Long-Term Effect of Erythritol on Dental Caries Development during Childhood: A Posttreatment Survival Analysis

Objective: Assess the effect of daily consumption of erythritol, xylitol, and sorbitol candies on caries development in mixed dentition during a three-year intervention and three years after the intervention. Methods: 485 Estonian first and second grade primary school children participated. Children were randomly allocated to an erythritol, xylitol, or sorbitol (control) group. Polyol-containing candies were administered on school days with a daily polyol consumption of 3x2.5 g. Yearly, caries development was assessed by calibrated dentists using the ICDAS criteria. Six years after initiation of the study and three years after cessation of daily polyol consumption, 420 participants were re-examined to identify potential long-term effects of polyol consumption. Survival curves were generated at the end of the intervention period and three years post intervention. The model included age of the subjects, schools, tooth surface ages and years of surface exposure to intervention. ICDAS scoring system based events included enamel/dentine caries development, dentine caries development, increase in caries score, and dentist intervention. Results: At the end of the intervention, time to enamel/dentine caries development, dentine caries development, increase in caries score, and dentist intervention was significantly longer in the erythritol group as compared to the sorbitol group. Except for increase in caries score, all effects persisted three years after cessation of daily polyol consumption. Conclusions: A caries preventive effect of three-year erythritol consumption as compared to sorbitol was established in children with mixed dentition. The effect persisted up to three years after the end of the intervention. Trial registration: ClinicalTrials.gov Identifier NCT01062633