by Glickman-Simon R

Tooth decay is caused by acid from bacteria that live in your mouth. Sugars increase the amount acid. This acid wears away the protective coating on your teeth called enamel. Over time, this leads to a cavity. There are many ways to prevent cavities:

  • Fluoride in drinking water
  • Fluoride in toothpaste and mouth washes
  • Brushing teeth 2 times a day
  • Flossing teeth once a day
  • Reducing sugar and carbohydrates in your diet
  • Regular dental visits

Natural Therapies

Both adults and children were involved in the studies listed below.

Likely Effective

  • Xylitol —a natural sweetener thought to slow the growth of cavity-causing bacteria. Often used in “sugarless” gums and candies. A1-A3

Possibly Effective

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions. Xylitol is generally safe, but in doses above 30 grams a day it may cause stomach upset, gas, and diarrhea.


REFA Xylitol

REFA1 Twetman S. Consistent evidence to support the use of xylitol- and sorbitol-containing chewing gum to prevent dental caries. Evid Based Dent. 2009;10(1):10-11.

REFA2 Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV. Xylitol-containing products for preventing dental caries in children and adults. Cochrane Database Syst Rev. 2015;(3):CD010743.

REFA3 Watthanasaen S, Merchant AT, Luengpailin S, Chansamak N, Pisek A, Pitiphat W. Xylitol-containing chewing gum for caries prevention in students with disabilities: a randomised trial. Oral Health Prev Dent. 2017;15(6):519-527.

REFB Probiotics

REFB1 Rodríguez G, Ruiz B, Faleiros S, et al. Probiotic compared with standard milk for high-caries children: a cluster randomized trial. J Dent Res. 2016;95(4):402-407.

REFB2 Gruner D, Paris S, Schwendicke F. Probiotics for managing caries and periodontitis: Systematic review and meta-analysis. J Dent. 2016;48:16-25.

REFB3 Pahumunto N, Piwat S, Chankanka O, Akkarachaneeyakorn N, Rangsitsathian K, Teanpaisan R. Reducing mutans streptococci and caries development by Lactobacillus paracasei SD1 in preschool children: a randomized placebo-controlled trial. Acta Odontol Scand. 2018:1-7.

REFC Vitamin D

REFC1 Hujoel PP. Vitamin D and dental caries in controlled clinical trials: systematic review and meta-analysis. Nutr Rev. 2013;71(2):88-97.

REFC2 Tanaka K, Hitsumoto S, Miyake Y, et al. Higher vitamin D intake during pregnancy is associated with reduced risk of dental caries in young Japanese children. Ann Epidemiol. 2015;25(8):620-625.

Revision Information

  • Reviewer: EBSCO NAT Review Board Richard Glickman-Simon, MD
  • Review Date: 03/2019
  • Update Date: 03/02/2019