Evaluating the Effect of Xylitol Wipes on Cariogenic Bacteria in Infants and Toddlers

This longitudinal interventional study is designed to assess the preventive effect of xylitol-containing dental wipes on oral bacteria linked to early childhood caries (ECC). The study enrolls 20 healthy, caries-free infants and toddlers aged 9 to 18 months attending the Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University. After obtaining informed consent, mothers are instructed to use commercially available xylitol dental wipes (Spiffies Baby Tooth Wipes™, Dr. Products Inc., USA) to clean their children's teeth and gums three times daily after meals for four consecutive weeks. Each wipe contains a xylitol-based solution intended to provide mechanical cleaning and daily exposure to approximately 4.2 g of xylitol.

Saliva samples are collected at baseline and at four weekly follow-up visits. Two primary outcome measures are assessed:

Lactic acid levels, using the Clinpro Cario-L-Pop chairside kit (3M ESPE, Germany) Mutans streptococci counts, using the CRT Bacteria Caries Risk Test (Ivoclar Vivadent, Liechtenstein) Participants are monitored weekly to assess compliance, document any dietary changes, and report potential side effects, including mild gastrointestinal symptoms. Children undergo oral examinations by a pediatric dentist at each visit to evaluate oral tissues and overall tolerance of the intervention.

The study protocol focuses on determining whether the regular use of xylitol wipes is feasible, acceptable to parents and children, and potentially useful as a preventive measure against early childhood oral bacterial activity.

Inclusion criteria

Healthy infants and toddlers aged 9 months to 18 months

Caries-free (no visible dental decay or white spot lesions)

Cooperative child and mother willing to participate for 4 weeks

Mother able to understand and follow instructions for xylitol wipe use

Written informed consent obtained from parent or legal guardian

Exclusion criteria

Infants or toddlers with systemic diseases or medical conditions affecting saliva

Use of antibiotics or antimicrobial mouth products within the past 4 weeks

Known allergy or sensitivity to xylitol or product components

Existing oral lesions or ongoing dental treatment

Non-compliance with study protocol or loss to follow-up