Impact of Xylitol chewing gum on levels of oral Streptococcus mutans. A systematic review

Abstract

Objectives. This systematic review evaluates the effectiveness of xylitol in combating Streptococcus mutans, a key bacterium associated with dental caries. Methods. We performed a search across Scopus, Open Grey, PubMed, Science Direct, and EBSCO databases. After screening and excluding articles that did not meet our predefined inclusion criteria, we selected seven out of the eighty-nine initially identified articles. Data extraction was carried out in three stages: identification, screening, and assessment of eligibility. Results. Among the studies included in this review, six were randomized clinical trials, and one was a before-and-after comparison. Most of these studies indicate that xylitol chewing gum may effectively reduce S. mutans counts, potentially lowering the risk of dental caries. Conclusion. The reviewed studies show that xylitol chewing gum positively affects both the quality and quantity of S. mutans. It inhibits S. mutans adhesion to tooth surfaces, reduces the production of sticky substances, and alters the bacteria's morphology. Consequently, this leads to improvements in plaque index, gingival index, and DMFT scores.