Xylitol

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Overview

Description: An ingredient added to dental products to remove bacteria.
Structure
Description: An ingredient added to dental products to remove bacteria.
DrugBank ID: DB11195
Type: Small Molecule
US Approved: NO
Other Approved: YES
Patents: 0
Indicated Conditions: 0
Clinical Trials: Phase 0
1
Phase 1
39
Phase 2
51
Phase 3
81
Phase 4
41

Identification

Summary

Xylitol is an ingredient added to dental products to remove bacteria.

Generic Name

Xylitol

DrugBank Accession Number

DB11195

Background

Xylitol is a naturally occurring five-carbon sugar alcohol found in most plant material, including many fruits and vegetables. Xylitol-rich plant materials include birch and beechwood ¹. It is widely used as a sugar substitute and in "sugar-free" food products. The effects of xylitol on dental caries have been widely studied, and xylitol is added to some chewing gums and other oral care products to prevent tooth decay and dry mouth. Xylitol is a non-fermentable sugar alcohol by most plaque bacteria, indicating that it cannot be fermented into cariogenic acid end-products ⁴. It works by inhibiting the growth of the microorganisms present in plaque and saliva after it accummulates intracellularly into the microorganism ⁴. The recommended dose of xylitol for dental caries prevention is 6–10 g/day, and most adults can tolerate 40 g/day without adverse events ¹.

Type

Small Molecule

Groups

Experimental, Investigational

Structure

Similar Structures

Weight: Average: 152.1458
Monoisotopic: 152.068473494
Chemical Formula: C₅H₁₂O₅

Synonyms

D-Xylitol
Xylitol

External IDs

E-967
E967
INS NO.967
INS-967

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Pharmacology

Indication

Indicated for use as a sugar substitute, and oral hygiene active ingredient.

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Pharmacodynamics

There has been evidence of xylitol in dental hygiene in reducing dental caries disease and also reversing the process of early caries ¹. Xylitol increases salivary flow and pH, reduces the levels of Streptococcus mutans in plaque and saliva and reduces the adhesion on the microorganism to the teeth surface ¹. Streptococcus mutans is the main target plaque microorganism ², but xylitol may potentially have inhibitory actions against several other bacterial species ¹. It prevents a shift of the bacterial community towards a more cariogenic microflora in oral environment ⁴. Oral ingestion of xylitol causes a smaller rise in plasma glucose and insulin concentrations than does the ingestion of glucose in healthy men and diabetics ⁶.

Mechanism of action

Xylitol is initially taken up by the microorganism and accumulates intracellularly. Accumulated xylitol is transported into an energy-consuming cycle, or the inducible fructose transport system. It is converted to non-metabolizable, toxic xylitol-5-phosphate via phosphoenolpyruvate: a constitutive fructose phosphotransferase system by S. mutans ¹. This metabolic process of xylitol, without the gain of any energy molecules, results in the development of intracellular vacuoles and cell membrane degradation. S. mutans dephosphorylates xylitol-5-phosphate and expels it from the cell, in which requires energy consumption. This ultimately leading to starving of microorganism and growth inhibition ¹. Long-term exposure to xylitol can cause microorganisms to develop resistance to xylitol. This clinically beneficial selection process creates xylitol-resistant mutans strains that are less virulent and less cariogenic than their parent strains ³. Xylitol also increases the concentrations of ammonia and amino acids in plaque, thereby neutralizing plaque acids ¹. A study suggests that xylitol may also promote remineralization of deeper layers of demineralized enamel by facilitating Ca2+ and phosphate movement and accessibility ⁵.

Target	Actions	Organism
UXylose isomerase	Not Available	Arthrobacter sp. (strain NRRL B3728)
UXylose isomerase	Not Available	Streptomyces rubiginosus
UXylose isomerase	Not Available	Streptomyces olivochromogenes
UXylose isomerase	Not Available	Actinoplanes missouriensis (strain ATCC 14538 / DSM 43046 / CBS 188.64 / JCM 3121 / NCIMB 12654 / NBRC 102363 / 431)
UHyaluronate lyase	Not Available	Streptococcus pneumoniae serotype 4 (strain ATCC BAA-334 / TIGR4)

Absorption

Xylitol is absorbed in the small intestine via passive diffusion with a slow absorption rate ¹.

Volume of distribution