Clinical caries studies with polyalcohols. A literature review.

Polyalcohols represent the most important group of sugar substitutes. Those most widely used in products advertising dental benefits compared to their sucrose containing homologues are sorbitol, mannitol (hexitols), xylitol (pentitol), maltitol, lactitol (12-carbon polyols), Lycasin (hydrogenated starch hydrolysate) and Palatinit (mixture of two 12-carbon polyols). All these polyalcohols have been proven to be non-cariogenic or extremely low cariogenic in rat caries experimentation, and some of them also in human clinical caries studies. They have also been shown to be non-acidogenic or hypoacidogenic in plaque pH telemetry. The low or non-cariogenicity of the above polyols can be termed a "passive" feature, because it is based on the fact that they are not, or only poorly and very slowly, fermented by the oral flora. More recent research, however, has also propagated "active", i.e. bacteriostatic and/or cariostatic properties of xylitol or mixtures of xylitol with other sugar substitutes. Such claims have not yet been substantiated in human caries trials.