There is little high quality evidence proving the effect of xylitol in preventing dental cavities, new research published in the Cochrane Library has found. Xylitol is a natural sweetener found in products including sugar-free chewing gum, toothpaste, gels, lozenges, and sweets.

Study authors compiled data from 5,903 subjects across 10 different studies. Most studies used varied methods where the researchers were unable to create a summary effect estimate. The team found low quality evidence based on data from two Costa Rican studies (n=4,216) that reported tooth decay levels were 13% lower in those using a fluoride toothpaste containing xylitol for three years vs. those who used a fluoride-only toothpaste. Little to no evidence of benefit was seen for other xylitol-containing products (eg, xylitol syrup, lozenges, tablets). Some studies included in the Cochrane review did not report sufficient information on the side effects of xylitol (eg, bloating, laxative effects).

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Researchers concluded that the identified evidence did not allow for any strong conclusions about the effects of xylitol or any benefit in preventing tooth decay. The limited data found on xylitol-containing toothpastes may pertain specifically to the study population, they noted.

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