Effects of xylitol-containing chewing gum on the oral microbiota

Abstract

In this interventional study, a randomized controlled trial was used to evaluate the short-term effects of xylitol-containing chewing gum on the salivary microbiota. In total, 70 healthy adult men recruited from the Japan Ground Self Defense Force participated in the study during a 2-day training at Yamaguchi camp, Yamaguchi Prefecture, Japan. The men were randomly divided into two groups: one group chewed two pieces of xylitol-containing chewing gum 7 times/day for 2 days (n = 34) and the other did not (n = 36). Baseline and follow-up stimulated saliva samples were collected and the salivary microbial composition was assessed using the 16S rRNA gene next-generation sequencing analysis. The total salivary bacterial count was quantified using a quantitative real-time PCR system. No statistically significant difference was found between the two groups regarding any parameter analyzed in the baseline samples; however, the follow-up samples of the test group showed significantly lower total salivary bacterial count than those of the control group. Conversely, no significant difference was observed in the overall composition of the salivary microbiota between the baseline and follow-up samples of the two groups. These results indicate that xylitol-containing chewing gum inhibits the increase in total salivary bacteria over a short time during which the salivary microbial composition is not affected.

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

“…In the studies by Seki et al [37] and Thabuis et al [41], results were presented in a way that made them very difficult to interpret, leading to a high risk of bias. In the paper by Takeuchi et al [46], the conclusions were not necessarily supported by the results, leading to an unclear risk of bias.…”

“…In four studies, the primary outcome measure was the amount or acidogenicity of plaque [27,36], and in two caries occurrence [42,44]. Two of the studies used plaque or saliva microbiota as the primary outcome measure [45,46] and two studies used the microbiota as the secondary outcome measure [38,43].…”

“…In this regard, only in two studies was proper blinding not carried out [31,41]. However, problems with allocation concealment and blinding are inevitable when the control group does not chew gum or consume candies [26,27,31,37,40,41,46]. An unclear or high risk of bias in the incomplete outcome data was mainly based on not taking dropouts into consideration [31,37,41,42,44,46].…”

“…Most of the evaluated studies reported that they obtained the tested xylitol and control products as gifts from various companies without other apparent funding. However, four studies appeared to be partly [28,33] or fully industry-funded [42,46] resulting in an unclear risk of funding bias.…”

“…In the paper by Thabuis et al [41], the authors report that subjects with low MS counts were selected for the study, even though the results suggest otherwise. In the study by Takeuchi et al [46], the test gum contained two active agents in addition to xylitol: funoran and Ca-phosphate, leading to a high risk of bias.…”