Study Suggest Xylitol May Not Live Up to Expectations

***UPDATED: November 5, 2015*** Orthodontic patients with fixed appliances have been shown to be susceptible to oral health issues, like dental caries. In an effort to minimize risk, patients have often been advised to chew gums or mints containing xylitol, a sweetening substance that has previously been thought to have decay-preventing qualities. However, according to a recent article from the Dental Tribune, a new study has found that xylitol has no clinical or bacterial benefit for these patients. For the study, adolescents and young adults who underwent orthodontic treatment were divided into three groups. One group consumed six pieces of xylitol gum per day for three months after each meal. The second group ate 12 xylitol chewable mints per day for the same period. The final group was the control group and did not receive any xylitol. All participants followed an oral hygiene routine which included regular cleaning and topical fluoride application. Clinical examinations at 3, 6 and 12 months showed that all three groups had a reduction in plaque, but there was no significant difference between the groups. In the end, researchers concluded that oral hygiene instructions and fluoride application are effective in preventing dental caries whether or not xylitol was consumed.

For several years now, a plethora of products sweetened by the popular sugar substitute, Xylitol, have been advertised as being “dentist recommended” with evidence suggesting it helped prevent tooth decay by stopping the growth of decay-producing bacteria. But a new study out of the University of Manchester in the United Kingdom is calling on dental professionals to think twice before pushing such products. While researchers did find some evidence that that using a fluoride toothpaste that contains xylitol may reduce tooth decay, the evidence is low quality, according to a recent American Dental Association news article.

Researchers examined information from over 4,000 school children who took part in two studies conducted in Costa Rica. In addition to the fluoride toothpaste containing xylitol, they also investigated other products, such as syrup, lozenges, and tablets drawing the same conclusion: little or no evidence suggested any benefit in the prevention of tooth decay. While it the sugar substitute is known to cause less damage to teeth than sugar, this review showed “there is insufficient high-quality evidence to prove that xylitol prevents tooth decay,” said the study’s lead author, Philip Riley, M.P.H., of the School of Dentistry at the University of Manchester. Additionally, the review also claims that several of the studies included in the review did not report sufficient information on the side effects of xylitol, which may include bloating, diarrhea and laxative effects.

While xylitol may not be all that it was once believed to be, sugarless gum and candies are still better than sugar, stated Mr. Riley. “The best evidence for preventing tooth decay is still brushing with fluoride toothpaste and eating less sugar,” he added.  The review is titled “Xylitol-Containing Products for Preventing Dental Caries in Children and Adults” can be found online at www.cochranelibrary.com.