Xylitol chewing gum could cut ear infection risk in children– study

By Oliver Nieburg

- Last updated on GMT

EFSA said more evidence was needed to establish a link. Photo credit: eekoliteW
EFSA said more evidence was needed to establish a link. Photo credit: eekoliteW
Researchers at the University of Toronto have published a study review that claims chewing xylitol- based chewing gum five times a day can reduce acute middle ear infections (AOM) in young children.

The report ‘Xylitol for preventing acute otitis media in children up to 12 years of age’ ​reviewed earlier trials that had examined the benefits of xylitol.

It said: “There is fair evidence to show that a daily dose 8.4 g of xylitol (two pieces of chewing gum, five times a day after meals for at least five minutes) can prevent AOM in children without acute upper respiratory infections.”

However, a scientific opinion published by the European Food Safety Authority (EFSA) in July (see here​) rejected the use of ear health claims on xylitol sweetened gums as evidence was still lacking.

According to the current review by The University of Toronto, AOM is the most common bacterial infection among young children in the US. By the age of three over two thirds of children will have experience at least one episode of AOM, it said.

The researchers said the frequency of AOMs in young children was draining the US healthcare system with an annual bill of around $3.8bn (€2.8bn).


They reviewed four clinical trials which had taken place between 1998 and 2007 where xylitol chewing gum, lozenges or syrup had been administered to over 3,000 Finnish day-care children.

Three of the four studies reviewed found that xylitol could cut the risk of ear infections in children.

In July, EFSA had picked up on two studies that found no link, meaning the review may have omitted a study that had a negative finding.

The review identified no adverse effects from xylitol and concluded that it could reduce the risk of AOM in healthy children by 25%.

It said that xylitol chewing gum was as effective as lozenges in preventing AOM in children and superior to syrup form.


Further studies may be needed to assess the significance of the review.

“This meta-analysis is limited since the data arise from a small number of studies, mainly from the same research group,”​ said the report.

EFSA’s Panel on Dietetic Products, Nutrition and Allergies also said in July that it was too early to establish a link between xylitol chewing gum and increased defences against ear infections.

“The evidence provided is insufficient to establish a cause and effect relationship between the use of sugar-free chewing gum sweetened with xylitol and defence against pathogens in the middle ear,”​ it said.

Related topics: Gum, Regulation & Safety, Ingredients

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