Xylitol in preventing dental caries: A systematic review and meta-analyses

Abstract

Xylitol is a sugar alcohol having the properties that reduce levels of mutans streptococci (MS) in the plaque and saliva. To assess the role of xylitol in preventing dental caries. Systematic review and meta-analysis developed by Cochrane cooperation were adapted. Electronic search was carried out in PubMed through the period up to 2014. Included clinical studies were done on (1) humans (2) participants include both individuals and as pairs (mother-child) (3) participants using orthodontic appliances (4) xylitol dispensed in any form (5) compare the effect of xylitol on dental caries and on other phenotype that determines the preventive effect on dental caries, such as decayed, missing, and filled (DMF/dmf) and salivary or plaque MS level. Twenty articles of the 477 articles initially identified. Among 20 studies indexed, 16 articles were accessed, systematically reviewed, and the meta-analysis was carried out. The evaluation of quality of the studies was done using risk of bias assessment tool. The quality of the studies was high risk and unclear risk for six and five trials. The meta-analysis shows a reduction in DMF/dmf with the standard mean (SM) of −1.09 (95% confidence interval [95% CI], −1.34, −0.83) comparing xylitol to all controls. The effect of DMF/dmf reduction by xylitol to fluoride varnish was with the SM of −1.87 (95% CI, −2.89, −0.84). The subgroup analysis, there was a reduction in MS count with SM of 0.30 (95% CI, 0.05, 0.56) when compared with all other caries preventive strategies; however, it was insignificant. Xylitol was found to be an effective strategy as self-applied caries preventive agent.

Effect of xylitol on salivary β‐glucosidase in humans

“…Several studies have demonstrated that xylitol possesses important oral health applications, especially for the control of cariogenic bacteria . Earlier studies evaluated the inhibitory effect of xylitol on the formation of Streptococcus mutans , Streptococcus mitis , and Streptococcus sanguinis biofilms, demonstrating that xylitol has the ability to inhibit the formation of biofilm mass by about 68% when used as a sucrose substitute.…”

“…Substances able to interfere with bacterial adhesion on oral surfaces are of great importance for biofilm control and oral health maintenance. Xylitol, which is used as a sucrose substitute, has many clinical applications owing to its anticariogenic and antiadherent effects that are mediated by a reduction of the adhesion of bacteria important for biofilm formation . Studies demonstrate that xylitol inhibits oral biofilm formation but the exact mode of action for biofilm inhibition is still not completely understood.…”

Propriedades antibacterianas e anticariogênicas do xilitol: uma revisão da literatura

“…In a recent systematic review, Janaldram et al 48 defended the use of xylitol over other preventive strategies. They considered that the use of xylitol in products suitable for self-application could be considered an effective strategy.…”

Knowledge and Self Perception about Preventive Dentistry among Indonesian Dental Students

“…It has been suggested that it is due to influence of multiple factors including use of fluoride, enhanced oral hygiene including brushing and flossing, dietary changes, xylitol and specific procedure performed in dentists office such as routine examination including diagnostic radiographs, scaling and polishing, fluoride applications, and sealant [6][7][8][9].…”