"In our current state, where so many of pathogenic bacteria become drug-resistant, using novel approaches to prevent infectious diseases needs to be . . . thought about a lot more," said study coauthor and University of Washington professor Marilyn Roberts.
Roberts said that xylitol affects only the tooth-decay-causing bacteria, leaving other "good" bacteria alone.
Xylitol is at least twice as effective as fluoride in preventing tooth decay, said study coauthor Dr. Peter Milgrom, also of the University of Washington.
Fluoride repairs teeth by rebuilding them with calcium and phosphate in the mouth. If too much damage occurs, this process can't keep up. Taken together, fluoride and xylitol "would absolutely have a synergistic effect," Milgrom said.
The key is to start early, he said. Before they emerge, teeth have no bacteria on them. Once the teeth begin growing into the mouth, bacteria begin attacking. Intervention during the year when teeth are growing in could have a significant effect, he said: "If we go in there with xylitol early, the teeth don't get colonized with bad bacteria."
"This study gives us a lot of optimism about an agent that's relatively inexpensive, easy to apply, and safe to prevent tooth decay," said Dr. Paul Casamassimo, chief of dentistry at Nationwide Children's Hospital in Columbus, Ohio.
Oral syrup may be an easier regimen for patients to follow than more traditional xylitol gum and lozenges, he added. "It can be given in a quick dose, and the patient doesn't have to chew on it or suck on it frequently. . . . We worry about giving people too many things to do to take care of teeth, and it can fall to the wayside."
Still, there could be unintended consequences, said Dr. Michael Weitzman, professor of pediatrics and psychiatry at New York University. The same children prone to decay may also be prone to obesity.
"You have to think about the number of calories that you're now going to expose children to," Weitzman said. "Commercial products can have as many as 10 calories per tablespoon. If you up your intake of calories by 10 per day, that's a pound a year; 100 calories a day is a pound a month."
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shara.yurkiewicz@latimes.com
