Xylitol versus sorbitol for tooth decay in clinical trials
What it found
In people, most datasets favoured xylitol over sorbitol for tooth decay, but the results were not consistent.
The authors say the evidence is contradictory and at high risk of bias.
What they found
Studies in people
Tooth decay outcomes
Most of the datasets favoured xylitol, but this was not consistent. Because of high clinical heterogeneity, no meta-analysis was performed.
Risk of bias
The accepted trials may be limited by selection bias. Sensitivity analysis indicated a high risk for attrition bias.
Possible confounders
External fluoride exposure and stimulated saliva flow may have confounded the measured anticariogenic effect of xylitol.
Other findings
Publication bias
The funnel plot and Egger's regression results suggest a low publication bias risk.
What the authors conclude
“The evidence identified in support of xylitol over sorbitol is contradictory, is at high risk for selection and attrition bias and may be limited by confounder effects.”
Also in their conclusions
- They say the evidence identified in support of xylitol over sorbitol is contradictory, is at high risk for selection and attrition bias and may be limited by confounder effects.
- They advise that future high-quality randomised controlled trials are needed to show whether xylitol has a greater anticariogenic effect than sorbitol.
How it was done
The authors wanted to assess the current clinical evidence and its risk of bias for the effects of xylitol compared with sorbitol, in the context of tooth decay.
They searched databases for clinical trials up to 19 March 2011. They included studies that tested a tooth decay related outcome, compared xylitol with sorbitol, had two or more arms and used a prospective design. Nine articles were found, eight were accepted and one was excluded.
What it can’t tell you
- We summarised it from the abstract only.
- The review could not combine the results because the studies were too different from each other.
- The included trials may be affected by selection and attrition bias, so their results may not be reliable.
Who paid
- Authors work at
- University of the Witwatersrand, South Africa
The paper
- Title
- Effect of xylitol versus sorbitol: a quantitative systematic review of clinical trials
- Type
- Systematic review
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Mickenautsch S, Yengopal V (2012). Effect of xylitol versus sorbitol: a quantitative systematic review of clinical trials. International dental journal. doi:10.1111/j.1875-595X.2011.00113.xFree full textPubMed 23016999DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error