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.
Department for Preventive and Pediatric Dentistry, Ernst-Moritz-Arndt-University, Greifswald, Germany. splieth@unigreifswald.de
Christian H
CH
Splieth
Mohammad
M
Alkilzy
Jan
J
Schmitt
Christine
C
Berndt
Alexander
A
Welk
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