Similarity of the Effects ofErythritol and Xylitol on SomeRisk Factors of Dental Caries

Abstract

Several sugar alcohols (polyols) have been promoted as potential sugar substitutes in caries limitation. However, differences in the effects of simple alditol-type sugar alcohol homologues on dental plaque have not been compared in clinical tests. The effects of 6-month use of erythritol (a sugar alcohol of the tetritol type), xylitol (a pentitol) and D-glucitol (sorbitol, a hexitol) were investigated in a cohort of 136 teenage subjects assigned to the respective polyol groups or to an untreated control group (n = 30–36 per group). The daily use of the polyols was 7.0 g in the form of chewable tablets, supplemented by twice-a-day use of a dentifrice containing those polyols. The use of erythritol and xylitol was associated with a statistically significant reduction (p < 0.001 in most cases) in the plaque and saliva levels of mutans streptococci. The amount of dental plaque was also significantly reduced in subjects receiving erythritol and xylitol. Such effects were not observed in other experimental groups. Chemical analyses showed D-glucitol to be a normal finding in dental plaque while xylitol was less consistently detected. Erythritol was detected in measurable amounts only in the plaque of subjects receiving this polyol. Erythritol and xylitol may exert similar effects on some risk factors of dental caries, although the biochemical mechanism of the effects may differ. These in vivo studies were supported by cultivation experiments in which xylitol, and especially erythritol, inhibited the growth of several strains of mutans streptococci.

Use of Polyols in Oral Biology Research

“…Recently, Yao et al (2009) reported in a Chinese study that the growth and acid production of S. mutans were higher in low (2% and less) concentrations of erythritol than in similar concentrations of xylitol, while they were lower at higher (<8%) erythritol levels than at corresponding xylitol levels. This finding may support an earlier (Mäkinen et al, 2005) contention that the mechanism of the inhibitory effect of erythritol and xylitol on the growth of MS differ, and that perhaps combinations of these alditols may turn out to be effective in caries limitation. Another Chinese study reported that maltitol chewing gum may lead to similar reduction of dental plaque as xylitol chewing gum (Li, 2010).…”

“…Future clinical trials on sugar alcohols should also investigate possible caries-limiting potential of their mixtures. Preliminary experiments suggest that mixtures of xylitol and erythritol may be more effective in affecting the growth of MS than those of D-glucitol and xylitol (Mäkinen et al, 2005). It has been suggested that the caries-limiting potential of common dietary alditols will increase as the number of hydroxyl groups decreases (Mäkinen, 2010).…”

“…Most studies have shown that D-glucitol and D-mannitol, owing to their hexitol nature, support the growth of MS and dental plaque. Erythritol in turn has been shown to reduce the growth of MS almost to the same extent as xylitol (Mäkinen et al, 2005), although published information is still scant (reviewed in Mäkinen, 2010). Recently, Yao et al (2009) reported in a Chinese study that the growth and acid production of S. mutans were higher in low (2% and less) concentrations of erythritol than in similar concentrations of xylitol, while they were lower at higher (<8%) erythritol levels than at corresponding xylitol levels.…”

“…Potential future alditol applications may include the study of combinations of erythritol and xylitol. Such studies are indeed warranted because it is possible that the mechanism of action of these alditols on MS differ (Mäkinen et al, 2005), making their combined effects additive and possibly clinically more effective than when using either one of these alditols separately.…”

Xylitol Content in Dental Care and Food Products Available on the Polish Market and Their Significance in Caries Prevention

“…It manifests anticarious action principally against Streptococcus mutans (SM) [2]. It inhibits the growth of SM in the presence of glucose, fructose, mannose, sorbitol and lactose, both in saliva and dental plaque, and decreases the amount of dental plaque [2][3][4][5][6]. Xylitol affects the adhesion of SM to the enamel.…”