Carbamide-containing polyol chewing gum and prevention of dental caries in schoolchildren in Madagascar

The objective of this investigation was to evaluate the effect on dental caries experience of using carbamide polyol chewing gum as a supplement to standard oral hygiene procedures for schoolchildren in a developing country (Madagascar). In 1994, grades 1 and 4 children of demonstration schools were allocated to experimental and control groups; all children participated in a school-based oral health education programme, including daily toothbrushing supervised by the classroom teacher. At grade 1, the test group (n = 125) also used chewing gum (V6: 55.5 per cent sorbitol, 4.3 per cent xylitol, 2 per cent carbamide) three times a day. At grade 4, one test group (n = 177) had chewing gum three times a day and an additional test group (n = 74) had chewing gum five times a day. The control groups included 117 children at grade 1 and 209 at grade 4. Dental caries was registered in 1994 and 1997 according to the Recording System for the Danish Child Dental Services. In grade 1 children, the preventive effect of the total DMFS was not statistically significant except for occlusal caries (-0.65 DMFS, P < 0.01). In the grade 4 test groups, non-significant reductions of dental caries experience were found when compared with controls. The present community trial indicates that the use of polyol chewing gum may be considered a supplement to the control of occlusal dental caries in young primary schoolchildren, particularly in developing countries with limited resources for dental care.