Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints

Table 2

Summary of dental caries clinical trials with erythritol.

Study type	Substance tested	Subjects		Age (years)	Dose	Results	Reference
Double-blind randomized controlled prospective intervention trial	Erythritol, xylitol, or sorbitol	School children	156–165	~8-9	7.5 g/day, 3x/school day (~200 school days/year) for 3 years	Erythritol group had significantly less tooth surfaces developing into enamel or dentin caries and significantly less enamel caries tooth surfaces developing into dentin caries when compared with sorbitol and xylitol; time of enamel or dentin caries lesions to develop and dentin caries to progress were significantly longer with erythritol	Honkala et al. (2014); [37]
Double-blind randomized controlled prospective intervention trial; (Examinations 3 years after cessation of all interventions in Honkala et al. (2014) study)	Erythritol, xylitol, or sorbitol	School children	129	~14-15	7.5 g/day, 3x/school day (~200 school days/year) for 3 years followed by 3 years without any intervention	No significant differences in decayed, missing, and filled teeth and surfaces between the intervention groups were noted However, erythritol group still had reduced percentages of surfaces developing enamel/dentin caries, dentin caries, or subject to dentist intervention compared to other groups	Falony et al.; (manuscript submitted)
Salivary and plaque counts of S. mutans and salivary counts of Lactobacillus (Sampling from Honkala et al. (2014) study)	Erythritol, xylitol, or sorbitol	School children	156–165	~8-9	7.5 g/day, 3x/school day (~200 school days/year) for 3 years (tablets)	At years 1 and 3, a significant reduction in the weight of freshly collected dental plaque of the subjects occurred with erythritol; No such changes with sorbitol or xylitol; no effect on the plaque levels of protein, glucose, glycerol, or calcium; erythritol was also generally associated with significantly lower counts of salivary and plaque S. mutans; No effect on salivary Lactobacillus levels	Runnel et al. (2013); [40]
Cluster-randomized, double-blinded clinical trial	Erythritol/maltitol or xylitol/maltitol	Healthy children	96–101	~10	4.5 g erythritol + 4.2 g maltitol/day; 4.7 g xylitol + 4.6 g maltitol/day, 3x/day for up to 2 years with a 4-year follow-up (lozenges)	No evidence of caries reduction; however, final caries diagnoses were made 27 or 39 months after termination of the interventions, and the study subjects lived in a fluoridated area and exhibited low caries activity	Hietala-Lenkkeri et al. (2012) [41]