One double-blind randomized controlled prospective clinical trial[1] tested the efficacy of the daily intake of erythritol candy compared with xylitol and sorbitol candy, on the development of enamel and dentin caries.

Over three years, nearly 500 school children consumed four erythritol, xylitol or sorbitol candies (about 7.5 g) three times per school day. Their teeth were examined after one year, two years and three years.

Results: after two and three years, the number of cavities in both dentin and enamel was significantly lower in the erythritol group than in the xylitol or sorbitol group. Also, the erythritol group took longest to develop any cavities at all.

During the above three-year trial, the same group of researchers took salivary and dental plaque samples  from the test subjects to determine the presence of Streptococcus mutans, acetic acid, propionic acid, Lactobacillus, protein and other variables.[2]

Results: the erythritol group showed a significant reduction in dental plaque weight during the intervention years while no such change occurred in the groups taking xylitol or sorbitol candies. Compared with the latter, consuming erythritol was associated with significantly lower Streptococcus mutans counts in both saliva and plaque.

Additionally, after three years, the plaque of the erythritol group contained significantly lower levels of acetic acid and propionic acid than that of the xylitol or sorbitol group.

There was no change in salivary Lactobacillus levels.

Finally, we have a comprehensive literature review of papers dealing with the efficacy and impact of erythritol on oral health (dental plaque [biofilm] and caries) as compared with xylitol and sorbitol.[3]

The review found important differences in the ability of erythritol, xylitol and sorbitol to maintain and improve oral health and furnished evidence for erythritol being more effective.

Erythritol reduced the adherence of oral bacteria to tooth surfaces, inhibited the growth of bacteria such as S. mutans, reduced the number of cavities, lowered plaque weight, and hindered the expression of bacterial genes involved in sucrose metabolism.


Among all tooth-friendly sugar replacements, erythritol  is not only  devoid of the disadvantages of other "sugar-alcohols" while boasting all their common advantages (such as sugar-like consistency and practically identical taste), it is also the best in terms of protecting tooth and gum health.

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1 Effect of erythritol and xylitol on dental caries prevention in children

2 Effect of three-year consumption of erythritol, xylitol and sorbitol candies on various plaque and salivary caries-related variables.

3 Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints

Dental self-healing