Is xylitol effective in the prevention of dental caries? A systematic review

Abstract

Background: Xylitol is a sugar alcohol increasingly used in dentistry as a preventative measure against dental caries. The objective of this systematic review was to assess xylitol’s efficacy in caries prevention through the reduction of the most commonly associated bacteria: Streptococcus mutans. Material and Methods: This systematic review followed PRISMA guidelines. A literature search was conducted in PubMed, Cochrane and Google Scholar databases. The search algorithm included the following key words: xylitol, dental caries, tooth demineralization, Streptococcus mutans, and prevention. The CASPe tool was used to assess risk of bias in the articles reviewed. Results: After the search and selection processes, nine clinical trials (some of them placebo-controlled) in humans were included in the review. The objective proposed – to assess the efficacy of xylitol in caries prevention – was not fulfilled conclusively in all the works. Little heterogeneity was observed among the trials, as the study groups, evaluation periods, daily doses of xylitol etc. varied considerably between the works. Conclusions: According to the present findings, the preventative effect of xylitol against dental caries cannot be confirmed. The results also highlight the need for further research with standardized protocols.