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Xylitol’s role in preventing cavities might be exaggerated, new research suggests

A new doctoral thesis questions the role of xylitol, a sugar alcohol, in preventing cavities. The product is popular in Finland and widely used as a post-meal sweet or chewing gum.

In her doctoral thesis Anja Hietala-Lenkkeri researched what kind of a role xylitol has in preventing dental caries in schoolchildren. Image: Julia Sieppi / Yle

Finns have been munching on the sugar alcohol xylitol after meals for decades, as it is believed to prevent dental cavities. The Finnish Dental Association even recommends the use of products with a high xylitol content (more than 30 percent) in dental care regimes.

However, according to a new doctoral thesis from the University of Turku the substance, does not, in fact, play a significant role in preventing dental cavities.

Aija Hietala-Jenkkeri spent four years examining school-age children for her doctoral thesis "Evaluation of xylitol use and bitewing radiographs among school-aged children in a low-caries level population", which she will defend at Turku University next week.

Xylitol "unnecessary" for those with healthy teeth

Finnish children, like most of the population, are generally free of dental cavities and have healthy teeth.

"Xylitol products like pastilles and chewing gum do not have a significant effect in preventing dental cavities in healthy teeth compared to cavity prevention treatments provided by health care centres," Hietala-Lenkkeri says.

Notwithstanding, earlier research on the matter proves that in populations where cavities occur frequently, xylitol products have a preventive effect.

"Recommending that the whole population use xylitol products might be unnecessary, but xylitol could be beneficial when used to target groups in particular need of preventive treatment. It should be consumed during the the very early stages of dental decay", Hietala-Lenkkeri says. 

X-rays play an important role in spotting cavities

In her doctoral dissertation, Aija Hietala-Lenkkeri also researched how cavity-induced damage is spotted in childen.

Väitöstutkija, hammaslääketieteen lisensiaatti Aija Hietala-Lenkkeri
Aija Hietala-Lenkkeri. Image: Eino Kossila / Yle

Most incipient cavities are not visible to the naked eye. Hietala-Lenkkeri’s findings reveal that nearly half of the 14-year-olds with healthy teeth in the study had cavities that needed filling.

"[In some case] the bacteria might be damaging the dentine behind the tooth enamel and won’t be visible until the enamel is thoroughly corrupted," Hietala-Lenkkeri says.

Hietala-Lenkkeri emphasises that the surprising results might be explained by the fact that some the teenagers had never had x-rays, so all of their dental problems came to light at once. 

She recommends considering x-rays as an addition to regular check-ups by age 15. However, in Finland x-rays are recommended solely on the basis of the need for treatment.

"Being alert is vital: the the denture might not always be as healthy as it seems", Hietala-Lenkkeri concludes.

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