The impact of polyol-containing chewing gums on dental caries: a systematic review of original randomized controlled trials and observational studies

J Am Dent Assoc. 2008 Dec;139(12):1602-14. doi: 10.14219/jada.archive.2008.0102.


Background: The authors conducted a systematic review of original studies that was designed to assess the impact of polyol-containing chewing gum on dental caries compared with the effect with no chewing gum.

Review methods: The authors searched MEDLINE, The Cochrane Library and Google Scholar up to May 2008 to identify peer-reviewed articles that compared polyol-containing chewing gum with no chewing gum. The authors extracted study characteristics, data on incremental dental caries and quality by consensus. Data on prevented fraction (PF) were pooled across studies.

Results: The results of 19 articles with data from 14 study populations showed that the use of xylitol, xylitol-sorbitol blend and sorbitol were associated with mean PF (95 percent confidence interval) of 58.66 percent (35.42-81.90), 52.82 percent (39.64-66.00) and 20.01 percent (12.74-27.27), respectively. For the sorbitol-mannitol blend, it was 10.71 percent (-20.50-41.93), which was not statistically significant. Sensitivity analyses confirmed the robustness of the findings.

Clinical implications: Although research gaps exist, particularly on optimal dosing and relative polyol efficacy, research evidence supports using polyol-containing chewing gum as part of normal oral hygiene to prevent dental caries.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Cariostatic Agents / administration & dosage
  • Cariostatic Agents / therapeutic use*
  • Chewing Gum*
  • Dental Caries / prevention & control*
  • Humans
  • Mannitol / administration & dosage
  • Mannitol / therapeutic use
  • Oral Hygiene
  • Sorbitol / administration & dosage
  • Sorbitol / therapeutic use
  • Sugar Alcohols / administration & dosage
  • Sugar Alcohols / therapeutic use*
  • Xylitol / administration & dosage
  • Xylitol / therapeutic use


  • Cariostatic Agents
  • Chewing Gum
  • Sugar Alcohols
  • Mannitol
  • Sorbitol
  • Xylitol