MECHANISMS OF THE ANTICARIOGENIC ACTION OF XYLITOL IN CHILDREN WITH NON-CARIOUS LESIONS OF DENTAL HARD TISSUES
Keywords:
xylitol, Streptococcus mutans, dental biofilm, caries prevention, non-carious lesions, remineralization, salivation, phosphotransferase system.Abstract
This paper reviews current understanding of the mechanisms underlying the anticariogenic action of xylitol, with particular attention to its relevance for children with non-carious lesions of dental hard tissues. Based on a content analysis of scientific papers and reviews indexed in major domestic and international databases, the mechanisms of xylitol action are shown to be multifactorial and mutually reinforcing, including direct inhibition of Streptococcus mutans growth, disruption of biofilm structure and microbial metabolic activity, and stimulation of salivary flow. A key feature of xylitol is its inability to be fermented by cariogenic bacteria into organic acids, which helps maintain plaque pH above the critical demineralisation threshold and supports conditions favourable for remineralisation of dental hard tissues. Interaction of xylitol with the bacterial phosphotransferase system disrupts normal carbohydrate metabolism in Streptococcus mutans, leading to futile energy expenditure and a progressive decline in cell viability. The regular use of xylitol containing products, including toothpastes, mouth rinses, chewing gum, and confectionery, is shown to provide a sustained reduction in caries risk, which is of particular importance in children with non-carious lesions of dental hard tissues and in those with xerostomia related to mouth breathing associated with pathology of the Pirogov Waldeyer lymphoid pharyngeal ring. It is concluded that the multifactorial mechanisms of xylitol action justify its inclusion, alongside fluorides and calcium containing compounds, in caries prevention regimens for children, together with controlled restriction of dietary sucrose.
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