Dr. Pentti Alanen, a professor in Public Health Dentistry, at the University of Turku, concentrated on the economic benefits that regular xylitol usage can have, not just for individuals, but especially at a macroeconomic level.
He used a vast array of graphs and statistics based on several studies to illustrate the cost benefit figures associated with the use of xylitol. The vast majority of this clinical research has been done in Finland, partly because their government provides free dental care up to the age of 18. It stands to reason then, that their public health department would want to decrease the incidence of caries.
Dr. Alanen showed how, through intensive prevention programs, Finland went from having very high caries figures in 1970, to having among the lowest figures by 1990.
One of the studies done on 12 and 18 year olds, showed a decrease in the groups DMF index from 8 in 1975 to the World Health Organizations target of 3 within 6 years. It then continued to decline to below 1 by 1990, where it stayed until the end of the study period in 2000.
Dr. Alanen mentioned how difficult it is to find control groups for clinical trials in Finland because most of the population uses xylitol. Almost all the gums in the country, he explained, contain xylitol. But because of its higher cost, very few contain enough xylitol to be effective, or its effectiveness is reduced by the presence of other sweeteners.
He expanded on some of the government programs in communities, particularly in schools and kindergartens. Effective xylitol products are purchased in bulk to reduce the cost, and then distributed after meals to eliminate the acid attack caused by the processed carbohydrates.
The most dramatic results were achieved when xylitol intervention takes place at an early age, ideally before dentition. Dr. Alanen presented some extremely impressive graphs illustrating the long term effect of teeth erupting into a xylitol rich, low Mutans, oral cavity. In many cases, the benefits were still evident after 40 years.
Using age pyramid graphs he made some extremely powerful points about demographic changes in industrialized nations across the world. Not only are people living longer, but the average age of a nation is rising as well. In conjunction with this, fewer people are losing their teeth.
In Finland for example, in the time that it takes for the elderly age group to quadruple, the number of natural teeth will have multiplied by 50. There will also be a corresponding increase in crowns, bridges, implants, and prostheses. With this in mind, controlling oral hygiene will become increasingly important in years to come.
Dr. Alanen concluded, by stating that xylitol is not only one of the best and most easily achievable solutions to early caries prevention, but that it could also be used to ensure the long-term success of expensive dental treatment. In his own words, “Clearly a win-win situation.”
The University of Turku in Finland has produced some excellent work in the field of xylitol research and the dental world is considerably richer for it. These presentations by Doctors Makinen, Soderling, and Alanen laid a firm foundation for what was to be an extremely informative and even entertaining seminar.