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The use of xylitol chewing gum in mothers lowered maternal oral bacterial load and reduced transmission of mutans streptococci to infants late in pregnancy and during the postpartum period. Xylitol is generally nontoxic based on various clinical studies and its historical use in foods, pharmaceuticals, and nutraceuticals. Animal studies also confirm its overall safety profile. Renocerebral oxalosis with renal failure is documented with large doses of IV administered xylitol. Xylitol is a 5-carbon sugar alcohol naturally found in the fibers of many fruits and vegetables, including raspberries, strawberries, yellow plum, lettuce, cauliflower, corn, and corn husks.
Xylitol was first discovered in by a German chemist, Emil Fischer. In Europe, Korea, Japan, Thailand, and China, chewing gum and lozenges containing xylitol are widely available and used by consumers. Finland implemented a national campaign and was the first country to promote xylitol to reduce tooth decay in children. Even the US Army implemented an initiative to promote xylitol to improve oral health among deployed troops. Xylitol chewing gum and hard candy products are considered choking hazards in young children; therefore, initiatives addressing tooth decay in young children have not been adopted until the creation of an acceptable xylitol delivery vehicle.
Xylitol is a natural carbohydrate and is classified as a polyhydric alcohol or sugar alcohol. All 5 carbon atoms bind to a hydroxide group; thus, the molecule has no reducing groups. A review article documents the chemical profile and clinical structural importance ie, the pentitol-hexitol theory of xylitol.
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One teaspoonful of xylitol contains approximately 10 calories, while 1 teaspoonful of sucrose contains 15 calories. Industrially, xylitol is produced by chemical hydrogenation of D-xylose into xylitol by the presence of a nickel catalyst. Alternative forms of industrial production of xylitol, such as the use of metabolically engineered yeasts, have been studied.
Medical literature documents the use of xylitol in medical conditions and applications, including acute otitis media, dental caries, IV nutrition, and osteoporosis. The mechanism of action for xylitol may involve altering the adherence surface by potentially blocking bacterial lectins. The xylitol-induced inhibition of S. In addition, xylitol affects the expression of the polysaccharide capsule and cell wall of pneumococci.
However, xylitol does not affect nasopharyngeal colonization of pneumococci. Dietary xylitol may improve oxidative killing in neutrophilic leukocytes and prolong the survival of rats suffering from sepsis caused by S. The daily dose varied from 8. Postoperative restoration of bowel motility was found to be significantly improved in patients who were given xylitol gum to chew after surgery. In a randomized controlled trial, patients requiring laparoscopic surgery for benign or malignant gynecologic disease received usual postoperative care plus either mint-flavored, sugarless xylitol chewing gum 3 times daily to be chewed for 30 minutes at each session starting 6 hours after surgery until first flatus or no gum.
Xylitol inhibits the cariogenicity, adhesivity, and acidogenic potential of plaque. A literature review of randomized controlled trials and observational studies involving nearly 12, patients supports the use of polyol-containing chewing gums in reducing dental caries. Dental caries reduction results from the buffering effect on plaque from saliva stimulation throughout the chewing process. Low-quality evidence suggested that 2. Remaining data was of insufficient quality to make any determinations regarding other monitored parameters.
Xylitol is a low-calorie sweetening alternative and is absorbed more slowly than sugar. Xylitol inhibited the major periodontopathogen Porphyromonas gingivalis, which is responsible for the initiation and progression of periodontitis by reducing inflammatory cytokine expression.clublavoute.ca/gegyr-conocer-hombres-en.php
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In parenteral nutrition, xylitol is often given with amino acids and other carbohydrates. Metabolically, parenterally administered xylitol products reduce gluconeogenesis, promote fatty acid oxidation, and moderate blood glucose and insulin levels. Because high plasma glucose concentrations are avoided, high hepatic glucose production is reduced and the release and oxidative use of free fatty acids is enhanced. Xylitol was successfully used to treat a patient with muscle pain and stiffness caused by myoadenylate deaminase deficiency, because it can be metabolically converted to D-ribose.
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Dietary xylitol increases the intestinal absorption of calcium and when added to calcium supplements, accelerates bone repair and improves the bioavailability of calcium salts in calcium-deficient rats. Dosage regimens vary in clinical studies. Research has shown that xylitol lozenges 1 g xylitol, 5 times daily reduced the caries increment 10 percent. This reduction, representing less than one-third of a surface per year, was not statistically significant.
Xylitol is considered safe in pregnancy and during breast-feeding, according to the FDA. Patients should be counseled if taking laxative products, because most sugar alcohols may have an additive laxative effect; sugar alcohols are not fully broken down during digestion. Xylitol appears to protect against ethanol-induced bone resorption and trabecular bone mineral density changes.
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