4.2 Antimicrobials
Xylitol
Xylitol, a low-calorie sugar substitute used in certain chewing gums
and other food products, may reduce the incidence of dental caries in
mothers and children. Short-term exposure to xylitol has been shown to
decrease S. mutans levels in saliva and plaque. In
addition to decreasing the incidence of dental caries, xylitol may also
decrease the transmission of S. mutans from mothers or other caregivers
to infants and children. Xylitol is most often sold as gum, mints or “candies.” However
these products are not appropriate for children under age 3 and may not
be appropriate for children with feeding or eating difficulties or poor
oral-motor control because of the risk of choking.
Xylitol, when used in conjunction with other preventive measures such
as fluoride, can result in an additive dental caries preventive
effect. Children over age 3 can use xylitol if they are able to chew gum
or to suck on hard small objects without choking on them. Xylitol should
be used for 3–5 minutes per session, three to five times per day.
Chewing xylitol gum has also been shown to reduce ear infections, which
are common in children with special health care needs.
Systemic Antibiotics
Systemic antibiotics for gingivitis should be used with caution if the child is on multiple medications or takes antibiotics frequently for other reasons. A consultation with the child’s primary care health professional may be indicated before prescribing antibiotics. The bacteria causing the infection should be identified before systemic antibiotics are administered. An exception is using subantimicrobial doses of doxycycline.
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