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Xylitol Syrup Helps to Prevent Childhood Tooth Decay

July 21, 2009

Marshall Islands toddler; photo courtesy of University of Washington One hundred and forty years ago this December, an Ohio dentist named William Sample received the first patent on chewing gum.  His recipe:  rubber, sugar, licorice, and charcoal.  Although Sample never actively pursued the patent, many subsequently wiled away a precious hour adding and subtracting ingredients to his crude, chewy concoction.  Among them was Walter Dierner, an accountant in the 1920s for the Fleer Chewing Gum Company in Philadelphia.  When the 23-year-old Dierner wasn’t crunching numbers, he dabbled on the side with his homespun chewing gum recipes.  One day Dierner got his latest recipe wrong and “ended up with something with bubbles.”  As Dierner recalled, his colleagues at Fleer recognized the novelty of “bubble gum” and launched plans to manufacture it.  To show just how different bubble gum was from regular chewing gum, Dierner and company decided to give it a different look.  The men dashed off to find a bottle of food coloring to do the trick, and by chance the only one to be found in the entire factory was pink.  The rest is history.

So in 1963, when scientists discovered that the natural sweetener xylitol inhibits the adhesion of the caries-causing oral bacterium Streptococcus mutans, it seemed logical to include the ingredient in chewing gum.  As great as the idea has been, it has had its limitations for small children.  The problem:  Toddlers need a fair amount of xylitol to protect their primary teeth as they erupt, and manufacturers can only pack so much of the compound into a stick of gum.  The toddlers would need to chew at least three sticks of gum per day to get the full decay-preventing benefit.  That has left researchers grasping for a more practical alterative. 

In the July issue of the Archives of Pediatrics & Adolescent Medicine, researchers partially funded through NIDCR may have found the answer.  It’s a soft capsule filled with 8 milliliters of strawberry-flavored xylitol syrup.  Parents can pull it apart and squeeze the syrup directly into their child’s mouth.  In a year-long randomized trial of 94 toddlers whose primary teeth were “coming in,” the researchers found that children who received two capsules a day could prevent up to 70 percent of decayed teeth.  They found that the protection against decay was not increased with three capsules per day.  The study was conducted in the Micronesian Marshall Islands, where the caries rate is two to three times that of the typical American mainland community.  According to the authors, this marks the first time to their knowledge that xylitol has been shown to be “effective for the prevention of decay in primary teeth for toddlers.”


  • Milgrom P, Ly KA, Tut OK, Mancl L, Roberts MC, Briand K, and Gancio MJ.  Xylitol pediatric topical oral syrup to prevent dental caries, Arch Pediatr Adolsc Med 2009:163: 601-607.

 

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This page last updated: February 26, 2014