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Pienihäkkinen K, Hietala-Lenkkeri A, Arpalahti I, Söderling E. The effect of xylitol chewing gums and candies on caries occurrence in children: a systematic review with special reference to caries level at study baseline. Eur Arch Paediatr Dent 2024; 25:145-160. [PMID: 38430364 PMCID: PMC11058973 DOI: 10.1007/s40368-024-00875-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 01/24/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE A systematic review of published data was carried out to assess the caries-preventive effects of xylitol chewing gums and candies in children. METHODS Electronic and hand searches were performed to find clinical studies on the effects of xylitol chewing gums and candies on dental caries in children (≤ 18 years). Prospective randomised or controlled clinical trials published before 2023 were included in the review. RESULTS The initial search identified 365 titles to be evaluated. After applying inclusion and exclusion criteria, 15 articles with either fair or low quality were reviewed. Nine articles studied chewing gums, five candies, and one both of them. In the ten evaluated xylitol chewing gum studies xylitol consumption significantly reduced caries occurrence when compared with no treatment or a placebo polyol gum. The effect was clinically significant in studies with high or moderate caries level at study baseline. The results also suggested that the caries-reducing effect of xylitol gums may differ from sorbitol/polyol gums. In five of the six heterogenous xylitol candy studies, no caries-reducing effect was found independent of caries level. In addition to caries level, also the daily xylitol dose was a confounding factor. CONCLUSION The present findings suggest that the caries-reducing effect of adding xylitol chewing gum to the daily diet has been well demonstrated in children and adolescents with high or moderate caries level at study baseline. Xylitol gum use could benefit subjects with active incipient caries lesions on smooth tooth surfaces.
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Affiliation(s)
- K Pienihäkkinen
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
| | - A Hietala-Lenkkeri
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
| | - I Arpalahti
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
| | - E Söderling
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland.
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Garmaroody ER, PahnehKolaei ND, Ramezani O, Hamedi S. Detoxification Approaches of Bagasse Pith Hydrolysate Affecting Xylitol Production by Rhodotorula mucilaginosa. Appl Biochem Biotechnol 2024; 196:129-144. [PMID: 37103733 DOI: 10.1007/s12010-023-04539-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 04/28/2023]
Abstract
In this study, the potential of bagasse pith (the waste of sugar and paper industry) was investigated for bio-xylitol production for the first time. Xylose-rich hydrolysate was prepared using 8% dilute sulfuric acid, at 120 °C for 90 min. Then, the acid-hydrolyzed solution was detoxified by individual overliming (OL), active carbon (AC), and their combination (OL+AC). The amounts of reducing sugars and inhibitors (furfural and hydroxyl methyl furfural) were measured after acid pre-treatment and detoxification process. Thereafter, xylitol was produced from detoxified hydrolysate by Rhodotorula mucilaginosa yeast. Results showed that after acid hydrolysis, the sugar yield was 20%. Detoxification by overliming and active carbon methods increased the reducing sugar content up to 65% and 36% and decreased the concentration of inhibitors to >90% and 16%, respectively. Also, combined detoxification caused an increase in the reducing sugar content (>73%) and a complete removal of inhibitors. The highest productivity of xylitol (0.366 g/g) by yeast was attained after the addition of 100 g/l non-detoxified xylose-rich hydrolysate into fermentation broth after 96 h, while the xylitol productivity enhanced to 0.496 g/g after adding the similar amount of xylose-rich hydrolysate detoxified by combined method (OL+AC2.5%).
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Affiliation(s)
- Esmaeil Rasooly Garmaroody
- Dept. of Bio-refinery, Faculty of New Technologies, Zirab Campus, Shahid Beheshti University, Savadkooh, Mazandaran, Iran
| | - Niloufar Davoodi PahnehKolaei
- Dept. of Bio-refinery, Faculty of New Technologies, Zirab Campus, Shahid Beheshti University, Savadkooh, Mazandaran, Iran
| | - Omid Ramezani
- Dept. of Bio-refinery, Faculty of New Technologies, Zirab Campus, Shahid Beheshti University, Savadkooh, Mazandaran, Iran.
| | - Sepideh Hamedi
- Dept. of Bio-refinery, Faculty of New Technologies, Zirab Campus, Shahid Beheshti University, Savadkooh, Mazandaran, Iran
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Söderling E, Pienihäkkinen K, Gursoy UK. Effects of sugar-free polyol chewing gums on gingival inflammation: a systematic review. Clin Oral Investig 2022; 26:6881-6891. [PMID: 36239787 DOI: 10.1007/s00784-022-04729-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/01/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES A systematic review of published data was conducted with the aim of assessing the effects of sugar-free polyol chewing gums on gingival inflammation. MATERIALS AND METHODS Electronic and hand searches were performed to find clinical studies concerning the effects of sugar-free chewing gums on gingival scores. Prospective randomized controlled clinical trials published between 1971 and 2021 were included in the review. RESULTS The initial search identified 46 erythritol, 102 xylitol, 23 sorbitol, and nine maltitol chewing gum articles. After applying inclusion and exclusion criteria, seven xylitol chewing gum studies, one sorbitol, and one maltitol chewing gum study with either high or fair quality were reviewed. In five out of the seven xylitol studies, xylitol gum decreased gingival scores. In two studies, xylitol decreased gingival scores compared to a polyol gum, and in three studies compared to no gum/gum base. As for sorbitol and maltitol, only sorbitol gum chewing showed a small decrease in gingival scores compared to the controls. CONCLUSIONS Habitual xylitol gum chewing may reduce gingival inflammation. The low number of studies and their heterogeneity provide clear indications that the effects of sugar-free polyol chewing gums on gingival inflammation need further, well-controlled studies. CLINICAL RELEVANCE Sugar-free chewing gums, especially xylitol gum, may function as adjuncts to toothbrushing for reducing gingival inflammation, but the evidence so far is inconclusive.
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Affiliation(s)
- Eva Söderling
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland.
| | - Kaisu Pienihäkkinen
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
| | - Ulvi Kahraman Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
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Martins ML, Leite KLDF, Magno MB, Masterson D, Vicente-Gomila JM, Cavalcanti YW, Maia LC, Fonseca-Gonçalves A. The Xylitol Applicability and its Effects in Health Area Worldwide: A Bibliometric Analysis Based on Randomized Controlled Trials. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Söderling E, Pienihäkkinen K. Effects of xylitol chewing gum and candies on the accumulation of dental plaque: a systematic review. Clin Oral Investig 2021; 26:119-129. [PMID: 34677696 PMCID: PMC8791908 DOI: 10.1007/s00784-021-04225-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022]
Abstract
Objectives A systematic review of published data was conducted with the aim of assessing the effects of xylitol consumption on the amount of dental plaque. Materials and methods Electronic and hand searches were performed to find clinical studies concerning the effects of xylitol chewing gum or candies on dental plaque. Prospective randomized controlled clinical trials published between 1971 and 2020 conducted in healthy subjects were included in the review. Results The initial search identified 424 xylitol articles. After applying inclusion and exclusion criteria, altogether 14 articles (16 studies) were reviewed. The review identified 12 of the total of 14 xylitol chewing gum studies as having fair or high quality. In 13 of the 14 chewing gum studies, xylitol gum decreased plaque accumulation. In six studies, xylitol gum chewing decreased plaque compared to sorbitol gum, and in three studies compared to gum base/no gum. In three fair-quality studies conducted with xylitol candies, plaque accumulation did not change. Conclusions Habitual xylitol gum chewing appears to show plaque-reducing effects that differ from those of sorbitol gum. This suggests specific effects for xylitol on plaque accumulation. Xylitol candies appear not to decrease plaque. The heterogeneity of the studies warrants further research. Clinical relevance Habitual xylitol gum chewing is likely to decrease plaque.
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Affiliation(s)
- Eva Söderling
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland.
| | - Kaisu Pienihäkkinen
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
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Gul P, Akgul N, Seven N. Anticariogenic potential of white cheese, xylitol chewing gum, and black tea. Eur J Dent 2019; 12:199-203. [PMID: 29988210 PMCID: PMC6004802 DOI: 10.4103/ejd.ejd_4_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective This study aimed to examine the effects of these foods on plaque pH and the potential development of tooth decay. Materials and Methods Plaque pH was measured using the sampling method before and after 1, 5, 10, 20, 30, 45, and 60 min following consumption of these foods individually and after rinsing with a 10% sucrose solution. Statistical analysis was performed using one-way ANOVA and Tukey honestly significant difference post hoc tests (α = 0.05). Results Although there were statistically significant differences in all test groups except the BT (P = 0.620) and sucrose + XCG (P = 0.550) groups in time, none of the participants chosen for this study were having a plaque pH value anywhere close to the critical value (pH = 5.5). Conclusion WC, BT, and XCG are advisable as anticariogenic foods because pH values are not below critical value.
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Affiliation(s)
- Pinar Gul
- Department of Restorative Dentistry, Faculty of Dentistry, Atatürk University, Erzurum, Turkye
| | - Nilgun Akgul
- Department of Restorative Dentistry, Faculty of Dentistry, Atatürk University, Erzurum, Turkye
| | - Nilgun Seven
- Department of Restorative Dentistry, Faculty of Dentistry, Atatürk University, Erzurum, Turkye
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Scarano S, Pascale E, Minunni M. The early nucleation stage of gold nanoparticles formation in solution as powerful tool for the colorimetric determination of reducing agents: The case of xylitol and total polyols in oral fluid. Anal Chim Acta 2017; 993:71-78. [DOI: 10.1016/j.aca.2017.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 12/01/2022]
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Yun EJ, Lee AR, Kim JH, Cho KM, Kim KH. 3,6-Anhydro-l-galactose, a rare sugar from agar, a new anticariogenic sugar to replace xylitol. Food Chem 2016; 221:976-983. [PMID: 27979302 DOI: 10.1016/j.foodchem.2016.11.066] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/20/2016] [Accepted: 11/15/2016] [Indexed: 01/25/2023]
Abstract
The significance for anticariogenic sugar substitutes is growing due to increasing demands for dietary sugars and rising concerns of dental caries. Xylitol is widely used as an anticariogenic sugar substitute, but the inhibitory effects of xylitol on Streptococcus mutans, the main cause of tooth decay, are exhibited only at high concentrations. Here, the inhibitory effects of 3,6-anhydro-l-galactose (AHG), a rare sugar from red macroalgae, were evaluated on S. mutans, in comparison with those of xylitol. In the presence of 5g/l of AHG, the growth of S. mutans was retarded. At 10g/l of AHG, the growth and acid production by S. mutans were completely inhibited. However, in the presence of xylitol, at a much higher concentration (i.e., 40g/l), the growth of S. mutans still occurred. These results suggest that AHG can be used as a new anticariogenic sugar substitute for preventing dental caries.
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Affiliation(s)
- Eun Ju Yun
- Department of Biotechnology, Graduate School, Korea University, Seoul 02841, South Korea
| | - Ah Reum Lee
- Department of Biotechnology, Graduate School, Korea University, Seoul 02841, South Korea
| | - Jung Hyun Kim
- Department of Biotechnology, Graduate School, Korea University, Seoul 02841, South Korea
| | - Kyung Mun Cho
- Department of Biotechnology, Graduate School, Korea University, Seoul 02841, South Korea
| | - Kyoung Heon Kim
- Department of Biotechnology, Graduate School, Korea University, Seoul 02841, South Korea.
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Salli K, Forssten S, Lahtinen S, Ouwehand A. Influence of sucrose and xylitol on an early Streptococcus mutans biofilm in a dental simulator. Arch Oral Biol 2016; 70:39-46. [DOI: 10.1016/j.archoralbio.2016.05.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 04/14/2016] [Accepted: 05/30/2016] [Indexed: 12/11/2022]
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Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints. Int J Dent 2016; 2016:9868421. [PMID: 27635141 PMCID: PMC5011233 DOI: 10.1155/2016/9868421] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/13/2016] [Indexed: 11/21/2022] Open
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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11
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Santi E, Facchin G, Faccio R, Barroso RP, Costa-Filho AJ, Borthagaray G, Torre MH. Antimicrobial evaluation of new metallic complexes with xylitol active against P. aeruginosa and C. albicans: MIC determination, post-agent effect and Zn-uptake. J Inorg Biochem 2015; 155:67-75. [PMID: 26619097 DOI: 10.1016/j.jinorgbio.2015.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/07/2015] [Accepted: 11/10/2015] [Indexed: 01/25/2023]
Abstract
Xylitol (xylH5) is metabolized via the pentose pathway in humans, but it is unsuitable as an energy source for many microorganisms where it produces a xylitol-induced growth inhibition and disturbance in protein synthesis. For this reason, xylitol is used in the prophylaxis of several infections. In the search of better antimicrobial agents, new copper and zinc complexes with xylitol were synthesized and characterized by analytical and spectrosco pic methods: Na2[Cu3(xylH−4)2]·NaCl·4.5H2O (Cu-xyl) and [Zn4(xylH−4)2(H2O)2]·NaCl·3H2O (Zn-xyl). Both copper and zinc complexes presented higher MIC against Pseudomona aeruginosa than the free xylitol while two different behaviors were found against Candida albicans depending on the complex. The growth curves showed that Cu-xyl presented lower activity than the free ligand during all the studied period. In the case of Znxyl the growth curves showed that the inhibition of the microorganism growth in the first stage was equivalent to that of xylitol but in the second stage (after 18 h) Zn-xyl inhibited more. Besides, the PAE (post agent effect)obtained for Zn-xyl and xyl showed that the recovery from the damage of microbial cells had a delay of 14 and 13 h respectively. This behavior could be useful in prophylaxis treatments for infectious diseases where it is important that the antimicrobial effect lasts longer. With the aim to understand the microbiological activities the analysis of the particle size, lipophilicity and Zn uptake was performed.
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Affiliation(s)
- E Santi
- Química Inorgánica (DEC), Facultad de Química (UDELAR), Gral. Flores 2124, Montevideo, Uruguay
| | - G Facchin
- Química Inorgánica (DEC), Facultad de Química (UDELAR), Gral. Flores 2124, Montevideo, Uruguay
| | - R Faccio
- Física (DETEMA), Facultad de Química (UDELAR), Gral. Flores 2124, Montevideo, Uruguay
| | - R P Barroso
- Laboratório de Biofisica Molecular, Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Brazil
| | - A J Costa-Filho
- Laboratório de Biofisica Molecular, Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Brazil
| | - G Borthagaray
- Microbiología (BIOCLIN), Facultad de Química (UDELAR), Gral. Flores 2124, Montevideo, Uruguay
| | - M H Torre
- Química Inorgánica (DEC), Facultad de Química (UDELAR), Gral. Flores 2124, Montevideo, Uruguay.
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Metabolic activity of Streptococcus mutans biofilms and gene expression during exposure to xylitol and sucrose. Int J Oral Sci 2014; 6:195-204. [PMID: 25059251 PMCID: PMC5153587 DOI: 10.1038/ijos.2014.38] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 11/24/2022] Open
Abstract
The objective of the study was to analyse Streptococcus mutans biofilms grown under different dietary conditions by using multifaceted methodological approaches to gain deeper insight into the cariogenic impact of carbohydrates. S. mutans biofilms were generated during a period of 24 h in the following media: Schaedler broth as a control medium containing endogenous glucose, Schaedler broth with an additional 5% sucrose, and Schaedler broth supplemented with 1% xylitol. The confocal laser scanning microscopy (CLSM)-based analyses of the microbial vitality, respiratory activity (5-cyano-2,3-ditolyl tetrazolium chloride, CTC) and production of extracellular polysaccharides (EPS) were performed separately in the inner, middle and outer biofilm layers. In addition to the microbiological sample testing, the glucose/sucrose consumption of the biofilm bacteria was quantified, and the expression of glucosyltransferases and other biofilm-associated genes was investigated. Xylitol exposure did not inhibit the viability of S. mutans biofilms, as monitored by the following experimental parameters: culture growth, vitality, CTC activity and EPS production. However, xylitol exposure caused a difference in gene expression compared to the control. GtfC was upregulated only in the presence of xylitol. Under xylitol exposure, gtfB was upregulated by a factor of 6, while under sucrose exposure, it was upregulated by a factor of three. Compared with glucose and xylitol, sucrose increased cell vitality in all biofilm layers. In all nutrient media, the intrinsic glucose was almost completely consumed by the cells of the S. mutans biofilm within 24 h. After 24 h of biofilm formation, the multiparametric measurements showed that xylitol in the presence of glucose caused predominantly genotypic differences but did not induce metabolic differences compared to the control. Thus, the availability of dietary carbohydrates in either a pure or combined form seems to affect the cariogenic potential of S. mutans biofilms.
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Pedrazzi V, Escobar EC, Cortelli JR, Haas AN, Andrade AKPD, Pannuti CM, Almeida ERD, Costa FO, Cortelli SC, Rode SDM. Antimicrobial mouthrinse use as an adjunct method in peri-implant biofilm control. Braz Oral Res 2014; 28 Spec No:S1806-83242014000200301. [PMID: 25003787 DOI: 10.1590/1807-3107bor-2014.vol28.0022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/11/2014] [Indexed: 01/23/2023] Open
Abstract
Great possibilities for oral rehabilitation emerged as a result of scientific consolidation, as well as a large number of dental implant applications. Along with implants appeared diseases such as mucositis and peri-implantitis, requiring management through several strategies applied at different stages. Biofilm accumulation is associated with clinical signs manifest by both tooth and implant inflammation. With this in mind, regular and complete biofilm elimination becomes essential for disease prevention and host protection. Chemical control of biofilms, as an adjuvant to mechanical oral hygiene, is fully justified by its simplicity and efficacy proven by studies based on clinical evidence. The purpose of this review was to present a consensus regarding the importance of antimicrobial mouthrinse use as an auxiliary method in chemical peri-implant biofilm control. The active ingredients of the several available mouthrinses include bis-biguanide, essential oils, phenols, quaternary ammonium compounds, oxygenating compounds, chlorine derivatives, plant extracts, fluorides, antibiotics and antimicrobial agent combinations. It was concluded that there is strong clinical evidence that at least two mouthrinses have scientifically proven efficacy against different oral biofilms, i.e., chlorhexidine digluconate and essential oils; however, 0.12% chlorhexidine digluconate presents a number of unwanted side effects and should be prescribed with caution. Chemical agents seem beneficial in controlling peri-implant inflammation, although they require further investigation. We recommend a scientifically proven antiseptic, with significant short and long term efficacy and with no unwanted side effects, for the prevention and/or treatment of peri-implant disease.
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Affiliation(s)
- Vinicius Pedrazzi
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Elaine Cristina Escobar
- Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil
| | - José Roberto Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Alex Nogueira Haas
- Periodontology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, RS, Brazil
| | | | - Claudio Mendes Pannuti
- Periodontology Department, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Eliete Rodrigues de Almeida
- Epidemiology and Pediatric Dentistry Department, School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - Fernando Oliveira Costa
- Periodontology Department, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sheila Cavalca Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Sigmar de Mello Rode
- Dental Materials and Prosthesis Department, Instituto de Ciência e Tecnologia, Univ Estadual Paulista, São José dos Campos, SP, Brazil
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Taipale T, Pienihakkinen K, Alanen P, Jokela J, Söderling E. Dissolution of xylitol from a food supplement administered with a novel slow-release pacifier: preliminary results. Eur Arch Paediatr Dent 2012; 8:123-5. [PMID: 17555696 DOI: 10.1007/bf03262581] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM The aim of the study was to monitor the pattern of release and salivary xylitol concentrations during sucking of a slow-release pacifier used to deliver a novel food supplement. METHODS The food supplement tablet contained 300 mg xylitol and 0.5 x 10(10) colony-forming units of Bifidobacterium lactis Bb-12 (Bb-12). The reference tablet contained 300 mg xylitol and was used by 10 adults (mean age 32 years) in the study. Whole saliva samples were collected with 2.5 min intervals during pacifier sucking. The salivary xylitol concentrations were determined using an enzyme assay kit. RESULTS All subjects showed salivary xylitol concentrations exceeding 1% at least at one collection point. The xylitol and xylitol-Bb-12 tablets showed similar dissolving with no clear concentration peaks (comparison of saliva collection times; p = 0.139). CONCLUSION Xylitol released from the food supplement, delivered with the novel pacifier, may result in salivary xylitol concentrations high enough to inhibit mutans streptococci in vivo.
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Affiliation(s)
- T Taipale
- Korpilahti-Muurame Health Care Center; University of Turku, Finland.
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Pereira ADFF, Silva TCD, Silva TLD, Caldana MDL, Bastos JRM, Buzalaf MAR. Xylitol concentrations in artificial saliva after application of different xylitol dental varnishes. J Appl Oral Sci 2012; 20:146-50. [PMID: 22666828 PMCID: PMC3894754 DOI: 10.1590/s1678-77572012000200004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 03/17/2010] [Indexed: 12/02/2022] Open
Abstract
Objective The present study analyzed xylitol concentrations in artificial saliva over time
after application of varnishes containing 10% and 20% xylitol. Material and Methods Fifteen bovine enamel specimens (8x4 mm) were randomly allocated to 3 groups
(n=5/group), according to the type of varnish used: 10% xylitol, 20% xylitol and
no xylitol (control). After varnish application (4 mg), specimens were immersed in
vials containing 500 µL of artificial saliva. Saliva samples were collected in
different times (1, 8, 12, 16, 24, 48 and 72 h) and xylitol concentrations were
analyzed. Data were assessed by two-way repeated-measures ANOVA (p<0.05). Results Colorimetric analysis was not able to detect xylitol in saliva samples of the
control group. Salivary xylitol concentrations were significantly higher up to 8 h
after application of the 20% xylitol varnish. Thereafter, the 10% xylitol varnish
released larger amounts of that polyol in artificial saliva. Conclusions Despite the results in short-term, sustained xylitol releases could be obtained
when the 10% xylitol varnish was used. These varnishes seem to be viable
alternatives to increase salivary xylitol levels, and therefore, should be
clinically tested to confirm their effectiveness.
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Almståhl A, Lingström P, Eliasson L, Carlén A. Fermentation of sugars and sugar alcohols by plaque Lactobacillus strains. Clin Oral Investig 2012; 17:1465-70. [PMID: 22956128 DOI: 10.1007/s00784-012-0832-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 08/24/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective was to analyse the ability of Lactobacillus strains isolated from supragingival plaque of subjects with hyposalivation and from healthy controls to ferment sugars and sugar alcohols. MATERIAL AND METHODS Fifty strains isolated from interproximal plaque from subjects with radiation-induced hyposalivation (25 strains), subjects with primary Sjögren's syndrome (16 strains) and from subjects with normal salivary secretion rate (9 strains) were tested. Growth and pH were determined after 24 and 48 h of anaerobic incubation in vials containing basal media with 1 % of glucose, fructose, sucrose, mannitol, sorbitol or xylitol. RESULTS No differences between strains isolated from hyposalivated subjects and controls were detected. All strains lowered the pH to <5.0 from fructose and the majority of the strains from glucose and sucrose. A pH of <5.5 was seen for 52 % of the strains using mannitol, 50 % using sorbitol and 36 % using xylitol. The ability to produce acids from sugars and sugar alcohols was highest among strains of Lactobacillus rhamnosus, Lactobacillus casei and Lactobacillus paracasei and lowest among Lactobacillus fermentum strains. CONCLUSION A large number of Lactobacillus strains are able to ferment not only sugars but also the sugar substitutes mannitol, sorbitol and xylitol to pH levels critical for enamel demineralisation. CLINICAL RELEVANCE Our findings suggest that products containing mannitol, sorbitol and/or xylitol may contribute to the acidogenic potential of the dental plaque and especially in hyposalivated subjects with high numbers of lactobacilli.
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Affiliation(s)
- Annica Almståhl
- Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Göteborg, Sweden.
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Yuen HK, Westwater C, Degarmo J, Bandyopadhyay D. Immediate Effect of Xylitol Chewing Gum and Mouth Rinse on Salivary Levels of Mutans Streptococci in Adults with Systemic Sclerosis: A Pilot Study. ACTA ACUST UNITED AC 2012; 2:89-92. [PMID: 24532975 DOI: 10.5455/jeim.221111.br.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare the immediate effect of xylitol chewing gum and xylitol mouth rinse on mutans streptococci (MS) levels in the saliva of adults with systemic sclerosis (SSc). METHODS Thirteen female adults with SSc were assigned randomly to either the xylitol chewing gum or xylitol mouth rinse groups. Participants in the chewing gum group were given 2 pellets (2.12g) of commercial xylitol chewing gum to chew for 10 min; whereas participants in the mouth rinse group were given 10 ml (10% [w/v]) of xylitol solution to rinse orally for 2 min. MS samples were collected using Dentocult®SM Strip mutans before and after xylitol exposure. RESULTS No significant difference in the change scores of MS levels between the two groups was observed at post xylitol exposure. CONCLUSIONS Mouth rinse may provide an alternative mode of xylitol delivery for this population.
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Affiliation(s)
- Hon K Yuen
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, 1530 3rd Avenue South, Birmingham, AL 35294-1212. Tel: (205) 934-6301; ;
| | - Caroline Westwater
- Department of Craniofacial Biology, College of Dental Medicine and Department of Microbiology & Immunology, College of Medicine, Medical University of South Carolina, SC 29425;
| | - Justin Degarmo
- College of Dental Medicine, Medical University of South Carolina, SC 29425;
| | - Dipankar Bandyopadhyay
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455;
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Uittamo J, Nieminen MT, Kaihovaara P, Bowyer P, Salaspuro M, Rautemaa R. Xylitol inhibits carcinogenic acetaldehyde production by Candida species. Int J Cancer 2011; 129:2038-41. [PMID: 21154745 DOI: 10.1002/ijc.25844] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 11/04/2010] [Indexed: 12/28/2022]
Abstract
Acetaldehyde is a highly toxic and mutagenic product of alcohol fermentation and metabolism which has been classified as a Class I carcinogen for humans by the International Agency for Research on Cancer of the World Health Organisation (WHO). Many Candida species representing oral microbiota have been shown to be capable of marked acetaldehyde production. The aim of our study was to examine the effects of various sugar alcohols and sugars on microbial acetaldehyde production. The study hypothesis was that xylitol could reduce the amount of acetaldehyde produced by Candida. Laboratory and clinical isolates of seven Candida species were selected for the study. The isolates were incubated in 12 mM ethanol and 110 mM glucose, fructose or xylitol at 37°C for 30 min and the formed acetaldehyde was measured by gas chromatography. Xylitol significantly (p < 0.0001) reduced the amount of acetaldehyde produced from ethanol by 84%. In the absence of xylitol, the mean acetaldehyde production in ethanol incubation was 220.5 μM and in ethanol-xylitol incubation 32.8 μM. This was found to be mediated by inhibition of the alcohol dehydrogenase enzyme activity. Coincubation with glucose reduced the amount of produced acetaldehyde by 23% and coincubation with fructose by 29%. At concentrations that are representative of those found in the oral cavity during the intake of proprietary xylitol products, xylitol was found to reduce the production of carcinogenic acetaldehyde from ethanol by Candida below the mutagenic level of 40-100 μM.
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Affiliation(s)
- Johanna Uittamo
- Research Unit on Acetaldehyde and Cancer, University of Helsinki, Helsinki, Finland.
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Chen X, Jiang ZH, Chen S, Qin W. Microbial and bioconversion production of D-xylitol and its detection and application. Int J Biol Sci 2010; 6:834-44. [PMID: 21179590 PMCID: PMC3005349 DOI: 10.7150/ijbs.6.834] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 12/06/2010] [Indexed: 11/22/2022] Open
Abstract
D-Xylitol is found in low content as a natural constituent of many fruits and vegetables. It is a five-carbon sugar polyol and has been used as a food additive and sweetening agent to replace sucrose, especially for non-insulin dependent diabetics. It has multiple beneficial health effects, such as the prevention of dental caries, and acute otitis media. In industry, it has been produced by chemical reduction of D-xylose mainly from photosynthetic biomass hydrolysates. As an alternative method of chemical reduction, biosynthesis of D-xylitol has been focused on the metabolically engineered Saccharomyces cerevisiae and Candida strains. In order to detect D-xylitol in the production processes, several detection methods have been established, such as gas chromatography (GC)-based methods, high performance liquid chromatography (HPLC)-based methods, LC-MS methods, and capillary electrophoresis methods (CE). The advantages and disadvantages of these methods are compared in this review.
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Affiliation(s)
- Xi Chen
- Biorefining Research Initiative and Department of Biology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
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20
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Scott DC, Coggan JW, Cruze CA, He T, Johnson RD. Topical Oral Cavity Pharmacokinetic Modeling of a Stannous Fluoride Dentifrice: An Unusual Two Compartment Model. J Pharm Sci 2009; 98:3862-70. [DOI: 10.1002/jps.21691] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Söderling EM, Hietala-Lenkkeri AM. Xylitol and erythritol decrease adherence of polysaccharide-producing oral streptococci. Curr Microbiol 2009; 60:25-9. [PMID: 19777305 DOI: 10.1007/s00284-009-9496-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 08/21/2009] [Indexed: 11/30/2022]
Abstract
Xylitol consumption decreases counts of mutans streptococci. However, the mechanism behind this decrease is not well understood. We studied not only type strains and clinical isolates of mutans streptococci, but also other polysaccharide-forming oral streptococci. Growth inhibition and adherence of cells to a smooth glass surface-reflecting synthesis of water-insoluble polysaccharides were studied in the presence of 2% (0.13 mol/l) and 4% (0.26 mol/l) xylitol. The effect of xylitol was compared to a novel polyol sweetener, erythritol. Except for Streptococcus mutans 10449 and S. sobrinus OMZ 176, the glass surface adhesion of most polysaccharide-forming streptococci was reduced by the presence of both 4% xylitol and erythritol. For the S. mutans and S. sobrinus type strains, the growth inhibition with 4% xylitol and erythritol was 36-77% and for the clinical S. mutans isolates 13-73%. Of the other oral streptococci, only S. sanguinis was inhibited with 4% xylitol (45-55%). For both polyols, the magnitude of the growth inhibition observed was not associated with the magnitude of the decrease in adherence (xylitol: r = -0.18; erythritol: r = 0.49). In conclusion, both xylitol and erythritol can decrease polysaccharide-mediated cell adherence contributing to plaque accumulation through a mechanism not dependent on growth inhibition.
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Affiliation(s)
- Eva M Söderling
- Institute of Dentistry, University of Turku, Turku, Finland.
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Affiliation(s)
- S. Twetman
- Department of Cariology and Endodontics, Faculty of Health Sciences, University of Copenhagen, Nørre Allé 20, DK-2200 Copenhagen N, Denmark
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Stecksén-Blicks C, Holgerson PL, Twetman S. Effect of xylitol and xylitol-fluoride lozenges on approximal caries development in high-caries-risk children. Int J Paediatr Dent 2008; 18:170-7. [PMID: 18341562 DOI: 10.1111/j.1365-263x.2007.00912.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the effect of xylitol- and xylitol/fluoride-containing lozenges on approximal caries development in young adolescents with high caries risk. STUDY DESIGN A 2-year double-blind trial with two parallel arms and a nonrandomized reference group. MATERIAL AND METHODS One hundred and sixty healthy 10- to 12-year-old children with high caries risk were selected. After informed consent, they were randomly assigned into a xylitol and a xylitol/fluoride group. They were instructed to take two tablets three times a day (total xylitol and fluoride dose 2.5 g and 1.5 mg, respectively). The compliance was checked continuously and scored as good, fair, or poor. A reference no-tablet group was also selected (n = 70) for group comparison. The outcome measure was approximal caries incidence. RESULTS The dropout rate was 28%, and 41% exhibited a good compliance with the study protocol. No statistically significant differences in caries incidence could be found between the study groups (P > 0.05). Among a subgroup of children who demonstrated good compliance, the mean DeltaDMFSa value was significantly lower in the xylitol/fluoride group compared to the xylitol group, 1.0 +/- 2.3 vs. 3.3 +/- 4.6 (P < 0.05), while no difference could be displayed between any of the study groups and the reference group (P > 0.05). CONCLUSION The results from this 2-year trial did not support a self-administered regimen of xylitol- or xylitol/fluoride-containing lozenges for the prevention of approximal caries in young adolescents with high caries risk.
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Riedy CA, Milgrom P, Ly KA, Rothen M, Mueller G, Hagstrom MK, Tolentino E, Zhou L, Roberts MC. A surrogate method for comparison analysis of salivary concentrations of Xylitol-containing products. BMC Oral Health 2008; 8:5. [PMID: 18267030 PMCID: PMC2267452 DOI: 10.1186/1472-6831-8-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Accepted: 02/11/2008] [Indexed: 11/26/2022] Open
Abstract
Background Xylitol chewing gum has been shown to reduce Streptococcus mutans levels and decay. Two studies examined the presence and time course of salivary xylitol concentrations delivered via xylitol-containing pellet gum and compared them to other xylitol-containing products. Methods A within-subjects design was used for both studies. Study 1, adults (N = 15) received three xylitol-containing products (pellet gum (2.6 g), gummy bears (2.6 g), and commercially available stick gum (Koolerz, 3.0 g)); Study 2, a second group of adults (N = 15) received three xylitol-containing products (pellet gum, gummy bears, and a 33% xylitol syrup (2.67 g). For both studies subjects consumed one xylitol product per visit with a 7-day washout between each product. A standardized protocol was followed for each product visit. Product order was randomly determined at the initial visit. Saliva samples (0.5 mL to 1.0 mL) were collected at baseline and up to 10 time points (~16 min in length) after product consumption initiated. Concentration of xylitol in saliva samples was analyzed using high-performance liquid chromatography. Area under the curve (AUC) for determining the average xylitol concentration in saliva over the total sampling period was calculated for each product. Results In both studies all three xylitol products (Study 1: pellet gum, gummy bears, and stick gum; Study 2: pellet gum, gummy bears, and syrup) had similar time curves with two xylitol concentration peaks during the sampling period. Study 1 had its highest mean peaks at the 4 min sampling point while Study 2 had its highest mean peaks between 13 to 16 minutes. Salivary xylitol levels returned to baseline at about 18 minutes for all forms tested. Additionally, for both studies the total AUC for the xylitol products were similar compared to the pellet gum (Study 1: pellet gum – 51.3 μg.min/mL, gummy bears – 59.6 μg.min/mL, and stick gum – 46.4 μg.min/mL; Study 2: pellet gum – 63.0 μg.min/mL, gummy bears – 55.9 μg.min/mL, and syrup – 59.0 μg.min/mL). Conclusion The comparison method demonstrated high reliability and validity. In both studies other xylitol-containing products had time curves and mean xylitol concentration peaks similar to xylitol pellet gum suggesting this test may be a surrogate for longer studies comparing various products.
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Affiliation(s)
- Christine A Riedy
- Northwest/Alaska Center to Reduce Oral Health Disparities and Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA.
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Growth inhibition of Streptococcus mutans with low xylitol concentrations. Curr Microbiol 2008; 56:382-5. [PMID: 18176823 DOI: 10.1007/s00284-007-9076-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/28/2007] [Accepted: 10/17/2007] [Indexed: 10/22/2022]
Abstract
No studies on the concentration dependency of the inhibition of Streptococcus mutans with xylitol are available. We studied xylitol-induced growth inhibition of two type strains, S. mutans NCTC 10449 and Ingbritt, and three clinical isolates of S. mutans. The strains were grown in Brain Hearth Infusion Medium in the presence of 0.001% (0.066 mM), 0.005% (0.33 mM), 0.01% (0.66 mM), 0.1% (6.6 mM), and 1% (66 mM) xylitol. Growth was followed by measuring the absorbance at a wavelength of 660 nm. The highest xylitol concentration tested in this study, 1%, showed mean inhibition percentages ranging from 61% to 76% when the growth inhibition of the five strains was compared to the control without xylitol at log-phase. For 0.1% xylitol, the inhibition percentages ranged from 22% to 59%. A concentration dependency was seen in the growth inhibition, with 0.01% xylitol being the lowest xylitol concentration inhibiting all five strains significantly (p < 0.001). The growth inhibition percentages determined for 0.01% xylitol, however, were low, and the inhibition was significantly weaker as compared to 0.1% and 1% xylitol. Our results suggest that low xylitol concentrations of 0.1% (6.6 mM) could inhibit mutans streptococci in vivo but even lower xylitol concentrations may be inhibitory.
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Caglar E, Kavaloglu SC, Kuscu OO, Sandalli N, Holgerson PL, Twetman S. Effect of chewing gums containing xylitol or probiotic bacteria on salivary mutans streptococci and lactobacilli. Clin Oral Investig 2007; 11:425-9. [PMID: 17574481 DOI: 10.1007/s00784-007-0129-9] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 05/21/2007] [Indexed: 11/29/2022]
Abstract
The aim was to evaluate the effect of xylitol and probiotic chewing gums on salivary mutans streptococci (MS) and lactobacilli (LB). The material consisted of 80 healthy young adults (21-24 years) who volunteered after informed consent. They were assigned by random into one of four parallel study groups: A, probiotic gum group; B, xylitol gum group; C, probiotic + xylitol gum group; and D, placebo gum group. The gums were taken three times daily after meals, and the intervention period was 3 weeks. The probiotic gums contained two strains of Lactobacilli reuteri (ATCC 55730 at a dose of 1 x 10(8) CFU/gum and ATCC PTA 5289 at a dose of 1 x 10(8) CFU/gum), and each pellet of the xylitol gum contained approximately 1.0 g xylitol as single sweetener. Pretreatment and posttreatment samples of stimulated whole saliva were collected and quantified for MS and LB with chair-side kits. A statistically significant reduction (p < 0.05) of salivary MS was displayed in group A and B after the intervention when compared with baseline. A similar but nonsignificant tendency was seen in group C. No alterations of salivary LB was demonstrated in any group. In conclusion, daily chewing on gums containing probiotic bacteria or xylitol reduced the levels of salivary MS in a significant way. However, a combination of probiotic and xylitol gums did not seem to enhance this effect.
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Affiliation(s)
- E Caglar
- Department of Paediatric Dentistry, School of Dentistry, Yeditepe University, Bagdat cad 238, Goztepe, 34728 Istanbul, Turkey.
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