The caries-inhibiting effect of unsupervised daily use of four different toothpastes was compared in a 3-year clinical and microbiological study: (1) 0.8% sodium monofluorophosphate (MFP) with 3% xylitol and 6% sorbitol; (2) 0.03% sodium fluoride with 3% xylitol and 6% sorbitol; (3) 0.8% MFP with 9% sorbitol, and (4) 0.03% sodium fluoride with 9% sorbitol. In all 284 children, 12-13 years old at baseline, took part in the study. After 3 years, no statistically significant differences were found between the different toothpaste groups concerning either development of initial or gross caries lesions or number of mutans streptococci and lactobacilli in saliva. However, children with no detectable approximal caries at baseline, who used the MFP toothpaste with the xylitol-sorbitol mixture, showed a lower (p less than 0.05) caries increment as compared with children who used the MFP toothpaste with sorbitol alone.