Assessment of Convenience of Glycyrrhiza uralensis Lollipops for Caries Reduction

Objective: Lollipops containing licorice root extract, Glycyrrhizol A, have been developed to reduce salivary levels of S. mutans, thus providing parents with another mode of caries prevention for their children.  This pilot study sought to evaluate compliance and attitudes toward the “Lollipop Regimen.”

Method: 35 Head Start children were instructed to use lollipops twice per day for ten days (20 lollipops).  Subjects were randomly assigned to either a control sugar-free lollipop group or to an herbal lollipop group (Dr. John’s Candies). Plaque samples were acquired from their teeth with a sterile cotton swab on Day 1 and Day 14, and were spiral-plated onto Mitis-Salivarius-Kanamycin-Bacitracin agar plates.  On Day 14, parents were asked to complete a survey which assessed actual compliance, the children’s opinions on taste, and their attitudes on convenience of the “Lollipop Regimen” (scale of 1-5).  Written responses elaborated reasons for these ratings.

Result:  18 children (51%) completed the study.  Of those, 5 consumed all 20 lollipops (28%), and 9 (50%) completed as many as 15 of 20.  A slight majority (53%) who completed the survey rated the convenience as average or worse (score of 3 or less).  Almost 75% of the children rated the taste highly, as either a 4 or 5.  Compliance and ratings for both convenience and taste did not differ between the sugar-free or herbal group.  There were no differences in bacterial counts between groups at either Day 1 or Day 14.

Conclusion: While children may approve of the taste of the herbal lollipops, actual compliance of the complete 10 day “Lollipop Regimen” was low.  Due to inconvenience, parents may not accept the herbal lollipops as an effective vehicle to use as a caries-preventive regimen.  Further research, using larger samples sizes, should be conducted to further assess compliance and effectiveness of these lollipops.