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 There was some evidence that xylitol reduces the risk of cavities –
or caries – among children, but people should be cautious about that
finding because of limitations in the previous studies, researchers
report in the Cochrane Library.
“It’s put in a lot of products as a preventive agent for caries, but
we weren’t sure what the evidence base was to substantiate the
claims,” said Dr. Deborah Moore, one of the study’s authors from
Manchester University in the UK.
Xylitol is a sugar alcohol that is as sweet as traditional sugar,
but is not absorbed by the body, according to the researchers. Its
properties allow xylitol, which occurs naturally in plants and
fruits, to be used in diabetic and “sugar-free” food products, like
gum and candies.
“Xylitol is known in the laboratory to kill the main bacteria that
cause tooth decay, which is why it was singled out as having
possible preventive effects on tooth decay,” Moore told Reuters
Health.
Moreover, she said, there is little or no risk of xylitol causing
tooth decay, especially when it’s compared to regular sugar.
Products that contain xylitol, like gum or lozenges, can increase
the production of saliva, which also may reduce the risk of
cavities.
The new review is part of The Cochrane Collaboration, an
international organization that evaluates medical research.
The researchers compiled the best available studies comparing
products containing xylitol to products with inactive ingredients.
They found 10 studies fitting their criteria, with a total of 5,903
participants.
Two studies had data on 4,216 Costa Rican children who used either
xylitol- and fluoride-containing toothpaste or simply
fluoride-containing toothpaste for three years and found a 13
percent reduction in cavities in the xylitol-fluoride group.
However, people should be cautious about interpreting those
findings, the researchers write. The data were judged to be of low
quality, and the benefits were only seen among the children who were
evaluated in both of the studies, so the results could have
something to do factors unique to those kids.
They also found that data on side effects were lacking for many of
the studies, and they note that xylitol is linked to some stomach
issues, including diarrhea.
Moore said that xylitol is better than sugar, but there is not
enough evidence to say it prevents cavities on its own.
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“If people are concerned about tooth decay the best thing to do is
be preventive,” she said, adding that using fluoride-containing
toothpaste, using mouthwash and reducing sugar consumption are the
best preventive measures.
Dr. Burton Edelstein, chair of the Section of Population Oral Health
at Columbia University College of Dental Medicine in New York City,
agreed that more research is needed on xylitol’s potential to
prevent cavities.
He cautioned that lack of evidence is not evidence against xylitol,
however.
For example, Edelstein and colleagues estimate in a new report
published in the Journal of the American Dental Association that
money might be saved by giving mothers xylitol products because they
cut the transmission of bacteria that cause tooth decay from mother
to child.
Mothers may pass on the bacteria to their children through direct
contact, such as sharing utensils or using their saliva to clean the
baby’s pacifier or face.
Edelstein's group estimates that for every $1 spent on xylitol
products for high-risk mothers on New York’s government-run
insurance programs for the poor, $1.76 will be saved over 10 years
in reduced dental care for the children.
Other cost-effective measures include encouraging increased brushing
among high-risk preschoolers and maximizing water fluoridation in
New York, they write.
“We’re dealing with this highly prevalent and almost completely
preventable disease that’s taxing public coffers,” Edelstein told
Reuters Health.
SOURCE: http://bit.ly/1HGTrty
Cochrane Library and
http://bit.ly/1HGTLII Journal of the American Dental
Association, online March 25, 2015.
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