Xylitol, a Promising Allied for Oral Heath

This work aimed to carry out a literature review correlating the use of xylitol with the prevention of dental caries, which is a chronic and multifactorial disease, caused by organic acids originated from the fermentation of dietary carbohydrates (dependent sucrose) by bacteria and, when associated with a limited ability to correct oral pH, lead to tooth decalcification, a process known as demineralization. The cariogenic potential of the oral microbiota is genetically determined and is accentuated by the availability of sucrose. Under these conditions, the metabolic pathways favor the reduction of pH, demineralization of the dental substrate and the synthesis of extracellular polysaccharides that act as an energy supply and adhesive strategy. Xylitol is an alcoholic sugar that hardly undergoes fermentation by oral bacteria. Therefore, it has been recommended as a substitute for sugar, especially when food is eaten between meals, helping to prevent tooth decay. The antimicrobial activity of xylitol occurs when the compound is incorporated into the bacterial cell, through the phosphorylation process in the glycolytic pathway of the bacterium, forming xylitol-5-phosphate, that is not metabolized by any enzyme, characterizing it as an intermediate compound. Xylitol is a safe nutrient for human use, and several studies have analyzed the influence of xylitol in dental caries prevention. However, there is a need for more robust clinical trials for the evaluation of the effectiveness of xylitol under ideal conditions propitious to its use.