Long-Term Effect of Erythritol on Dental Caries Development during Childhood: A Posttreatment Survival Analysis

Falony, Gwen; Honkala, Sisko; Runnel, Riina; Olak, Jana; Nõmmela, Rita; Russak, Silvia; Saag, Mare; Mäkinen, Pirkko‐Liisa; Mäkinen, Kauko K.; Vahlberg, Tero; Honkala, Eino

doi:10.1159/000450762

Cited by 37 publications

(43 citation statements)

References 27 publications

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“…A substantial body of evidence suggests that 5-6 g of xylitol per day delivered over 3 exposures are needed for worthwhile anticaries effects [Milgrom et al, 2009]. Among other sugar polyols, erythritol has been attracting increasing attention as it is has been shown to be more effective than xylitol and sorbitol, and importantly, its anticaries effects were shown to persist for up to 3 years [Honkala et al, 2014;de Cock et al, 2016;Falony et al, 2016].…”

Section: Sugar Polyolsmentioning

confidence: 99%

Ecological Approaches to Dental Caries Prevention: Paradigm Shift or Shibboleth?

Philip

Suneja²,

Walsh³

2018

Caries Res

143

113

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Contemporary paradigms of dental caries aetiology focus on the ecology of the dental plaque biofilm and how local environmental factors can modulate this to cause disease. The crucial role that a healthy oral microbiome plays in preventing caries and promoting oral health is also being increasingly recognized. Based on these concepts, several ecological preventive approaches have been developed that could potentially broaden the arsenal of currently available caries-preventive measures. Many of these ecological approaches aim for long-term caries control by either disrupting cariogenic virulence factors without affecting bacterial viability, or include measures that can enhance the growth of health-associated, microbially diverse communities in the oral microbiome. This paper argues for the need to develop ecological preventive measures that go beyond conventional caries-preventive methods, and discusses whether these ecological approaches can be effective in reducing the severity of caries by promoting stable, health-associated oral biofilm communities.

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Section: Sugar Polyolsmentioning

confidence: 99%

Ecological Approaches to Dental Caries Prevention: Paradigm Shift or Shibboleth?

Philip

Suneja²,

Walsh³

2018

Caries Res

143

113

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“…At low doses, no adverse effects have been reported [10], making it an attractive food additive. Erythritol has been shown to have potential caries-reducing properties [11,12]. It reduces the abundance of Streptococcus mutans , significant acid-producing species, in plaque, as well as total plaque accumulation after 6 months’ consumption [13], while plaque levels of propionic acid, acetic acid, and lactic acid were reduced after 3 years of erythritol consumption [14].…”

Section: Introductionmentioning

confidence: 99%

Effect of erythritol on microbial ecology of in vitro gingivitis biofilms

Janus

Volgenant

Brandt

et al. 2017

Journal of Oral Microbiology

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Gingivitis is one of the most common oral infections in humans. While sugar alcohols such as erythritol are suggested to have caries-preventive properties, it may also have beneficial effects in prevention of gingivitis by preventing maturation of oral biofilms. The aim of this study was to assess the effect of erythritol on the microbial ecology and the gingivitis phenotype of oral microcosms. Biofilms were inoculated with stimulated saliva from 20 healthy donors and grown in a gingivitis model in the continuous presence of 0 (control group), 5, and 10% erythritol. After 9 days of growth, biofilm formation, protease activity (gingivitis phenotype), and microbial profile analyses were performed. Biofilm growth was significantly reduced in the presence of erythritol, and this effect was dose dependent. Protease activity and the Shannon diversity index of the microbial profiles of the biofilms were significantly lower when erythritol was present. Microbial profile analysis revealed that presence of erythritol induced a compositional shift from periodontitis- and gingivitis-related taxa toward early colonizers. The results of this study suggest that erythritol suppresses maturation of the biofilms toward unhealthy composition. The gingivitis phenotype was suppressed and biofilm formation was reduced in the presence of erythritol. Therefore, it is concluded that erythritol may contribute to a healthy oral ecosystem in vitro.

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“…The evidence for superior noncariogenicity of xylitol over other sugar alcohols is not sufficient. Several studies reported that erythritol may be comparable [Thabuis et al, 2013] or superior to xylitol in caries inhibition [Falony et al, 2016]. However, many of these studies were conducted in children with mixed dentition where missing teeth might have different rates of caries, and this information was not considered.…”

Section: Discussionmentioning

confidence: 99%