XYLITOL
Xylitol is a
natural sugar alcohol that sweetens without causing decay. It actually inhibits
caries formation. Below are some facts
about xylitol.
The most fundamental difference between xylitol and other sweeteners is that xylitol reduces the amount of plaque and the virulence of mutans streptococci in plaque. Xylitol functions as a modulator of the oral flora. Oral bacteria will not adapt to metabolize xylitol regardless of the duration of its use, so its benefits continue while it’s being consumed and after Xylitol is no longer a part of daily use. This effect has been shown to persist for at least five years.
A study published in the Journal of Dental Research (March 2000) demonstrated significant reductions in the transmission of mutans streptococci (MS) from mother to child as a direct result of the consumption of chewing xylitol-containing chewing gum by their mothers.
Soderling E. et al; J Dent Res 2000 Mar; 79(3)882-7
A follow-up study published in the Journal of Dental Research looked at whether maternal consumption of sugar free chewing gum sweetened with xylitol could reduce the risk of dental caries in their children. Earlier published studies have demonstrated that prevention of colonization by these bacteria in early childhood can lead to reduction of dental decay and that mothers are the primary source of infection with mutans streptococci. These bacteria are passed from mother to child through everyday contacts such as kissing and tasting of food.
Isokangas P et al; J Dent Res 2000 Nov;79(11):1885-9
In study in which
xylitol was placed in a reservoir in the pacifiers of one year old children (Aaltonen
et al. Acta Odontol Scand. 2000 Dec; 58(6):285-92.), xylitol was shown to
produce the following results:
IHS dental staff
can easily implement a xylitol gum program by providing the gum to post-natal
mothers as an indirect preventive method (to decrease the transmission of S.
Mutans from mother to child) or by providing the gum to a fixed group of
children, such as Head Start, working in
collaboration with the Head Start teachers.
Additional information about Xylitol and its use in caries-prevention programs can be found at the following links:
http://www.aapd.org/media/Policies_Guidelines/P_Xylitol.pdf
http://jada.ada.org/cgi/reprint/137/2/190
(you will need to be an
Xylitol Abbreviated Bibliography
To date, nearly 1,000
articles have been written on Xylitol. The following are some directed
to caries prevention research.
Alanen P, et al. (2000). Sealants and xylitol chewing gum are equal in caries prevention. Acta Odontol Scand. 58(6):279-84.
Alanen P, et al. (2000). Xylitol candies in caries prevention: results of a field study in Estonian children. Community Dent Oral Epidemiol. 28(3):218-24.
Autio JT. (2002). Effect of xylitol chewing gum on salivary Streptococcus mutans in preschool children. ASDC J Dent Child. 69(1):81-6, 13.
Calamari SE, et al. (1997). Effects of xylitol, sorbitol and fluoride mouthrinses on glucose clearance in adolescents. Acta Odontol Latinoam.l0(1):25-36.
Edgar WM. (1998). Sugar substitutes, chewing gum and dental caries--a review. Br Dent J. 184(1):29-32.
Gales MA, Nguyen TM. (2000). Sorbitol compared with xylitol in prevention of dental caries. Ann Pharmacother. 34(1):98-100.
Hayes C. (2001). The effect of non-cariogenic sweeteners on the prevention of dental caries: a review of the evidence. J Dent Educ. 65(10):1106-9.
Hildebrandt GH, Sparks BS. (2000). Maintaining mutans streptococci suppression with xylitol chewing gum. J Am Dent Assoc. 131(7):909-16.
Honkala S, et al. (1999). Use of xylitol chewing gum among Finnish schoolchildren. Acta Odontol Scand. 57(6):306-9.
Hujoel PP, et al. (1999). The optimum time to initiate habitual xylitol gum-chewing for obtaining long-term caries prevention. J Dent Res. 78(3):797-803.
Isokangas P, et al. (2000). Occurrence of dental decay in children after maternal consumption of xylitol chewing gum, a follow-up from 0 to 5 years of age. J Dent Res. 79(11):1885-9.
Isogangas P, et al. (1993). Long-term effect of xylitol chewing gum in the prevention of dental caries: a follow-up 5 years after termination of a prevention program. Caries Res. 27(6):495-8.
Machiulskiene V, et al. (2001). Caries preventive effect of sugar-substituted chewing gum. Community Dent Oral Epidemiol. 20 29(4):278-88.
Makinen KK, et al. (1998). Physical, chemical, and histologic changes in dentin caries lesions of primary teeth induced by regular use of polyol chewing gums. Acta Odontol Scand. 56(3):148-56.
Makinen KK, et al. (1998). A descriptive report of the effects of a 16-month xylitol chewing-gum programme subsequent to a 40-month sucrose gum programme. Caries Res. .32(2):107-12.
Makinen KK, et al. (1996). Conclusion and review of the Michigan Xylitol Programme (1986-1995) for the prevention of dental caries. Int Dent J. 46(1):2234.
Makinen KK, et al. (1996). Polyol-combinant saliva stimulants and oral health in Veterans Affairs patients--an exploratory study. Spec Care Dentist. 16(3):104-15.
Petersson LG, et al. (1991). Caries-preventive effect of
dentifrices containing various types and concentrations of fluorides and sugar
alcohols. Caries Res. 25(1):74-9.
Rekola M. (1986). Changes in buccal white spots during 2-year consumption of dietary sucrose or xylitol. Acta Odontol Scand. 44(5):285-90.
Roberts MC, et al. (2002). How xylitol-containing products
affect cariogenic bacteria. J Am Dent Assoc.
133(4):435-41.
Scheie AA, Fejerskov OB. (1998). Xylitol in caries prevention: what is the evidence for clinical efficacy? Oral Dis. 4(4):268-78.
Scheinin A, et al. (1993). Xylitol-induced changes of enamel microhardness paralleled by microradiographic observations. Acta Odontol Scand. 51(4):241-6.
Scheinin A, et al. (1985). Collaborative WHO xylitol field
studies in
Simons D, et al. (2002). The effect of medicated chewing gums on oral health in frail older people: a 1-year clinical trial. J Am Geriatr Soc. 50(8):1348-53.
Simons D, et al. (1999). The effect of xylitol and chlorhexidine acetate/xylitol chewing gums on plaque accumulation and gingival inflammation. J Clin Periodontol. 26(6):388-91.
Soderling E, et al. (2000). Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. J Dent Res. 79(3):882-7.
Soderling E, et al. (1991). Long-term xylitol consumption and mutans streptococci in plaque and saliva. Caries Res. 25(2):153-7.
Soderling E, Scheinin A. (1991). Perspectives on
xylitol-induced oral effects. Proc Finn Dent
Soc. 87(2):217-29.
Tanzer JM. (1995). Xylitol chewing gum and dental caries. Int Dent J. 45(1 Suppl 1):65-76.
Trahan L, et al. (1996). Emergence of multiple xylitol-resistant (fructose PTS-) mutants from human isolates of mutans streptococci during growth on dietary sugars in the presence of xylitol. J Dent Res. 75(11):1892-900.
Yanagisawa T, Miake Y, Saeki Y, Takahashi M. (2003)
Remineralization in enamel caries and restoration of carious lesions by
enhanced remineralization induced by saliva and xylitol. Dent in