Xylitol products for preventing tooth decay in children and adults
What it found
A fluoride toothpaste with 10% xylitol may cut tooth decay in children's permanent teeth by 13% over 2.5 to 3 years compared with fluoride-only toothpaste.
The evidence for other xylitol products is too weak to show whether they help.
What they found
Studies in people
Fluoride toothpaste with xylitol
Over 2.5 to 3 years, a fluoride toothpaste containing 10% xylitol may reduce tooth decay by 13% compared with a fluoride-only toothpaste. This was in 4216 children, and the evidence was low quality.
Xylitol syrup in infants
One small study found that xylitol syrup (8 g per day) reduced tooth decay by 58% compared with a low-dose xylitol syrup (2.67 g per day) over 1 year. This was in 94 infants, and the evidence was low quality.
Other xylitol products in children
For xylitol lozenges, sucking tablets, tablets compared with sorbitol tablets, and wipes in children and infants, the results could mean either a reduction or an increase in tooth decay. The evidence was very low to low quality.
Xylitol lozenges in adults
Only one study looked at xylitol lozenges compared with control lozenges in adults. The result could mean either a reduction or an increase in tooth decay, and the evidence was low quality.
Side effects
Four studies reported no side effects from any of the xylitol products. Two studies found similar rates of side effects between groups. Side effects mentioned include mouth sores, cramps, bloating, constipation, gas, and loose stool or diarrhoea.
What the authors conclude
“We found some low quality evidence to suggest that fluoride toothpaste containing xylitol may be more effective than fluoride-only toothpaste for preventing caries in the permanent teeth of children, and that there are no associated adverse-effects from such toothpastes.”
Also in their conclusions
- They found some low quality evidence to suggest that fluoride toothpaste containing xylitol may be more effective than fluoride-only toothpaste for preventing caries in the permanent teeth of children, and that there are no associated adverse-effects from such toothpastes.
- They say the effect estimate should be interpreted with caution due to high risk of bias and the fact that it comes from two studies by the same authors in the same population.
- They conclude that the remaining evidence is of low to very low quality and is insufficient to determine whether any other xylitol-containing products can prevent caries in infants, older children, or adults.
How it was done
Tooth decay is a very common long-term disease that affects most people. It has been suggested that eating xylitol could help prevent decay, but the evidence was unclear, so the authors summarised it to find out how well it works and whether it is safe.
They looked at randomised controlled trials of xylitol products for tooth decay in children and adults. They found 10 studies with a total of 5903 participants.
What it can’t tell you
- We summarised it from the abstract only.
- The evidence for most xylitol products is low or very low quality, so it cannot show whether they prevent tooth decay.
- The main finding comes from two studies by the same authors in the same group of people, so it may not apply to other groups.
- The studies do not show whether xylitol prevents tooth decay in adults or in infants and older children, except for the specific products tested.
Who paid
- Conflicts
- There are no financial conflicts of interest and the review authors declare that they do not have any associations with any parties who may have vested interests in the results of this review.
- Authors work at
- The University of Manchester, M PL
The paper
- Title
- Xylitol-containing products for preventing dental caries in children and adults
- Type
- Systematic review and meta-analysisThe authors follow a set, published method to find every relevant study, then combine the numbers from them into one result.
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV (2015). Xylitol-containing products for preventing dental caries in children and adults. The Cochrane database of systematic reviews. doi:10.1002/14651858.CD010743.pub2Free full textPubMed 25809586DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error