New research from The University of Manchester out
today (26 March) concludes that there is limited
evidence to show that xylitol is effective in
preventing dental cavities in children and adults.
Xylitol is a natural sweetener that is widely
promoted globally, and can be found in wide range of
everyday products including sugar–free chewing gum,
toothpaste, gels, lozenges and sweets.
Xylitol is a popular sugar substitute in sweets and
it is already known to cause less damage to teeth
than sugar. It has also been suggested that the
addition of xylitol to products may help to prevent
tooth decay by stopping the growth of
decay-producing bacteria.
However, according to new evidence published in the
Cochrane Library there is little high quality
evidence that it is beneficial in the fight against
tooth decay, which affects up to 90% of children and
most adults worldwide.
The authors gathered together data from 5,903
participants in ten different studies. In most cases,
the studies used such different methods that the
researchers could not combine the results to create
a summary effect estimate.
Based on information from 4,216 school children who
took part in two Costa Rican studies, they found low
quality evidence that levels of tooth decay were 13%
lower in those who used a fluoride toothpaste
containing xylitol for three years, compared to
those who used a fluoride-only toothpaste.
For other xylitol-containing products, such as
xylitol syrup, lozenges and tablets, there was
little or no evidence of any benefit.
Lead researcher, Philip Riley of the School of
Dentistry at The University of Manchester, said:
“This Cochrane review was produced to assess whether
or not xylitol could help prevent tooth decay in
children and adults. The evidence we identified did
not allow us to make any robust conclusions about
the effects of xylitol, and we were unable to prove
any benefit in the natural sweetener for preventing
tooth decay.
“The limited research on xylitol-containing
toothpastes in children may only be relevant to the
population studied.”
He added: “For other products containing xylitol we
were unable to determine whether they were
beneficial. We were particularly surprised to see
such a lack of evidence on xylitol-containing
chewing gums.”
Several of the studies included in the Cochrane
review did not report sufficient information on the
side effects of xylitol, which can include bloating,
diarrhoea and laxative effects. Philip Riley
remarked: “We expected all studies to report adverse
effects as an outcome. Sugar-free gums, sweets,
mints and other products are well-known for their
gastrointestinal effects and these should be clearly
reported in future studies.”
For more information
Riley P, Moore D, Sharif MO, Ahmed F, Worthington
HV.
Xylitol-containing products for preventing dental
caries in children and adults.
Cochrane Database of Systematic Reviews 2015 Issue
3. Art. No.: CD010743. DOI:
10.1002/14651858.CD010743.pub2.
The University of Manchester
MDN |