EFSA Approves Xylitol Health Claims

PARMA, ItalyThe European Food Safety Authoritys (EFSA) Panel on Dietetic Products, Nutrition and Allergies approved a health claim for xylitol, sorbitol and mannitol-based sugar-free chewing gum that it reduces the risk of tooth decay.

A systematic review included eight trials on the effects of using sugar-free gum with sorbitol, with xylitol, and with a combination of sorbitol/xylitol. The use of chewing gum varied in frequency per day and duration. Seven out of eight studies demonstrated significant caries reduction. Caries reduction appeared to be independent of polyol type, polyol composition and concentration and chewing regimes.

The de- and remineralisation equilibrium of teeth is mainly driven by saliva and the main contributors are flow rate and concentrations of calcium, phosphate and bicarbonate. At rest, low amounts of saliva are secreted, but stimulation by chewing may increase saliva flow more than tenfold. When flow rate increases, saliva concentration of calcium, phosphate and bicarbonate also increases, and such increases favor remineralisation of tooth crystals.

In weighing the evidence, the Panel took into account that almost all of the clinical trials of sugar-free chewing gum consumption showed reduced tooth demineralisation as indicated by a reduction in caries incidence, and that there was strong evidence supporting the biological plausibility for the effect.

The Panel considers that, in order to obtain the claimed effect, 2-3 g of sugar-free chewing gum should be chewed for 20 minutes at least three times per day after meals. This quantity and pattern of use of chewing gum can easily be included within a balanced diet.