Xylitol has been used in the medcine since early 1960s (Mäkinen, 1978). Dental benefits of Xylitol were closely studied in 1970s in Turku, Finland. The Finnish Xylitol studies, better known as Turku Sugar Studies demonstrated how the consumption of Xylitol chewing gums had an effect on caries inhibition (Scheinin et al., 1975). The studies suggested that Xylitol is not readily metabolized by oral bacteria and has therefore non- and anticariogenic properties (Scheinin et al., 1975).
Since the Turku Sugar Studies Xylitol has been widely researched, field studies have confirmed the first findings (Mäkinen et al., 1995; Alanen et al., 2000) and Xylitol is officially accepted as self-applied caries preventive agent. The European Food Safety Authority approved 2008 the health claim “xylitol chewing gum reduces the risk of caries in children” (EFSA, 2008) and the American Academy of Pediatric Dentistry supports the use of Xylitol as noncariogenic sweetener (AAPD, 2022). The US Food and Drug Administration has recognized the good qualities of Xylitol and supports the health claim "Xylitol may reduce the risk of dental caries/tooth decay" (FDA, 2023).
In the last decade researchers have found even more health benefits of Xylitol beyond oral health (Salli et al., 2019; Gasmi Benahmed at al., 2020).

AAPD, 2022
American Academy of Pediatric Dentistry. (2022). Policy on use of xylitol in pediatric dentistry. The Reference Manual of Pediatric Dentistry,76-77.

Alanen et al., 2000
Alanen, P., Isokangas, P., & Gutmann, K. (2000). Xylitol candies in caries prevention: results of a field study in Estonian children. Community dentistry and oral epidemiology, 28(3), 218–224. https://doi.org/10.1034/j.1600-0528.2000.280308.x

EFSA, 2008
European Food Safety Authority. (2008). Xylitol chewing gum/pastilles and reduction of the risk of tooth decay. The EFSA Journal, 852, 1- 16, https://doi.org/10.2903/j.efsa.2008.852

FDA, 2023
U.S. Food and Drug Administration. 21CFR101.80 Food Labeling: Health claims: dietary noncariogenic carbohydrate sweeteners and dental caries. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=101.80&SearchTerm=sugar%20alcohols. Accessed: March 12, 2024.

Gasmi Benahmed et al., 2020
Gasmi Benahmed, A., Gasmi, A., Arshad, M., Shanaida, M., Lysiuk, R., Peana, M., Pshyk-Titko, I., Adamiv, S., Shanaida, Y., & Bjørklund, G. (2020). Health benefits of xylitol. Applied microbiology and biotechnology, 104(17), 7225–7237. https://doi.org/10.1007/s00253-020-10708-7

Mäkinen, 1978
Mäkinen Kaupo K. (1978). Biochemical principles of the use of xylitol in medicine and nutrition with special consideration of dental aspects, Experientia Supplementum, Volume 30. Basel: Birkhäuser Verlag,1-160. https://doi.org/10.1007/978-3-0348-5757-4

Mäkinen et al., 1995
Mäkinen, K. K., Bennett, C. A., Hujoel, P. P., Isokangas, P. J., Isotupa, K. P., Pape, H. R., Jr, & Mäkinen, P. L. (1995). Xylitol chewing gums and caries rates: a 40-month cohort study. Journal of dental research, 74(12), 1904–1913. https://doi.org/10.1177/00220345950740121501

Mäkinen, 2011
Mäkinen, Kauko K. (2011). Sugar alcohol sweeteners as alternatives to sugar with special consideration of xylitol. Med Princ Pract, 20(4), 303–320. https://doi.org/10.1159/000324534

Nayak et al., 2014
Nayak, P. A., Nayak, U. A., & Khandelwal, V. (2014). The effect of xylitol on dental caries and oral flora Clinical, cosmetic and investigational dentistry, 6, 89–94. https://doi.org/10.2147/CCIDE.S55761

Runnel et al., 2013
Runnel, R., Mäkinen, K. K., Honkala, S., Olak, J., Mäkinen, P. L., Nõmmela, R., Vahlberg, T., Honkala, E., & Saag, M. (2013). Effect of three-year consumption of erythritol, xylitol and sorbitol candies on various plaque and salivary caries-related variables. Journal of dentistry, 41(12), 1236–1244. https://doi.org/10.1016/j.jdent.2013.09.007

Salli et al., 2019
Salli, K., Lehtinen, M. J., Tiihonen, K., & Ouwehand, A. C. (2019). Xylitol's Health Benefits beyond Dental Health: A Comprehensive Review. Nutrients, 11(8), 1813. https://doi.org/10.3390/nu11081813

Scheinin et al., 1975
Scheinin, A., Mäkinen, K. K., Tammisalo, E., & Rekola, M. (1975). Turku sugar studies XVIII: Incidence of dental caries in relation to 1-year consumption of xylitol chewing gum, Acta Odontologica Scandinavica, 33(5), 269-278, https://doi.org/10.3109/00016357509004632

Scheinin et al., 1976
Scheinin, A., Mäkinen, K. K., & Ylitalo, K. (1976). Turku sugar studies V: Final report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man, Acta Odontologica Scandinavica, 34(4), 179-216, https://doi.org/10.3109/00016357608997711