Effect of Erythritol and Xylitol on Dental Caries Prevention in Children

Abstract

Objective: The aim of this study was to test the efficacy of long-term, daily intake of erythritol and xylitol candy, compared with sorbitol candy, on the development of enamel and dentin caries lesions. Methods: The study was a double-blind randomized controlled prospective clinical trial. Altogether 485 primary school children, first- and second-graders at baseline, from southeastern Estonia participated in this 3-year intervention. Each child consumed four erythritol, xylitol or sorbitol (control) candies three times per school day. The daily intake of polyol was about 7.5 g. The International Caries Detection and Assessment System (ICDAS) was used in the clinical examinations by four calibrated examiners at baseline and at 12, 24 and 36 months. Results: The annual examination analyses and the follow-up analyses confirmed that the number of dentin caries teeth and surfaces at 24 months follow-up and surfaces at 36 months follow-up was significantly lower in the mixed dentition in the erythritol group than in the xylitol or control group. Time of enamel/dentin caries lesions to develop and of dentin caries lesions to progress was significantly longer in the erythritol group compared to the sorbitol and xylitol groups. Also the increase in caries score was lower in the erythritol group than in the other groups. Conclusions: In the follow-up examinations, a lower number of dentin caries teeth and surfaces was found in the erythritol group than in the xylitol or control groups. Time to the development of caries lesions was longest in the erythritol group. Trial registration: ClinicalTrials.gov Identifier NCT01062633.

Gut hormone secretion, gastric emptying, and glycemic responses to erythritol and xylitol in lean and obese subjects

“…The 13 C exhalation was determined by nondispersive infrared spectroscopy using an isotope ratio mass spectrophotometer (IRIS; Wagner Analysen Technik, Bremen, Germany) and expressed as the relative difference (␦%) from the universal reference standard (carbon from Pee Dee Belemnite limestone). 13 C enrichment was defined as the difference between preprandial 13 C exhalation and postprandial 13 C exhalation at defined time points, ␦ over basal (%). ⌬values were converted into atom percent excess and then into percent of administered dose of 13 C excreted per hour.…”

“…13 C enrichment was defined as the difference between preprandial 13 C exhalation and postprandial 13 C exhalation at defined time points, ␦ over basal (%). ⌬values were converted into atom percent excess and then into percent of administered dose of 13 C excreted per hour. In this last conversion, the CO2 production of the subjects was used, which is assumed to be 300 mmol/h multiplied by the body surface area.…”

“…In particular, xylitol has gained popularity, as several studies were able to show a dental caries preventive effect, which was also demonstrated for erythritol (13). Apart from the proven anticariogenic properties, xylitol seems to be effective in reducing the accumulation of visceral fat, and in animal models xylitol improves glycemia (1,6,16,27).…”

Long-Term Effect of Erythritol on Dental Caries Development during Childhood: A Posttreatment Survival Analysis

“…For an extensive overview of study design and procedures, we refer to an earlier publication [Honkala et al, 2014]. Briefly, the study was set up in 2008 as a double-blind, randomized, controlled prospective intervention trial.…”

“…We evaluated the efficacy of long-term, daily intake of polyol-containing candies on the development of enamel and dentin caries lesions in a cohort of 485 Estonian primary school children through a double-blind, randomized, controlled prospective intervention trial [Honkala et al, 2014]. During 3 years, participating children consumed each 4 erythritol, xylitol, or sorbitol (control) candies 3 times per school day, resulting in a total daily polyol intake of 7.5 g. Dental health and caries development were clinically assessed using the International Caries Detection and Assessment System (ICDAS) [Ismail et al, 2007] at baseline and months 12, 24, and 36 of the intervention.…”