Title: Alternative Sweeteners

348 Olinger and Pepper
formation of insoluble glucans and lipoteichoic acid, two products of bacterial
metabolism that play an important role in the adhesion and cohesion of dental
plaque (143,157).
Chewing gums sweetened with xylitol or sorbitol have been investigated
regarding their impact on the formation of plaque. The results of these studies
suggest that chewing gums sweetened with xylitol have a greater impact on
plaque reduction (169,170).
F. Dental Endorsements and Claims
The dental benefits provided by xylitol have been recognized by a number of
dental associations.
VII. EVOLVING APPLICATIONS
New, beneficial and potentially existing applications of xylitol continue to be
either discovered or suggested. These new applications include the following.
1. The use of xylitol as a bulk satiety sweetener
2. The use of xylitol to reduce the potential occurrence of acute otitis
media
The effects of xylitol on gastric emptying and food intake when measured
in 10 healthy male volunteers suggests that ingestion of a 25 g xylitol preload
may be associated with an approximate 25% reduction of caloric intake during
a subsequent test meal (171). Other bulk sweeteners did not suppress caloric
intake when tested at the same 25 g level. The study suggests that xylitol could
be applied at efficacious levels in meal replacement or diet-supporting products
to facilitate weight reduction programs.
Acute otitis media, an infection of the middle ear, is a common illness that
affects a significant number of young children. During 1990, for example, an
estimated 24.5 million visits were made to office-based physicians in the United
States at which the principal diagnosis was otitis media. A study of the effect of
xylitol ingestion on acute otitis media with either a xylitol-sweetened chewing
gum, syrup, or lozenge, suggests that each xylitol-sweetened material has a positive
influence in the reduction of acute otitis media occurrence. Reductions of
40%, 30%, and 20% were reported for the chewing gum, syrup, and lozenge,
respectively (172,173). The observed benefit is believed to be associated with
the ability of xylitol to reduce the growth of Streptococcus pneumonia and thus
minimize the attacks of acute otitis media caused by pneumococci (174).