Effects of probiotic yogurt, casein phosphopeptide‑amorphous calcium phosphate, and xylitol chewing gums on the salivary count of Streptococcus mutans: A single‑blinded randomized controlled clinical trial

Dental caries is a preventable multifactorial disease, with Streptococcus mutans being suggested to be its primary pathogen. Our study aim was to compare the effects of three different low‑cost and easy‑to‑use regimens with that of the gold standard (chlorhexidine [CHX] mouthwash) on the count of salivary S. mutans in dental students over 30 days.

In this single‑blinded parallel randomized controlled clinical trial, a total of 120 dental students were included and randomly allocated into four intervention groups: (1) CHX mouthwash (control(, (2) probiotic yogurt, (3) casein phosphopeptide‑amorphous calcium phosphate chewing gum, and (4) xylitol chewing gum. Salivary S. mutans counts were evaluated at baseline, 15 days, and 30 days after initiation of the study and compared at different times and among different groups using the repeated measures analysis of variance design analysis and least significant difference test with SPSS software version 20. The level of significance was determined to be 0.05.

The microorganism count variable at baseline, first, and second follow‑ups was significantly different for all groups except the probiotic yogurt group (P = 0.340). S. mutans count was significantly different when comparing the first follow‑up and baseline values in the CHX and xylitol gum groups (P = 0.027, P = 0.037). When comparing the second follow‑up with baseline values, a significant difference was observed in the xylitol gum group (P = 0.003).

Xylitol chewing gum seems to be a viable alternative to the gold standard (CHX mouthwash) in reducing the salivary count of S. mutans.