Preventive Effect of Xylitol in Dental Caries

Xylitol, a 5-carbon sugar alcohol, is used in paediatric dentistry, with or without fluoride. For a long time, our dentists have been using xylitol and fluoride at random, without the knowledge of pathogen's growth curve. These Gram positive pathogens grow in clusters which are linked via chain. Previously it has not been very effective due to lack of knowledge about the growth curve. Now, with knowledge of growth curve published recently we believe in a new combination therapy where fluoride needs to be added first within 100 ppm (not bacteriocidal dose) followed by xylitol (2% or more). Even the combination therapy of xylitol and fluoride may not be necessary if xylitol is present in the environment all along. Xylitol (more than 2%) significantly inhibits the growth of the pathogens by interfering in StkP and PBP2x assembly in bacterial cell wall cleavage at the septal and peripheral junction which is also very important for StkP – PASTA signalling activity.