Prevention of Dental Caries by Xylitol

Abstract

Dental caries is caused by a diet‐associated pathologic process affecting the teeth. This is an infectious, transmissible disease, the infecting agents being specific micro‐organisms, with a streptococcal species, i.e. Streptococcus mutans (or other members of the so‐called mutans streptococci), being especially cariogenic under certain dietary conditions. The transmissibility of the disease is reflected, for example, in the fact that young children usually receive their S. mutans infection from their mothers. According to present scientific knowledge, dental caries should be fully preventable. Maximisation of preventive efforts is of fundamental importance; relying on only one prevention procedure, like a fluoride‐based method, is insufficient. Relying solely on reparative philosophy is wrong. As to dietary approaches, mere prohibition of sugar as the only educational measure is hypocritical. Maximisation of prevention automatically includes the use of sugar substitutes. Of these, xylitol, a natural, physiologic carbohydrate sweetener, has been rigorously tested in long‐term human clinical trials, and has been found to be safe and effective. An effective way to use xylitol is as xylitol‐containing chewing gum, lozenges or chewable tablets. This prevention procedure can easily be promoted in environments where children or young adults are reachable, i.e. at schools, universities, garrisons, public health centres and related institutions. Results from clinical studies suggest that less than 10 grams of xylitol per day, consumed in about five chewing episodes, significantly increases protection against dental caries. This approach, a single‐component modification of diet, can be used to complete existing prevention methods, both at individual and community level.