that a popular sweetener reduces the
likelihood of cavities on its own, according
to a new analysis of past research.
There was some evidence that xylitol
reduces the risk of cavities – or caries –
among children, but people should be
cautious about that finding because of
limitations in the previous studies,
researchers report in the Cochrane
“It’s put in a lot of products as a
preventive agent for caries, but we weren’t
sure what the evidence base was to
substantiate the claims,” said Dr. Deborah
Moore, one of the study’s authors from
Manchester University in the UK.
Xylitol is a sugar alcohol that is as sweet as
traditional sugar, but is not absorbed by the
body, according to the researchers. Its
properties allow xylitol, which occurs
naturally in plants and fruits, to be used in
diabetic an “sugar-free” food products, like
gum and candies.
“Xylitol is known in the laboratory to kill the
main bacteria that cause tooth decay, which
is why it was singled out as having possible
preventive effects on tooth decay,” Moore
told Reuters Health.ADVERTISING
Moreover, she said, there is little or no risk
of xylitol causing tooth decay, especially
when it’s compared to regular sugar.
Products that contain xylitol, like gum or
lozenges, can increase the production of
saliva, which also may reduce the risk of
The new review is part of The Cochrane
Collaboration, an international organization
that evaluates medical research.
The researchers compiled the best available
studies comparing products containing xylitol
to products with inactive ingredients.
They found 10 studies fitting their criteria,
with a total of 5,903 participants.
Two studies had data on 4,216 Costa Rican
children who used either xylitol- and
fluoride-containing toothpaste or simply
fluoride-containing toothpaste for three
years and found a 13 percent reduction in
cavities in the xylitol-fluoride group.
However, people should be cautious about
interpreting those findings, the researchers
write. The data were judged to be of low
quality, and the benefits were only seen
among the children who were evaluated in
both of the studies, so the results could
have something to do factors unique to
They also found that data on side effects
were lacking for many of the studies, and
they note that xylitol is linked to some
stomach issues, including diarrhea.
Moore said that xylitol is better than sugar,
but there is not enough evidence to say it
prevents cavities on its own.
“If people are concerned about tooth decay
the best thing to do is be preventive,” she
said, adding that using fluoride-containing
toothpaste, using mouthwash and reducing
sugar consumption are the best preventive
Dr. Burton Edelstein, chair of the Section of
Population Oral Health at Columbia
University College of Dental Medicine in New
York City, agreed that more research is
needed on xylitol’s potential to prevent
He cautioned that lack of evidence is not
evidence against xylitol, however.
For example, Edelstein and colleagues
estimate in a new report published in the
Journal of the American Dental Association
that money might be saved by giving
mothers xylitol products because they cut
the transmission of bacteria that cause tooth
decay from mother to child.
Mothers may pass on the bacteria to their
children through direct contact, such as
sharing utensils or using their saliva to clean
the baby’s pacifier or face.
Edelstein's group estimates that for every $1
spent on xylitol products for high-risk
mothers on New York’s government-run
insurance programs for the poor, $1.76 will
be saved over 10 years in reduced dental
care for the children.
Other cost-effective measures include
encouraging increased brushing among
high-risk preschoolers and maximizing water
fluoridation in New York, they write.
“We’re dealing with this highly prevalent and
almost completely preventable disease that’s
taxing public coffers,” Edelstein told Reuters
Journal of the American Dental Association,
online March 25, 2015.