A new review of existing research from the University of Manchester has challenged the belief that natural sweetener xylitol can help prevent tooth decay in children and adults.
While it is clear that the substance is less harmful to teeth than sugar, the researchers found no substantial evidence that it could actively combat decay. Xylitol is widely used and promoted throughout the world, and can be found in syrups, lozenges, toothpastes, gels, sweets, chewing gum and tablets.
The research used the data of 5,903 participants from ten existing studies, although often the methodologies were so different that a direct comparison was impossible. In two studies of 4,216 Costa Rican children, it was found that those using a toothpaste with fluoride and xylitol were 13 per cent less likely to experience tooth decay than those using a fluoride-only product over three years.
However, the data was deemed to be low-quality, and therefore does not prove a causative link between xylitol and lack of tooth decay.
Lead researcher Philip Riley explained: “The limited research on xylitol-containing toothpastes in children may only be relevant to the population studied. For other products containing xylitol we were unable to determine whether they were beneficial. We were particularly surprised to see such a lack of evidence on xylitol-containing chewing gums.”
He added: “This Cochrane review was produced to assess whether or not xylitol could help prevent tooth decay in children and adults. The evidence we identified did not allow us to make any robust conclusions about the effects of xylitol, and we were unable to prove any benefit in the natural sweetener for preventing tooth decay.”
Interestingly, a number of the studies included in the research did not record instances of the known side effects of xylitol, which include diarrhoea, bloating and other gastrointestinal problems. The researchers suggest that this is a problem that could be examined in future studies.
The research has been published in the Cochrane Database of Systematic Reviews.