Xylitol and sorbitol effects on the microbiome of saliva and plaque

Reisha Rafeek,Christine V F Carrington,Andres Gomez,Derek Harkins,Manolito Torralba,Claire Kuelbs,Jonas Addae,Ahmed Moustafa,Karen E Nelson

doi:10.1080/20002297.2018.1536181

Reisha Rafeek, Christine V F Carrington + Show 7 more

Open Access

https://doi.org/10.1080/20002297.2018.1536181

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Abstract

ABSTRACTChewing gum containing xylitol may help prevent caries by reducing levels of mutans streptococci (MS) and lactobacilli in saliva and plaque. Very little is known about other species which are possibly beneficial to oral health. In this study, we employed high-throughput sequencing of the 16S rRNA gene to profile microbial communities of saliva and plaque following short-term consumption of xylitol and sorbitol containing chewing gum. Participants (n = 30) underwent a washout period and were randomly assigned to one of two groups. Each group chewed either xylitol or sorbitol gum for three weeks, before undergoing a second four-week washout period after which they switched to the alternate gum for three weeks. Analysis of samples collected before and after each intervention identified distinct plaque and saliva microbial communities that altered dependent on the order in which gum treatments were given. Neither the xylitol nor sorbitol treatments significantly affected the bacterial composition of plaque. Lactobacilli were undetected and the number of Streptococcus mutans sequence reads was very low and unaffected by either xylitol or sorbitol. However, sorbitol affected several other streptococcal species in saliva including increasing the abundance of S. cristatus, an oral commensal shown to inhibit bacteria associated with chronic periodontitis.Trial registration: ClinicalTrials.gov identifier: NCT03668015.

Highlights

Global increases in sugar consumption have led to systemic health concerns including obesity, type 2 diabetes mellitus and oral health [1]
465 OTUs were identified belonging to eight phyla, with Firmicutes accounting for the majority of reads in both plaque and saliva
Our results revealed the distinct microbial profiles of saliva and plaque and showed that plaque microbial composition was unaffected by three-week sorbitol or xylitol treatments

Summary

Introduction

Global increases in sugar consumption have led to systemic health concerns including obesity, type 2 diabetes mellitus and oral health [1]. This has fuelled interest in sugar substitutes including polyols or nonfermentable sugars, of which the most commonly used are the nutritive sweeteners sorbitol and xylitol. There is an association between caries and the presence of mutans streptococci (MS) (most notably Streptococcus mutans and S. sobrinus) and lactobacilli in saliva and plaque [2]. Xylitol is thought to have specific anti-cariogenic properties such as the reduction of dental plaque [5] and of MS and/or lactobacilli [6,7,8,9,10]. Sorbitol can be fermented to a small degree whereas xylitol is not fermented by most cariogenic bacteria [11,12,13]

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