Xylitol and Its Vehicles for Public Health Needs

Milgrom, Peter; Ly, Kiet A.; Rothen, Marilynn

doi:10.1177/0895937409335623

Cited by 48 publications

(36 citation statements)

References 20 publications

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“…information suggests that the 5 gm/day dose may fall below a therapeutic threshold (Milgrom et al, 2009). While the root-caries-preventive effect observed in this study was statistically significant (40% less root surface caries/yr), the magnitude of the risk reduction effect (0.15 surface/yr) was clinically modest.…”

contrasting

confidence: 43%

Tooth-surface-specific Effects of Xylitol

et al. 2013

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The Xylitol for Adult Caries Trial was a three-year, double-blind, multi-center, randomized clinical trial that evaluated the effectiveness of xylitol vs. placebo lozenges in the prevention of dental caries in caries-active adults. The purpose of this secondary analysis was to investigate whether xylitol lozenges had a differential effect on cumulative caries increments on different tooth surfaces. Participants (ages 21-80 yrs) with at least one follow-up visit (n = 620) were examined at baseline, 12, 24, and 33 months. Negative binomial and zero-inflated negative binomial regression models were used to estimate incidence rate ratios (IRR) for xylitol's differential effect on cumulative caries increments on root and coronal surfaces and, among coronal surfaces, on smooth (buccal and lingual), occlusal, and proximal surfaces. Participants in the xylitol arm developed 40% fewer root caries lesions (0.23 D 2 FS/year) than those in the placebo arm (0.38 D 2 FS/year; IRR = 0.60; 95% CI [0.44, 0.81]; p < .001). There was no statistically significant difference between xylitol and control participants in the incidence of smoothsurface caries (p = .100), occlusal-surface caries (p = .408), or proximal-surface caries (p = .159). Among these caries-active adults, xylitol appears to have a caries-preventive effect on root surfaces (ClinicalTrials.gov NCT00393055).

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confidence: 43%

Tooth-surface-specific Effects of Xylitol

et al. 2013

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“…Five to six grams and three daily exposures are required for this clinical effect. 16 A xylitol concentration of 65 mM has been shown to have antimicrobial activity against otopathogenic bacteria. 17 In our study, the final concentration of 110 mM xylitol was used.…”

Section: Discussionmentioning

confidence: 99%

Xylitol inhibits carcinogenic acetaldehyde production by Candida species

Uittamo

Nieminen

Kaihovaara

et al. 2011

Intl Journal of Cancer

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Acetaldehyde is a highly toxic and mutagenic product of alcohol fermentation and metabolism which has been classified as a Class I carcinogen for humans by the International Agency for Research on Cancer of the World Health Organisation (WHO). Many Candida species representing oral microbiota have been shown to be capable of marked acetaldehyde production. The aim of our study was to examine the effects of various sugar alcohols and sugars on microbial acetaldehyde production. The study hypothesis was that xylitol could reduce the amount of acetaldehyde produced by Candida. Laboratory and clinical isolates of seven Candida species were selected for the study. The isolates were incubated in 12 mM ethanol and 110 mM glucose, fructose or xylitol at 37°C for 30 min and the formed acetaldehyde was measured by gas chromatography. Xylitol significantly (p < 0.0001) reduced the amount of acetaldehyde produced from ethanol by 84%. In the absence of xylitol, the mean acetaldehyde production in ethanol incubation was 220.5 μM and in ethanol–xylitol incubation 32.8 μM. This was found to be mediated by inhibition of the alcohol dehydrogenase enzyme activity. Coincubation with glucose reduced the amount of produced acetaldehyde by 23% and coincubation with fructose by 29%. At concentrations that are representative of those found in the oral cavity during the intake of proprietary xylitol products, xylitol was found to reduce the production of carcinogenic acetaldehyde from ethanol by Candida below the mutagenic level of 40–100 μM.

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“…Because dental caries has been identified by health authorities as a significant public health problem, it is essential that the public be informed about the beneficial effects of xylitol (and most likely erythritol) on dental health. Since there is currently significant scientific information on xylitol as a cariesreducing sugar substitute, it is understandable that the utility value of xylitol and its vehicles for public health needs has recently received attention among leading experts in the field [129][130][131] .…”

Section: Discussionmentioning

confidence: 99%

Sugar Alcohol Sweeteners as Alternatives to Sugar with Special Consideration of Xylitol

Mäkinen¹

2011

Med Princ Pract

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Introduction: Dental caries is a diet-associated disease which continues to be a serious health problem in most industrialized and developing countries. Strategies to maximize caries prevention should automatically consider the use of sugar substitutes. It is important that public health authorities are made cognizant of the availability of new polyol-type sugar substitutes. Review Summary: Clinical studies have shown that xylitol, a natural, physiologic sugar alcohol of the pentitol type, can be used as a safe and effective caries-limiting sweetener. Habitual use of xylitol-containing food and oral hygiene adjuvants has been shown to reduce the growth of dental plaque, to interfere with the growth of caries-associated bacteria, to decrease the incidence of dental caries, and to be associated with remineralization of caries lesions. Numerous public regulatory bodies have endorsed the use of xylitol as a caries-limiting agent. Other sugar alcohols that have been successfully used as sugar substitutes include D-glucitol (sorbitol), which, however, owing to its hexitol nature, normally has no strong effect on the mass and adhesiveness of bacterial plaque and on the growth of mutans streptococci. A tetritol-type alditol, erythritol, has shown potential as a non-cariogenic sugar substitute. Combinations of xylitol and erythritol may reduce the incidence of caries more effectively than either alditol alone. Conclusions: Partial sugar substitution with polyols is an important dietary tool in the prevention of dental caries that should be used to enhance existing fluoride-based caries prevention programmes. The most effective method of conveying this information to the public is through a proper health claim for these alditols in food labelling. The present review summarizes clinical and biochemical aspects of the above three dietary polyols and emphasizes the role of sugar substitution as a potential health-promoting strategy.

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Xylitol and Its Vehicles for Public Health Needs

Cited by 48 publications

References 20 publications

Tooth-surface-specific Effects of Xylitol

Tooth-surface-specific Effects of Xylitol

Xylitol inhibits carcinogenic acetaldehyde production by Candida species

Sugar Alcohol Sweeteners as Alternatives to Sugar with Special Consideration of Xylitol

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