TABLE 3

Summary of Xylitol Preventive Treatments

Author, Year, QualityStudy DesignInterventionsCountry; Setting; Fluoridation StatusAge at EnrollmentSample SizeF-U, yMean Caries IncrementAbsolute Reduction in Caries IncrementReduction in Caries IncrementOther Dental Caries Outcomes
Alamoudi et al 201223 PoorRCTA: Xylitol chewable tablets (1.2 g, 84% xylitol) chewed for 5 min 3 times dailySaudi Arabia; Recruitment setting: Well-infant clinics and dental clinics; Water fluoridation status: Not reported2–5 y341.5dmft3.682%A vs B
B: Fluoride varnish, every 6 mo throughout studyA: 0.8dmft at baseline: 8.4 vs 10.3 (P = .19) dmft at 18 mo: 9.2 vs 14.7 (P = .001)
B: 4.4
P = not reported
Kovari et al 200326, a FairCluster RCT (11 clusters)A: 65% Xylitol gum 3 times per day, chewed for 3–5 min, for total of 2.5 g/dFinland; Recruitment setting: day care centers; Water fluoridation status: Not reported3–6 y7863–6Not reportedNot reportedNot reportedA vs B
B: Tooth brushing with 0.05% NaF toothpaste after lunchCaries at 7 y old: 31% (98/316) vs 35% (149/427), RR 0.88 (95% CI 0.72–1.10)
Caries at 9 y old: 43% (133/310) vs 51% (221/434), RR 0.84 (95% CI 0.72–0.99)
dmft: 1.1 vs 1.0 at 7 y, 1.2 vs 1.6 at 9 y
Oscarson et al 200629 FairRCTA: One 0.48-g xylitol tablet at bedtime after brushing for 6 mo; then 1 tablet twice daily to age 3 y and 6 moSweden; Recruitment setting: Public dental clinic; Water fluoridation status: Not reported25 mo1152dmfs0.4252%A vs B
B: No tabletsA: 0.38Dental caries: 18% (10/55) vs 25% (16/63), OR 0.65 (95% CI 0.27–1.59)
B: 0.80
P > .05
Seki et al 201130 PoorCluster, non–randomized controlled clinical trial (3 clusters)A: Xylitol chewing gum (100% xylitol, 1.33 g); 1 pellet chewed 5 min 4 times dailyJapan; Recruitment setting: Preschool; Water fluoridation status: Not reported (states fluoridation “limited” in Japan)66%–72% 4 y old1611dfs0.13%A vs B
B: No interventionA: 3.3Development of caries from baseline–6 mo: 1.7 vs 1.6 (P > .05)
B: 3.4Development of caries from 6 mo–1 y: 1.6 vs 1.8 (P > .05)
P > .05
Zhan et al 201235 FairRCTA: Xylitol wipes, 2 at a time, 3 times per day (estimated daily dosage 4.2 g) every 3 moUnited States; Recruitment setting: University pediatric clinic; Water fluoridation status: Not reported6–35 mo371dmfsb0.4891%A vs B
B: Placebo wipesA: 0.05New caries lesions at 1 yb: 5% vs 40% (P = .03); NNT 3
B: 0.53ITT analysis of new caries lesions at 1 y: 5% vs 32%; RR 0.14 (95% CI 0.02–1.07); NNT 4
P = .01
  • CI, confidence interval; dfs, decayed and filled surfaces; dmft, decayed, missing, and filled teeth; F-U, follow-up; NNT = number needed to treat; OR, odds ratio; RCT, randomized controlled trial; RR, relative risk.

  • a Baseline caries status not defined.

  • b Numbers based on per protocol analysis.