


Bloodstream infections (BSIs) from oral organisms are a significant cause of morbidity and mortality in hematopoietic stem cell transplantation (HSCT) recipients. There are no proven strategies to decrease BSIs from oral organisms. The aim of this study was to evaluate the impact of daily xylitol wipes in improving oral health, decreasing BSI from oral organisms, and modulating the oral microbiome in pediatric HSCT recipients. This was a single-center 1:1 randomized controlled trial in pediatric HSCT recipients age >2 years. Age-matched healthy children were enrolled to compare the oral microbiome. The oral hygiene standard of care (SOC) group continued to receive the standard oral hygiene regimen. The xylitol group received daily oral xylitol wipes (with .7 g xylitol) in addition to the SOC. The intervention started from the beginning of the transplantation chemotherapy regimen and extended to 28 days following transplantation. The primary outcome was oral health at interval time points, and secondary outcomes included BSIs from oral organisms in the first 30 days following transplantation, oral microbiome abundance, and diversity and oral pathogenic organism abundance. The study was closed early due to efficacy after an interim analysis of the first 30 HSCT recipients was performed (SOC group, n = 16; xylitol group, n = 14). The xylitol group had a significantly lower rate of gingivitis at days 7, 14, and 28 following transplantation (P = .031, .0039, and .0005, respectively); oral plaque at days 7 and 14 (P = .045 and .0023, respectively); and oral ulcers >10 mm at day 14 (P = .049) compared with the SOC group. The xylitol group had no BSI from oral organisms compared with the SOC group, which had 4 (P = .04). The xylitol group had significantly lower abundance of potential BSI pathogens, such as Staphylococcus aureus (P = .036), Klebsiella pneumoniae (P = .033), and Streptococcus spp (P = .011) at the day after transplantation compared with the SOC group. Healthy children and young adults had significantly increased oral microbiome diversity compared with all HSCT recipients (P < .001). The addition of xylitol to standard oral care significantly improves oral health, decreases BSI from oral organisms, and decreases the abundance of pathogenic oral organisms in pediatric and young adult HSCT recipients.

Keywords: Bloodstream infection; Hematopoietic stem cell transplantation; Microbiome; Mucosal barrier injury laboratory-confirmed bloodstream infection; Xylitol.

Copyright © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.