Use of a Postoperative Xylitol Rinse to Prevent Alveolar Osteitis

Thursday, October 10, 2013: 7:10 AM
Ammar Sarraf DDS, Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, VA
Brian C Thompson DMD, Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, VA
Omar Abubaker DMD, PhD, Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, VA
Daniel M. Laskin DDS,MS, Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, VA
Background and objectives: Alveolar osteitis (AO) is the most common postoperative complication following extraction of mandibular third molars. Studies have shown that the symptoms of AO are caused by an acute inflammation of the socket as a result of fibrinolysis of the clot. Studies have also shown that bacteria can play a role in this process. Because xylitol has been reported to have antibacterial properties, this study sought to determine if there is a decrease in the incidence of alveolar osteitis when a xylitol rinse is used postoperatively following impacted third molar removal to reduce the bacterial load.

Patients and Methods: Patients who met the inclusion and exclusion criteria were enrolled in a double blind study involving two groups. Group 1 was the control group and they rinsed with a placebo 4% sorbitol mouthwash 3 times daily for 5 days. Group 2 rinsed with 4% xylitol in a similar manner. 

Results:  Forty-nine patients completed the study (23 in Group 1, 26 in Group 2). The incidence of AO among both groups was 9% (9/98 impacted teeth).  The incidence in the patients who rinsed with placebo was 13% (6/46) vs 5.7% (3/52) for patients that rinsed with xylitol.

Conclusions: Based on these findings, it appears that postoperative xylitol rinses result in a lower incidence of alveolar osteitis. This is similar to what has been previously reported with postoperative chlorhexidine rinses. Because xylitol has fewer undesirable side-effects such as staining and bad taste, further clinical trials are warranted.

 

  1. A novel use of xylitol sugar in preventing acute otitis media.  Uhari M, Kontiokari T, Niemela M. Pediatrics 1998; 102:879-884.
  2. Effect of xylitol/chlorhexidine versus xylitol or chlorhexidine as single rinses on initial biofilm formation of cariogenic streptococci. Decker E-M, Maier G, Axmann D et al.  Quintessence Int 2008; 39: 17-22.
  3. Effect of xylitol and sorbitol on plaque acidogenesis. Splieth CH, Alkilzy M, Schmitt J, et al. Quintessence Int 2009;40: 279-285.
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