This work aimed to carry out a literature review correlating the use of xylitol with the prevention of dental caries, which is a chronic and multifactorial disease, caused by organic acids originated from the fermentation of dietary carbohydrates (dependent sucrose) by bacteria and, when associated with a limited ability to correct oral pH, lead to tooth decalcification, a process known as demineralization. The cariogenic potential of the oral microbiota is genetically determined and is accentuated by the availability of sucrose. Under these conditions, the metabolic pathways favor the reduction of pH, demineralization of the dental substrate and the synthesis of extracellular polysaccharides that act as an energy supply and adhesive strategy. Xylitol is an alcoholic sugar that hardly undergoes fermentation by oral bacteria. Therefore, it has been recommended as a substitute for sugar, especially when food is eaten between meals, helping to prevent tooth decay. The antimicrobial activity of xylitol occurs when the compound is incorporated into the bacterial cell, through the phosphorylation process in the glycolytic pathway of the bacterium, forming xylitol-5-phosphate, that is not metabolized by any enzyme, characterizing it as an intermediate compound. Xylitol is a safe nutrient for human use, and several studies have analyzed the influence of xylitol in dental caries prevention. However, there is a need for more robust clinical trials for the evaluation of the effectiveness of xylitol under ideal conditions propitious to its use.

Background: Streptococcus mutans (S. mutans) are present in the bacterial biofilm involved in the onset and progression of childhood caries, favoring acid production and dental demineralization. Sugar consumption favors the high incidence of caries in childhood, from 5 to 12 years old. A chewable lozenge incorporated with natural antimicrobial agents of recognized potency, such as red propolis and xylitol, would be an adjuvant to control caries. Materials and Methods: This is a randomized, placebo-controlled, cross-sectional clinical trial. 40 participants were divided into four groups: Placebo (group I), Red Propolis 2.5% (group II); Red propolis 6.4% (group III) and Xylitol 15% (group IV). They had saliva collected at different times of the trial for analysis of antimicrobial action. The study was registered with REBEC. Results: In the group I there were variations before and after the administration of the tablets, but no statistical significance, in relation to the group II it was found a significant reduction in the salivary concentration of S. mutans in all salivary dilutions (34,25% -63,65%), fact observed with the group III (38,42% -45,02%) and group IV (50,72% -42,92%). Conclusion: With encouraging results, further studies are needed for a longitudinal follow-up, being a low-cost alternative with anticariogenic potential.