Effect of xylitol and sorbitol on plaque acidogenesis.
OBJECTIVE
To evaluate the in vivo potential of xylitol to reduce plaque acidogenicity in comparison to sorbitol.


METHODS
After completing a questionnaire on general health, smoking, diet, and oral hygiene habits, 61 dentate adults refrained from oral hygiene for 3 days before the clinical baseline examination, which included decayed, missing, and filled teeth (DMFT) index, mutans streptococci and lactobacilli counts, and plaque acidogenicity (cH) index after a sucrose rinse. Then the participants were randomly allocated to consume either sorbitol or xylitol lozenges (5 pieces/day, 2 g each) for 4 weeks and were asked to refrain from oral hygiene for the 3 days prior to the final examination (cH, area < pH 7, bacterial counts).


RESULTS
The variation of acidogenicity in different individuals was considerable at baseline (range: 0.2 to 446.6 min micromol/L) with a mean value of 37.9 +/- 58.9 min micromol/L for the sorbitol group and 60.6 +/- 87.6 min micromol/L for the xylitol group. At the end of the study, the reduction in the xylitol group (42.9 +/- 80.6 min micromol/L) was statistically significantly higher than in the sorbitol group (6.0 +/- 69.4 min micromol/L, P = .034), which was also confirmed in an additional analysis excluding 2 participants with extreme values (reduction for xylitol: 29.5 +/- 36.9 min micromol/L; sorbitol: 1.7 +/- 57.0 min micromol/L; P = .019). Statistically significant differences were also found for the area below pH 7 (reduction for xylitol: 10.8 min pH; sorbitol, 0.2 min pH; P = .0025).


CONCLUSIONS
The regular consumption of xylitol lozenges modifies dental plaque, resulting in a marked reduction in the plaque acidogenicity, which could not be detected using sorbitol lozenges. Therefore, xylitol could have an additional benefit in caries prevention.
Splieth
Christian H
CH
Department for Preventive and Pediatric Dentistry, Ernst-Moritz-Arndt-University, Greifswald, Germany. splieth@unigreifswald.de
Alkilzy
Mohammad
M
Schmitt
Jan
J
Berndt
Christine
C
Welk
Alexander
A
D000143:Acids / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D002327:Cariostatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D015169:Colony Count, Microbial; D004245:DMF Index; D003773:Dental Plaque / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D004311:Double-Blind Method; D005260:Female; D005285:Fermentation / Q000187:drug effects*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007778:Lactobacillus / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D013012:Sorbitol / Q000494:pharmacology* / Q000627:therapeutic use; D013295:Streptococcus mutans / Q000187:drug effects / Q000378:metabolism; D011795:Surveys and Questionnaires; D013549:Sweetening Agents / Q000494:pharmacology* / Q000627:therapeutic use; D014993:Xylitol / Q000494:pharmacology* / Q000627:therapeutic use; D055815:Young Adult
D000143:Acids; D002327:Cariostatic Agents; D013549:Sweetening Agents; D013012:Sorbitol; D014993:Xylitol