Effects of maltitol and xylitol chewing-gums on parameters involved in dental caries development

Eur J Paediatr Dent. 2013 Dec;14(4):303-8.


Aim: The effects on plaque parameters of sugar free chewing-gums (CG) sweetened with either maltitol or xylitol were assessed to better understand the role polyols can play in dental caries prevention.

Materials and methods: A double-blind, parallel, randomised, controlled study was conducted in China. Subjects (N = 258, age = 13 to 15 years-old) were divided into 4 groups: 2 receiving polyols CG, containing respectively maltitol or xylitol, a group receiving gum base (placebo) and a negative control group not receiving any gum. CG were chewed for 30 days. This corresponds to a 10 g consumption of polyol per day. Plaque parameters (growth, pH, bacteria and insoluble glucans) were evaluated throughout the experimental period.

Results: All parameters studied were significantly modified with gum base compared to no-gum: plaque pH increased; plaque growth, bacteria (S. mutans, S. sobrinus, A. viscosus and Lactobacillus) and insoluble glucans decreased. Maltitol and xylitol CG led similarly to a higher plaque pH (AUC, p⋜0.05) on short (at baseline after the first CG consumption) and long term (after 4 weeks of daily CG consumption), with or without saliva stimulation compared to both control and placebo groups. They led to a decrease in plaque growth (p=0.02) over the experimental period compared to controls. Moreover, they significantly reduced the concentration of 4 cariogenic bacteria species (p⋜0.05) in dental plaque compared to gum base.

Conclusion: Sugar free CG sweetened with either maltitol or xylitol can similarly reduce plaque acidogenicity compared to gum base through a decrease in oral bacteria presence. The use of a gum base placebo allowed to isolate effects on parameters involved in dental caries development specific to maltitol and xylitol, and to show these effects were similar.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actinomyces viscosus / isolation & purification
  • Adolescent
  • Analysis of Variance
  • Area Under Curve
  • Cariostatic Agents / therapeutic use*
  • Chewing Gum*
  • Dental Caries / prevention & control*
  • Dental Plaque / chemistry
  • Dental Plaque / microbiology
  • Dental Plaque Index
  • Double-Blind Method
  • Glucans / analysis
  • Humans
  • Hydrogen-Ion Concentration
  • Lactobacillus / isolation & purification
  • Maltose / analogs & derivatives*
  • Maltose / therapeutic use
  • Statistics, Nonparametric
  • Streptococcus mutans / isolation & purification
  • Streptococcus sobrinus / isolation & purification
  • Sugar Alcohols / therapeutic use*
  • Xylitol / therapeutic use*


  • Cariostatic Agents
  • Chewing Gum
  • Glucans
  • Sugar Alcohols
  • Maltose
  • maltitol
  • Xylitol