Effects of xylitol and erythritol consumption on mutans streptococci and the oral microbiota: a systematic review

Abstract

Objective: A systematic review of published data was conducted with the aim of assessing effects of xylitol and erythritol consumption on levels of mutans streptococci (MS) and the oral microbiota. Materials and methods: Electronic and hand searches were performed to find clinical microbiological studies concerning the consumption of xylitol and erythritol chewing gum or candies, and published between 2000 and 2019. Prospective randomized controlled clinical trials conducted in healthy subjects were included in the review. Results: The initial search identified 561 xylitol and 83 erythritol studies. After applying inclusion and exclusion criteria, 21 xylitol studies and one erythritol study were reviewed. The review identified nine xylitol studies with a fair or high quality, four conducted in children and five in adults, all demonstrating a decrease in MS levels in association with habitual consumption of xylitol. The three microbiota studies employing multispecies probe approaches revealed no effects for xylitol on the microbiota. The only erythritol study fulfilling the inclusion criteria showed no consistent effects on MS levels. Conclusions: Xylitol consumption is likely to decrease MS counts but it may not change the overall microbiota. Xylitol shows thus properties of an oral prebiotic. More studies are needed to demonstrate the effects of erythritol on MS.

Effects of xylitol chewing gum and candies on the accumulation of dental plaque: a systematic review

“…The result appeared to be similar in short- and long-term studies, and in children and adults. In all but one study [ 47 ], the daily doses of xylitol were high enough, approximately 5 g or higher, to achieve “xylitol effects” demonstrated, for example, in association with decreases in counts of mutans streptococci [ 15 , 52 ]. In six studies, xylitol gum chewing decreased plaque compared to sorbitol gum suggesting specific effects for xylitol on plaque accumulation [ 39 , 41 a, b, c, 43 , 45 ].…”

“…Also, when information not found in the paper was submitted by the authors, the bias was classified as unclear. The overall level of risk for each study was classified as low (all quality items were met: high quality), unclear (unclear risk of bias for one or more domain: fair quality), or high (high risk of bias for one or more domain: low quality) [15,36,37].…”

“…However, xylitol administered with pastilles [ 12 ], syrup [ 13 ] and wipes [ 14 ] has also reduced caries. There is good evidence that habitual xylitol consumption decreases counts of caries-associated mutans streptococci [ 15 ]. Xylitol appears to act as an oral prebiotic decreasing mutans streptococci without affecting the overall microbiota, and may thus increase the resistance of the microbiota to dysbiosis [ 15 ].…”

Obesity influences composition of salivary and fecal microbiota and impacts the interactions between bacterial taxa

“…Interestingly, all of the listed compounds with the exception of pectin are used as sweeteners [122, 123]. Although the effect of sweeteners on gut microbiota was extensively shown in humans and animal models, the studies on oral bacteria community are limited [124, 125]. To the best of our knowledge, this work is the first report on the correlation between dietary sweeteners and phylogenetic diversity of the human’s salivary bacterial community.…”

Co-production of Xylooligosaccharides and Xylose From Poplar Sawdust by Recombinant Endo-1,4-β-Xylanase and β-Xylosidase Mixture Hydrolysis

“…Generally, β-1,4-xylosidase can mainly degrade XOS from the non-reducing end to produce xylose. In fermentation processes, using xylose as a carbon source to produce ethanol and xylitol is of great industrial relevance (Sderling and Pienihkkinen, 2020). With deciding the optimal hydrolysis conditions of XOS from poplar sawdust xylan by Xln-DT, the effects of temperature, pH, and enzyme dosage were studied in the second stage treatment.…”