{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:19:23Z","timestamp":1787750363780,"version":"build-2784847793"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"\n Context:<\/jats:title>\n Over the years, dental caries management strategies have evolved tremendously, and a recent paradigm shift toward the preventive approach has been observed. The use of biotics with conventional preventive measures has been reported to have beneficial effects, especially in children with special healthcare needs (SHCN) having increased oral health risks.<\/jats:p>\n <\/jats:sec>\n \n Aim:<\/jats:title>\n \n To compare and evaluate the effects of toothpastes containing xylitol and xylitol-\n Bacillus coagulans,<\/jats:italic>\n on levels of\n Streptococcus mutans<\/jats:italic>\n and\n Lactobacilli<\/jats:italic>\n in the saliva of children with SHCN.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n A randomized controlled clinical trial including 90 children, divided into three groups, with an age range of 7\u201313 years, at a residential school for SHCN children. Group I received conventional (fluoride) toothpaste. Group II received prebiotic (xylitol), and Group III received prebiotic\u2013probiotic (xylitol\u2013\n B. coagulans<\/jats:italic>\n ) toothpaste. Saliva samples were collected preintervention, at 3 and 6 weeks postintervention, and cultured to quantify\n S. mutans<\/jats:italic>\n and\n Lactobacilli<\/jats:italic>\n growth. Statistical analysis used repeated measures ANOVA for intragroup and One-way ANOVA for intergroup comparisons, with significance set at\n P<\/jats:italic>\n < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n All three groups demonstrated a significant reduction (\n P<\/jats:italic>\n < 0.001) in\n S. mutans<\/jats:italic>\n CFU counts at all time points in order of Group III > Group II > Group I, whereas for\n Lactobacilli<\/jats:italic>\n , none of the toothpaste groups showed a significant reduction (\n P<\/jats:italic>\n > 0.001) at 3- and 6-weeks postintervention.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n Xylitol\u2013\n B. coagulans<\/jats:italic>\n containing toothpaste demonstrated the highest antimicrobial efficacy against\n S. mutans,<\/jats:italic>\n compared to xylitol and conventional fluoride toothpaste.\n <\/jats:p>\n 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