Söderling Eva, Pienihäkkinen Kaisu
Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland.
BMC Oral Health. 2025 Jul 29;25(1):1275. doi: 10.1186/s12903-025-06602-1.
A systematic review of published data was carried out to assess specific effects of xylitol chewing gum on levels of mutans streptococci (MS), dental plaque, or caries.
Electronic and hand searches were performed to find clinical studies on levels of MS, or plaque, or caries comparing effects of xylitol gum with a polyol control gum. Prospective randomized or controlled clinical studies published before 2025 were included in the review.
The search identified 908 titles on MS, 879 titles on plaque, and 658 on caries to be evaluated. After applying inclusion and exclusion criteria, 16 articles on MS, ten on plaque and five on caries were reviewed. In 12/14 studies xylitol gum significantly decreased MS counts compared with sorbitol gum. Plaque accumulation decreased in 6/10 studies and caries occurrence in 3/5 trials when xylitol gum was compared with sorbitol/sorbitol-containing gum. Three studies on MS and/or plaque accumulation had a maltitol gum control, but the results of the studies were conflicting.
The best evidence of specific beneficial effects for xylitol gum differing from those of sorbitol gum are found in the evaluated MS and plaque studies. The results of the reviewed caries trials are in line with this idea. Xylitol gum chewing is suggested to act as an adjunct to toothbrushing for reducing caries-associated MS and plaque accumulation to control and prevent caries occurrence in children and adults. Adults with other plaque-related diseases like periodontal disease should also benefit from xylitol gum.
对已发表的数据进行系统评价，以评估木糖醇口香糖对变形链球菌（MS）水平、牙菌斑或龋齿的特定影响。
通过电子检索和手工检索，查找关于MS水平、牙菌斑或龋齿的临床研究，比较木糖醇口香糖与多元醇对照口香糖的效果。纳入2025年前发表的前瞻性随机或对照临床研究进行综述。
检索到908篇关于MS的文献标题、879篇关于牙菌斑的标题和658篇关于龋齿的标题以供评估。应用纳入和排除标准后，对16篇关于MS的文章、10篇关于牙菌斑的文章和5篇关于龋齿的文章进行了综述。在12/14项研究中，与山梨醇口香糖相比，木糖醇口香糖显著降低了MS计数。与山梨醇/含山梨醇口香糖相比，在6/10项研究中牙菌斑积聚减少，在3/5项试验中龋齿发生率降低。三项关于MS和/或牙菌斑积聚的研究以麦芽糖醇口香糖作为对照，但研究结果相互矛盾。
在评估的MS和牙菌斑研究中发现了木糖醇口香糖与山梨醇口香糖不同的特定有益效果的最佳证据。综述的龋齿试验结果与此观点一致。建议咀嚼木糖醇口香糖作为刷牙的辅助手段，以减少与龋齿相关的MS和牙菌斑积聚，从而控制和预防儿童和成人龋齿的发生。患有其他与牙菌斑相关疾病（如牙周病）的成年人也应从木糖醇口香糖中受益。
