Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints - PubMed (original) (raw)

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Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints

Peter de Cock et al. Int J Dent. 2016.

Abstract

Objective. To provide a comprehensive overview of published evidence on the impact of erythritol, a noncaloric polyol bulk sweetener, on oral health. Methods. A literature review was conducted regarding the potential effects of erythritol on dental plaque (biofilm), dental caries, and periodontal therapy. The efficacy of erythritol on oral health was compared with xylitol and sorbitol. Results. Erythritol effectively decreased weight of dental plaque and adherence of common streptococcal oral bacteria to tooth surfaces, inhibited growth and activity of associated bacteria like S. mutans, decreased expression of bacterial genes involved in sucrose metabolism, reduced the overall number of dental caries, and served as a suitable matrix for subgingival air-polishing to replace traditional root scaling. Conclusions. Important differences were reported in the effect of individual polyols on oral health. The current review provides evidence demonstrating better efficacy of erythritol compared to sorbitol and xylitol to maintain and improve oral health.

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Figures

Figure 1

Figure 1

Percent change in fresh dental plaque weight against baseline over a 6-month period in a teenage cohort consuming erythritol-, sorbitol-, or xylitol-containing chewable tablets. Adapted from Mäkinen et al. [10] and Mäkinen (personal communication). ∗ p < 0.05 when compared to baseline using a paired _t_-test. ∗∗ p < 0.001 when compared to baseline using a paired _t_-test. A p < 0.05 changes from baseline when compared with untreated control, sorbitol, or xylitol.

Figure 2

Figure 2

Percent change in salivary and plaque S. mutans score against baseline over a 6-month period in a teenage cohort consuming erythritol-, sorbitol-, or xylitol-containing chewable tablets. Adapted from Mäkinen et al. [10]. ∗∗ p < 0.001 when compared to baseline using a paired _t_-test.

Figure 3

Figure 3

Effect of polyol concentration (mol/L) on growth of S. mutans (strain 267-S) after 5 hours. Adapted from Mäkinen et al. [10] and Mäkinen [36].

Figure 4

Figure 4

Effect of polyol concentration (g/100 mL) on growth of S. mutans (strain 267-S) after 5 hours. Adapted from Mäkinen et al. [10] and Mäkinen [36].

Figure 5

Figure 5

Mean percent inhibition of streptococci biofilm formation by xylitol and erythritol in a microtiter plate assay. From Ghezelbash et al. [14], ∗ p < 0.05 when compared to control using analysis of variance (ANOVA) repeated measures and ∗∗ p < 0.01 when compared to control using analysis of variance (ANOVA) repeated measures (a). From Ghezelbash et al. [14], ∗ p < 0.05 when compared to control using analysis of variance (ANOVA) repeated measures and ∗∗ p < 0.01 when compared to control using analysis of variance (ANOVA) repeated measures (b).

Figure 6

Figure 6

Growth (a), adhesion (b), and gene expression ((c); gtf and ftf) of S. mutans (strain ATCC 31989) in the presence of 10% sucrose, erythritol, xylitol, or sorbitol (adapted from Park et al. [17]). p < 0.05 when compared to control (water) using analysis of variance (ANOVA) repeated measures (a). SD: standard deviation; overall difference (p < 0.05) based on the Kruskal-Wallis test. A, B, C, DThe same letter indicates no significant difference (p < 0.05) based on Mann-Whitney testing (b). ∗ p < 0.05, based on the Kruskal-Wallis test, A, B, C, Dthe same letter indicates no significant difference based on Mann-Whitney testing (c).

Figure 7

Figure 7

Percentage of tooth surfaces developing into enamel or dentin caries, percentage of enamel caries developing into dentin caries, and percentage of surfaces with an increase in caries score (increase in caries score is transition from any caries score to increase in score of 1 or more) over a 3-year period in a child cohort consuming erythritol-, sorbitol-, or xylitol-containing candies. From Honkala et al. [37]. ∗∗∗ p < 0.001 when compared to sorbitol using Fisher's exact test (two-tailed).

Figure 8

Figure 8

Percentage of tooth surfaces developing into enamel or dentin caries, percentage of enamel caries developing into dentin caries, and percentage of surfaces with an increase in caries score (increase in caries score is transition from any caries score to increase in score of 1 or more) in a child cohort consuming erythritol-, sorbitol-, or xylitol-containing candies 3 years after intervention. From Falony et al. (manuscript submitted). ∗∗ p < 0.05 when compared to sorbitol using Fisher's exact test (two-tailed). ∗∗∗ p < 0.001 when compared to sorbitol using Fisher's exact test (two-tailed).

Figure 9

Figure 9

Percent change in dental plaque weight against baseline over a 3-year period in a child cohort consuming erythritol-, sorbitol-, or xylitol-containing candies. Adapted from Runnel et al. [40]. ∗ p < 0.05 when compared to baseline using the Wilcoxon Signed Rank test with the Bonferroni correction.

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