Xylitol and caries prevention - Is it a magic bullet?

Abstract

Several recent publications have focused discussion on the value of xylitol in caries prevention. Some reviewers have concluded that xylitol has a unique active role in caries prevention, while other reviewers have been more cautious saying that the case is not yet proven. Chewing xylitol gum is certainly effective at preventing caries development compared with chewing sugared gum or not chewing any gum. Xylitol gum appears to be more effective than sorbitol gum or combinations of xylitol and sorbitol. One recent trial suggested that the effectiveness of eating a xylitol candy could be similar to that of chewing xylitol gum: this is valuable as it would remove the necessity of disposing of spent gum; it has also been suggested that xylitol has a positive action in addition to the favourable effect of chewing. A further recent publication reported substantial reductions in caries development in children whose mothers had chewed xylitol gum. The main explanation appears to be that xylitol changed the plaque flora of the mothers so that transmission of cariogenic oral micro-organisms from mother to child was reduced. Further developments in this field are awaited, but at present we may conclude that xylitol exhibits dental health benefits which are superior to other polyols in all areas where polyols have been shown to have an effect. In addition, xylitol's specific effects on oral flora and especially on certain strains of mutans streptococci add to its caries-preventive profile and give it a unique role in preventive strategies for dental health.