Article | . Vol. 19, Issue. 4
Effect of xylitol on dental caries prevention : a literature review



Department of Dental Hygiene, Daegu Health College1
Department of Preventive Dentistry, School of Dentistry, Kyungpook National University2
University3Department of Dental Hygiene, College of Science & Technology, Kyungpook National University3




.. 449:465


PDF XML




Xylitol is a sweetening agent used to prevent dental caries. It is formulated and consumed in various forms, and its use is recommended in particular for oral health. However, dental specialists are not familiar with xylitol or well-acquainted with the appropriate method to use it. Furthermore, the caries-prevention effect of xylitol has been controversial. Thus, in this study, we aimed to analyze previously published studies on the dental caries prevention effect of xylitol to verify its true effects and establish an appropriate method to use it. We analyzed 94 clinical research manuscripts obtained from domestic and international online databases and found that although 11 manuscripts reported no significant dental caries prevention effect of xylitol, most manuscripts reported dental caries prevention with xylitol. Compared to the manuscripts that reported dental caries prevention with xylitol, those are assessed lower amounts of xylitol or shorted consumption periods, and had dosage form that could not retain xylitol sufficiently long in the mouth, similar to milk. Thus, consumption of 5–11 g of xylitol in the form of gums, candies, or tablets over a long time period could effectively reduce the risk of dental caries. It has the advantage of ease of consumption, regardless of the gender, age, or disability of the person.



1. Washuttl J, Riederer P, Bancher E. Qualitative and quantitative study of sugar-alcohols in several foods. J Food Sci 1973;38(7):1262-3.   

2. Hansom J, Campbell L. Xylitol and caries prevention. J Mass Dent Soc 2011;60(2):18-21.   

3. Mühlemann HR, Regolati B, Marthaler TM. The effect on rat fissure caries of xylitol and sorbitol. Helv Odontol Acta 1970;14(1):48-50.   

4. Scheinin A, Mäkinen KK, Tammisalo E, Rekola M. Turku sugar studies XVIII. Incidence of dental caries in relation to 1-year consumption of xylitol chewing gum. Acta Odontol Scand 1975;33(5):269-78.   

5. Scheinin A, Mäkinen KK, Ylitalo K. Turku sugar studies V final report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man. Acta Odontol Scand 1976;34(4):179-216.   

6. Gupta M. Sugar substitutes: mechanism, availability, current use and safety concerns-an update. Open Access Maced J Med Sci 2018;6(10):1888-94. https://doi.org/10.3889/oamjms.2018.336   

7. Jung JY, Kang JK, Kim SH, Shin MS, Cho MS, Hwang YS, et al. The recognition of oral health professionals on oral health promoting effect of xylitol among dental personnel in Korea. J Korean Acad Dent Health 2008;32(3):287-98.   

8. Lee JC, Lee KH, Kim DE. An effect of xylitol on the adhesiveness of Streptococcus mutans to synthetic hydroxyapatite; an in vitro study. J Korean Acad Pediatr Dent 2002;29(1):92-9.   

9. Bader JD, Vollmer WM, Shugars DA, Gilbert GH, Amaechi BT, Brown JP, et al. Results from the xylitol for adult caries trial (X-ACT). J Am Dent Assoc 2013;144(1):21-30. https://doi.org/10.14219/jada.archive.2013.0010  

10. Kumar S , Sogi SH , Indushekar KR . Comparative evaluation of the effects of xylitol and sugar-free chewing gums on salivary and dental plaque pH in children. J Indian Soc Pedod Prev Dent 2013;31(4):240-4. https://doi.org/10.4103/0970-4388.121822   

11. Moon HS. Effect of xylitol in chewing gum on Streptococcus mutans and lactobacilli . J Korean Acad Dent Health 1995;19(2):245-6.  

12. Twetman S, Stecksén-Blicks C. Effect of xylitol-containing chewing gums on lactic acid production in dental plaque from caries active pre-school children. Oral Health Prev Dent 2003;1(3):195-9.   

13. Massoth D, Massoth G, Massoth IR, Laflamme L, Shi W, Hu C, et al. The effect of xylitol on streptococcus mutans in children. J Calif Dent Assoc 2006;34(3):231-4.   

14. Autio JT. Effect of xylitol chewing gum on salivary streptococcus mutans in preschool children. J Dent Child 2002;69(1):81-6.   

15. Lif Holgerson P, Stecksén-Blicks C, Sjöström I, Twetman S. Effect of xylitol-containing chewing gums on interdental plaque-pH in habitual xylitol consumers. Acta Odontol Scand 2005;63(4):233-8. https://doi.org/10.1080/00016350510019883   

16. Holgerson PL, Sjöström I, Stecksén-blicks C, Twetman S. Dental plaque formation and salivary mutans streptococci in schoolchildren after use of xylitol-containing chewing gum. Int J Paediatr Dent 2007;17(2):79-85. https://doi.org/10.1111/j.1365-263X.2006.00808.x   

17. Thabuis C, Cheng CY, Wang X, Pochat M, Han A, Miller L, et al. Effects of maltitol and xylitol chewing-gums on parameters involved in dental caries development. Eur J Paediatr Dent 2013;14(4):303-8.   

18. Söderling E, ElSalhy M, Honkala E, Fontana M, Flannagan S, Eckert G, et al. Effects of short-term xylitol gum chewing on the oral microbiome. Clin Oral Investig 2015;19(2):237-44. https://doi.org/10.1007/s00784-014-1229-y   

19. Tulsani SG, Chikkanarasaiah N, Siddaiah SB, Krishnamurthy NH. The effect of propolis and xylitol chewing gums on salivary streptococcus mutans count: a clinical trial. Indian J Dent Res 2014;25(6):737-41. https://doi.org/10.4103/0970-9290.152182   

20. Anttonen V, Halunen I, Päkkilä J, Larmas M, Tjäderhane L. A practice-based study on the effect of a short sucrose/xylitol exposure on survival of primary teeth caries free. Int J Paediatr Dent 2012;22(5):356-62. https://doi.org/10.1111/j.1365-263X.2011.01205.x   

21. Thaweboon S, Thaweboon B, Soo-Ampon S. The effect of xylitol chewing gum on mutans streptococci in saliva and dental plaque. Southeast Asian J Trop Med Public Health 2004;35(4):1024-7.   

22. Seki M, Karakama F, Kawato T, Tanaka H, Saeki Y, Yamashita Y. Effect of xylitol gum on the level of oral mutans streptococci of preschoolers: block-randomised trial. Int Dent J 2011;61(5):274-80. https://doi.org/10.1111/j.1875-595X.2011.00073.x   

23. Han SK, Choi YH, Son EY, Song KB, Kim YG, Nam SH. Prevention of dental caries gum in pre-school children during 12-months. J Korean Acad Pediatr Dent 2004;31(2):159-68.   

24. Holgerson PL, Sjöström I, Twetman S. Decreased salivary uptake of [14C]-xylitol after a four-week xylitol chewing gum regimen. Oral Health Prev Dent 2007;5(4):313-9.   

25. Mäkinen KK, Isotupa KP, Mäkinen PL, Söderling E, Song KB, Nam SH, et al. Six-month polyol chewing-gum programme in kindergarten-age children: a feasibility study focusing on mutans streptococci and dental plaque. Int Dent J 2005;55(2):81-8. https://doi.org/10.1111/j.1875-595X.2005.tb00038.x   

26. Kovari H, Pienihäkkinen K, Alanen P. Use of xylitol chewing gum in daycare centers: a follow up study in Savonlinna, Finland. Acta Odontol Scand 2003;61(6):367-70.   

27. Alanen P, Isokangas P, Gutmann K. Xylitol candies in caries prevention: results of a field study in Estonian children. Community Dent Oral Epidemiol 2000;28(3):218-24. https://doi.org/10.1034/j.1600-0528.2000.280308.x  

28. Mäkinen KK, Alanen P, Isokangas P, Isotupa K, Söderling E, Mäkinen PL, et al. Thirty-nine-month xylitol chewing-gum programme in initially 8-year-old school children: a feasibility study focusing on mutans streptococci and lactobacilli . Int Dent J 2008;58(1):41-50. https://doi.org/10.1111/j.1875-595X.2008.tb00175.x   

29. Mäkinen KK, Bennett CA, Hujoel PP, Isokangas PJ, Isotupa KP, Pape HR Jr, et al. Xylitol chewing gums and caries rates: A 40-month cohort study. J Dent Res 1995;74(12):1904-13. https://doi.org/10.1177/00220345950740121501  

30. Isokangas P, Alanen P, Tiekso J, Makinen KK. Xylitol chewing gum in caries prevention: a field study in children. J Am Dent Assoc 1988;117(2):315-20. https://doi.org/10.1016/S0002-8177(88)72017-6  

31.  Mäkinen KK, Chen CY, Mäkinen PL, Bennett CA, Isokangas PJ, Isotupa KP, et al. Properties of whole saliva and dental plaque in relation to 40-month consumption of chewing gums containing xylitol, sorbitol of sucrose. Caries Res 1996;30(3):180-8. https://doi.org/10.1159/000262157  

32. Mäkinen KK, Hujoel PP, Bennett CA, Isotupa KP, Mäkinen PL, Allen P. Polyol chewing gums and caries rates in primary dentition: a 24-month cohort study. Caries Res 1996;30(6):408-17. https://doi.org/10.1159/000262352  

33. Campus G, Cagetti MG, Sacco G, Solina G, Mastroberardino S, Lingström P. Six months of daily high-dose xylitol in high-risk schoolchildren: a randomized clinical trial on plaque pH and salivary mutans streptococci . Caries Res 2009;43(6):455-61. https://doi.org/10.1159/000264682  

34.  Mäkinen KK, Hujoel PP, Bennett CA, Isokangas P, Isotupa K, Pape HR Jr, et al. A descriptive report of the effects of a 16-month xylitol chewing-gum programme subsequent to a 40-month sucrose gum programme. Caries Res 1998;32(2):107-12. https://doi.org/10.1159/000016439  

35. Mäkinen KK, Mäkinen PL, Pape HR Jr, Allen P, Bennett CA, Isokangas PJ, et al. Stabilization of rampant caries: polyol gums and arrest of dentine caries in two long-term cohort studies in young subjects. Int Dent J 1995;45(1 suppl 1):93-107.  

36. Alanen P, Holsti ML, Pienihäkkinen K. Sealants and xylitol chewing gum are equal in caries prevention. Acta Odontol Scand 2000;58(6):279-84.   

37. Hujoel PP, Mäkinen KK, Bennett CA, Isotupa KP, Isokangas PJ, Allen P, et al. The optimum time to initiate habitual xylitol gum-chewing for obtaining long-term caries prevention. J Dent Res 1999;78(3):797-803. https://doi.org/10.1177/00220345990780031301  

38. Machiulskiene V, Nyvad B, Baelum V. Caries preventive effect of sugar-substituted chewing gum. Community Dent Oral Epidemiol 2001;29(4):278-88.   

39. Machiulskiene V, Nyvad B, Baelum V. Determinants of dropout in a community intervention trial on the caries-preventive effect of chewing gums. J Public Health Dent 2002;62(1):21-7.   

40. Mäkinen KK, Chiego DJ Jr, Allen P, Bennett C, Isotupa KP, Tiekso J, et al. Physical, chemical, and histologic changes in dentin caries lesions of primary teeth induced by regular use of polyol chewing gums. Acta Odontol Scand 1998;56(3):148-56.  

41. Kandelman D, Gagnon G. A 24-month clinical study of the incidence and progression of dental caries in relation to consumption of chewing gum containing xylitol in school preventive programs. J Dent Res 1990;69(11):1771-5. https://doi.org/10.1177/00220345900690111201  

42.  [42] Park KK, Hernandez D, Schemehorn BR, Katz BP, Stookey GK, Sanders PG, et al. Effect of chewing gums on plaque pH after a sucrose challenge. ASDC J Dent Child 1995;62(3):180-6.   

43. Tellefsen G, Larsen G, Kaligithi R, Zimmerman GJ, Wikesjö ME. Use of chlorhexidine chewing gum significantly reduces dental plaque formation compared to use of similar xylitol and sorbitol products. J Periodontol 1996;67(3):181-3. https://doi.org/10.1902/jop.1996.67.3.181   

44. Cronin M, Gordon J, Reardon R, Balbo F. Three clinical trials comparing xylitol- and sorbitol-containing chewing gums for their effect on supragingival plaque accumulation. J Clin Dent 1994;5(4):106-9.   

45. Birkhed D, Edwardsson S, Wikesjö U, Ahldén ML, Ainamo J. Effect of 4 days consumption of chewing gum containing sorbitol or a mixture of sorbitol and xylitol on dental plaque and saliva. Caries Res 1983;17(1):76-88. https://doi.org/10.1159/000260652   

46. Söderling E, Mäkinen KK, Chen CY, Pape HR Jr, Loesche W, Mäkinen PL. Effect of sorbitol, xylitol, and xylitol/sorbitol chewing gums on dental plaque. Caries Res 1989;23(5):378-84. https://doi.org/10.1159/000261212  

47. Merikallio T, Sodering E. Xylitol as a plaque-control agent in military conditions. Mil Med 1995;160(5):256-8.   

48.  Söderling E, Trahan L, Tammiala-Salonen T, Häkkinen L. Effects of xylitol, xylitol-sorbitol, and placebo chewing gums on the plaque of habitual xylitol consumers. Eur J Oral Sci 1997;105(2):170-7. https://doi.org/10.1111/j.1600-0722.1997.tb00196.x  

49. Bahador A, Lesan S, Kashi N. Effect of xylitol on cariogenic and beneficial oral streptococci : a randomized, double-blind crossover trial. Iran J Microbiol 2012;4(2):75-81.   

50. Aguirre-Zero O, Zero DT, Proskin HM. Effect of chewing xylitol chewing gum on salivary flow rate and the acidogenic potential of dental plaque. Caries Res 1993;27(1):55-9. https://doi.org/10.1159/000261516  

51.  Wennerholm K, Arends J, Birkhed D, Ruben J, Emilson CG, Dijkman AG. Effect of xylitol and sorbitol in chewing-gums on mutans streptococci , plaque pH and mineral loss of enamel. Caries Res 1994;28(1):48-54. https://doi.org/10.1159/000261620   

52. Biria M, Eslami G, Taghipour E, Baghban AA. Effects of three mastic gums on the number of mutans streptococci , lactobacilli and pH of the saliva. J Dent 2014;11(6):672-9.   

53.  Tuncer D, Önen A, Yazici AR. Effect of chewing gums with xylitol, sorbitol and xylitol-sorbitol on the remineralization and hardness of initial enamel lesions in situ . Dent Res J(Isfahan) 2014;11(5):537-43.  

54. Haghgoo R, Afshari E, Ghanaat T, Aghazadeh S. Comparing the efficacy of xylitol-containing and conventional chewing gums in reducing salivary counts of streptococcus mutans : An in vivo study. J Int Soc Prev Community Dent 2015;5(suppl 2):S112-7.   

55. Fraga CP, Mayer MP, Rodrigues CR. Use of chewing gum containing 15% of xylitol and reduction in mutans streptococci salivary levels. Braz Oral Res 2010;24(2):142-6.   

56. Martínez-Pabón MC, Duque-Agudelo L, Díaz-Gil JD, Isaza-Guzmán DM, Tobón-Arroyave SI. Comparison of the effect of two sugar-substituted chewing gums on different caries- and gingivitis-related variables: a double-blind, randomized, controlled clinical trial. Clin Oral Investig 2014;18(2):589-98. https://doi.org/10.1007/s00784-013-0989-0   

57. Söderling E, Hirvonen A, Karjalainen S, Fontana M, Catt D, Seppä L. The effect of xylitol on the composition of the oral flora: a pilot study. Eur J Dent 2011;5(1):24-31.   

58. Ly KA, Milgrom P, Roberts MC, Yamaguchi DK, Rothen M, Mueller G. Linear response of mutans streptococci to increasing frequency of xylitol chewing gum use: a randomized controlled trial. BMC oral health 2006;6:1-6. https://doi.org/10.1186/1472-6831-6-6   

59.  [59] Haresaku S, Hanioka T, Tsutsui A, Yamamoto M, Chou T, Gunjishima Y. Long-term effect of xylitol gum use on mutans streptococci in adults. Caries Res 2007;41(3):198-203. https://doi.org/10.1159/000099318   

60. Milgrom P, Ly KA, Roberts MC, Rothen M, Mueller G, Yamaguchi DK.Mutans streptococci dose response to xylitol chewing gum. J Dent Res 2006;85(2):177-81. https://doi.org/10.1177/154405910608500212   

61. Mäkinen KK, Pemberton D, Cole J, Mäkinen PL, Chen CY, Lambert P. Saliva stimulants and the oral health of geriatric patients. Adv Dent Res 1995;9(2):125-6. https: //doi.org/10.1177/08959374950090020901  

62. Ghasemi E, Mazaheri R, Tahmourespour A. Effect of probiotic yogurt and xylitol-containing chewing gums on salivary S. mutans count. J Clin Pediatr Dent 2017;41(4):257-63. https://doi.org/10.17796/1053-4628-41.4.257   

63. Cocco F, Carta G, Cagetti MG, Strohmenger L, Lingström P, Campus G. The caries preventive effect of 1-year use of low-dose xylitol chewing gum. A randomized placebo-controlled clinical trial in high-caries-risk adults. Clin Oral Investig 2017;21(9):2733-40.  

64. Shinga-Ishihara C, Nakai Y, Milgrom P, Söderling E, Tolvanen M, Murakami K. Xylitol carryover effects on salivary mutans streptococci after 13 months of chewing xylitol gum. Caries Res 2012;46(6):519-22. https://doi.org/10.1159/000341221   

65. Lee YE, Choi YH, Jeong SH, Kim HS, Lee SH, Song KB. Morphological changes in streptococcus mutans after chewing gum containing xylitol for twelve months. Curr Microbiol 2009;58(4):332-7. https://doi.org/10.1007/s00284-008-9332-4  

66. Mäkinen KK, Pemberton D, Mäkinen PL, Chen CY, Cole J, Hujoel PP, et al. Polyol-combinant saliva stimulants and oral health in Veterans Affairs patients-An exploratory study. Spec Care Dentist 1996;16(3):104-15.  

67. Isokangas P, Söderling E, Pienihäkkinen K, Alanen P. Occurrence of dental decay in children after maternal consumption of xylitol chewing gum, a follow-up from 0 to 5 years of age. J Dent Res 2000;79(11):1885-9. https://doi.org/10.1177/00220345000790111201  

68. Söderling E, Isokangas P, Pienihäkkinen K, Tenovuo J, Alanen P. Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci : 6-year follow-up. Caries Res. 2001;35(3):173-7. https://doi.org/10.1159/000047452   

69. Alamoudi NM, Hanno AG, Almushayt AS, Masoud MI, El Ashiry EA, El Derwi DA. Early prevention of childhood caries with maternal xylitol consumption. Saudi Med J 2014 ;35(6):592-7.   

70. Alamoudi NM, Hanno AG, Sabbagh HJ, Masoud MI, Almushayt AS, El Derwi DA. Impact of maternal xylitol consumption on mutans streptococci , plaque and caries levels in children. J Clin Pediatr Dent 2012;37(2):163-6.   

71. Alamoudi NM, Hanno AG, Masoud MI, Sabbagh HJ, Almushayt AS, Masoud IM. Effects of xylitol on salivary mutans streptococcus , plaque level, and caries activity in a group of Saudi mother-child pairs. An 18-month clinical trial. Saudi Med J 2012;33(2):186-92.   

72. Fontana M, Catt D, Eckert GJ, Ofner S, Toro M, Gregory RL, et al. Xylitol: effects on the acquisition of cariogenic species in infants. Pediatr Dent 2009;31(3):257-66.   

73. Thorild I, Lindau B, Twetman S. Long-term effect of maternal xylitol exposure on their children’s caries prevalence. Eur Arch Paediatr Dent 2012;13(6):305-7.   

74. Thorild I, Lindau B, Twetman S. Caries in 4-year-old children after maternal chewing of gums containing combinations of xylitol, sorbitol, chlorhexidine and fluoride. Eur Arch Paediatr Dent 2006;7(4):241-5.  

75.  [75] Thorild I, Lindau B, Twetman S. Salivary mutans streptococci and dental caries in three-year-old children after maternal exposure to chewing gums containing combinations of xylitol, sorbitol, chlorhexidine and fluoride. Acta Odontol Scand 2004;62(5):245-50.   

76. Thorild I, Lindau B, Twetman S. Effect of maternal use of chewing gums containing xylitol, chlorhexidine or fluoride on mutans streptococci colonization in the mothers’ infant children. Oral Health Prev Dent 2003;1(1):53-7.   

77.  Hanno AG, Alamoudi NM, Almushayt AS, Masoud MI, Sabbagh HJ, Farsi NM. Effect of xylitol on dental caries and salivary streptococcus mutans levels among a group of mother-child pairs. J Clin Pediatr Dent 2011;36(1):25-30.   

78. Laitala ML, Alanen P, Isokangas P, Söderling E, Pienihäkkinen K. Long-term effects of maternal prevention on children’s dental decay and need for restorative treatment. Community Dent Oral Epidemiol 2013;41(6):534-40. https://doi.org/10.1111/cdoe.12057   

79. Söderling E, Isokangas P, Pienihäkkinen K, Tenovuo J. Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. J Dent Res 2000;79(3):882-7.   

80. Nakai Y, Shinga-Ishihara C, Kaji M, Moriya K, Murakami-Yamanaka K, Takimura M. Xylitol gum and maternal transmission of mutans streptococci . J Dent Res 2010;89(1):56-60. https://doi.org/10.1177/0022034509352958   

81. Olak J, Saag M, Vahlberg T, Söderling E, Karjalainen S. Caries prevention with xylitol lozenges in children related to maternal anxiety. A demonstration project. Eur Arch Paediatr Dent 2012;13(2):64-9.  

82. Watthanasaen S, Merchant AT, Luengpailin S, Chansamak N, Pisek A, Pitiphat W. Xylitol-containing chewing gum for caries prevention in students with disabilities: a randomized trial. Oral Health Pprev Dent 2017;15(6):519-27. https://doi.org/10.3290/j.ohpd.a39668   

83. Isotupa KP, Gunn S, Chen CY, Lopatin D, Mäkinen KK. Effect of polyol gums on dental plaque in orthodontic patients. Am J Orthod Dentofacial Orthop 1995;107(5):497-504. https://doi.org/10.1016/S0889-5406(95)70117-6   

84. Steinberg LM, Odusola F, Mandel ID. Remineralizing potential, antiplaque and antigingivitis effects of xylitol and sorbitol sweetened chewing gum. Clin Prev Dent 1992;14(5):31-4.   

85. Topitsoglou V, Birkhed D, Larsson LA, Frostell G. Effect of chewing gum containing xylitol, sorbitol or a mixture of sorbitol and xylitol on plaque formation, pH change and acid production in human dental plaque. Caries Res 1983;17(4):369-78. https://doi.org/10.1159/000260690   

86. Bader JD, Shugars DA, Vollmer WM, Gullion CM, Gilbert GH, Amaechi BT, et al. Design of the xylitol for adult caries trial (X-ACT). BMC Oral Health 2010;10:22-9. https://doi.org/10.1186/1472-6831-10-22   

87. Brown JP, Amaechi BT, Bader JD, Gilbert GH, Makhija SK, Lozano-Pineda J. Visual scoring of non cavitated caries lesions and clinical trial efficiency, testing xylitol in caries-active adults. Community Dent Oral Epidemiol 2014;42(3):271-8. https://doi.org/10.1111/cdoe.12082   

88. Splieth CH, Alkilzy M, Schmitt J, Berndt C, Welk A. Effect of xylitol and sorbitol on plaque acidogenesis. Quintessence Int 2009;40(4):279-85.   

89. Honkala E, Honkala S, Shyama M, Al-Mutawa SA. Field trial on caries prevention with xylitol candies among disabled school students. Caries Res 2006;40(6):508-13. https://doi.org/10.1159/000095650   

90. Sengun A, Sari Z, Ramoqlu SI, Malkoc S, Duran I. Evaluation of the dental plaque pH recovery effect of a xylitol lozenge on patients with fixed orthodontic appliances. Angle Orthod 2004;74(2):240-4.   

91. Taipale T, Pienihäkkinen K, Alanen P, Jokela J, Söderling E. Administration of Bifidobacterium animalis subsp. lactis BB-12 in early childhood: a post-trial effect on caries occurrence at four years of age. Caries Res 2013;47(5):364-72. https://doi.org/10.1159/000348424   

92. Oscarson P, Holgerson PL, Sjöström I, Twetman S, Stecksén-Blicks C. Influence of a low xylitol-dose on mutans streptococci colonization and caries development in preschool children. Eur Arch Paediatr Dent 2006;7(3):142-7. https://doi.org/10.1007/bf03262555   

93. Mäkinen KK, Isotupa KP, Kivilompolo T, Mäkinen PL, Toivanen J, Söderling E. Comparison of erythritol and xylitol saliva stimulants in the control of dental plaque and mutans streptococci . Caries Res 2001;35(2):129-35. https://doi.org/10.1159/000047444   

94. Mäkinen KK, Isotupa KP, Kivilompolo T, Mäkinen PL, Murtomaa S, Petäjä J, et al. The effect of polyol-combinant saliva stimulants on S. mutans levels in plaque and saliva of patients with mental retardation. Spec Care Dentist 2002;22(5):187-93. https://doi.org/10.1111/j.1754-4505.2002.tb00269.x   

95. Stecksén-Blicks C, Holgerson PL, Olsson M, Bylund B, Sjöström I, Sköld-Larsson K, et al. Effect of xylitol on mutans streptococci and lactic acid formation in saliva and plaque from adolescents and young adults with fixed orthodontic appliances. Eur J Oral Sci 2004;112(3):244-8. https://doi.org/10.1111/j.1600-0722.2004.00130.x   

96. Roberts MC, Riedy CA, Coldwell SE, Nagahama S, Judge K, Lam M,et al. How xylitol-containing products affect cariogenic bacteria. J Am Dent Assoc 2002;133(4):435-41. https://doi.org/10.14219/jada.archive.2002.0201   

97. Scheinin A, Bánóczy J. Xylitol and caries: the collaborative WHO oral disease preventive programme in Hungary. Int Dent J 1985;35(1):50-7.   

98. Milgrom P , Ly KA , Tut OK , Mancl L , Roberts MC , Briand K , et al. Xylitol pediatric topical oral syrup to prevent dental caries. Arch Pediatr Adolesc Med 2009;163(7):601-7. https://doi.org/10.1001/archpediatrics.2009.77   

99. Ly KA, Riedy CA, Milgrom P, Rothen M, Roberts MC, Zhou L. Xylitol gummy bear snacks: a school-based randomized clinical trial. BMC oral health 2008;8(20):1-11. https://doi.org/10.1186/1472-6831-8-20  

100. Chi DL, Zegarra G, Vasquez Huerta EC, Castillo JL, Milgrom P, Roberts MC, et al. Milk sweetened with xylitol: A proof-of-principle caries prevention randomized clinical trial. J Dent Child (Chic) 2016;83(3):152-60.  

101. Leach SA, Green RM. Reversal of fissure caries in the albino rat by sweetening agents. Caries Res 1981;15(6):508-11.   

102. Bird JL, Baum BJ, Mäkinen KK, Bowen WH, Longton RW. Xylitol associated changes in amylase and protein content of monkey parotic saliva. J Nutr 1977;107(10):1763-7. https://doi.org/10.1093/jn/107.10.1763   

103. Mäkinen KK, Tenovuo J, Scheinin A. Xylitol-induced elevation of lactoperoxidase activity. J Dent Res 1976;55(4):652-60. https://doi.org/10.1177/00220345760550041901   

104. Mäkinen KK, Söderling E, Kölling D. Secretory activity of salivary gland slices in the presence of polyols. Proc Finn Dent Soc 1983;79(5-6):2218-23.   

105. Trahan L, Bareil M, Gauthier L, Vadeboncoeur C. Transport and phophorylation of xylitol by a fructose phosphotransferase system in Streptococcus mutans . Caries Res 1985;19(1):53-63. https://doi.org/10.1159/000260829   

106. Trahan L. Xylitol: a review of its action on mutans streptococci and dental plaque-its clinical significance. Int Dent J 1995;45(1):77-92.   

107. Culbert SJ, Wang YM, Fritsche HA, Carr D, Lantin E, Jan van Eys. Oral xylitol in American adults. Nutr Res 1986;6(8):913-22. https://doi.org/10.1016/S0271-5317(86)80066-5   

108. Koizumi N, Ninomoiya R, Fujii M. Estimation of maximum No-effect dose of xylitol in causing diarrhea in humans. Jpn J Food Chem 1998;5(2):218-25.   

109. Akerblom HK, Koivukangas T, Puukka R, Mononen M. The tolerance of increasing amount of dietary xylitol in children. Int J Vit Nutr Res 1982;22:53-66.   

110. Rethman MP, Beltrán-Aguilar ED, Billings RJ, Hujoel PP, Katz BP, Milgrom P, et al. Nonfluoride caries-preventive agents: executive summary of evidence-based clinical recommendations. J Am Dent Assoc 2011;142(9):1065-71. https://doi.org/10.14219/jada.archive.2011.0329   

111. Edgar WM, Geddes DA. Chewing gum and dental health: a review. Br Dent J 1990;168(4):173-7. https://doi.org/10.1038/sj.bdj.4807129   



online submission
online submission
online submission
online submission
online submission
Sub Menu
Sub Banner
Sub Menu
Sub Banner
Sub Banner
Sub Banner
Sub Banner
Sub Menu
Sub Menu