Chewing xylitol gum may serve as a helpful addition to toothbrushing by reducing plaque and decreasing the risk of caries-associated Streptococcus mutans, according to a review recently published in BMC Oral Health.
Additionally, patients with gum disease may see benefits from xylitol gum chewing, the authors wrote.
“Xylitol gum chewing is suggested to act as an adjunct to toothbrushing for reducing caries-associated mutans streptococci (MS) and plaque accumulation to control and prevent caries occurrence in children and adults,” wrote the authors, led by Eva Söderling of the University of Turku Institute of Dentistry in Finland (BMC Oral Health, July 29, 2025, Vol. 25, 1275).
For this review, a search was conducted for clinical studies comparing the effects of xylitol gum and polyol control gum on MS, plaque, or caries. To be included, studies had to report the daily xylitol dose, use xylitol as the main polyol, have a polyol control gum with little or no xylitol, and last at least six months for caries trials with a two-year follow-up, they wrote.
After applying inclusion and exclusion criteria, 16 MS studies, 10 plaque studies, and five caries studies were selected. The trials examined xylitol gum’s impact on MS levels, plaque accumulation, or caries development, with outcomes measured by comparing baseline and postintervention values.
In 12 out of 14 studies, xylitol gum significantly reduced MS levels compared to sorbitol gum. Of these, seven studies showed five to tenfold reductions in MS, which are considered clinically meaningful. In six studies, plaque buildup decreased and caries occurrence dropped in three of five trials comparing xylitol gum with sorbitol-containing gum, they wrote.
Furthermore, one two-week study reported a 29% reduction in plaque weight with xylitol gum, while plaque increased in the sorbitol group.
However, the clinical effectiveness of xylitol gum chewing may require additional controlled studies to draw more definitive conclusions, the authors added.
“The fact that the results of the MS, dental plaque, and caries studies are all in line with each other gives support to the idea that xylitol gum has specific effects,” they wrote.
