Janket SJ, et al. - In this narrative review, researchers tested the effectiveness of xylitol in caries prevention and analyzed the sources of discrepancy by searching the following databases for English-language terms “xylitol” or “artificial sweeteners”: PubMed, Web of Science, Evidenced-Based Medicine, Scopus, and the Cochrane database. Investigators found that replacing a carbonyl group with alcohol radical in xylitol impedes its absorption and releases sugar into the bloodstream slowly. This quality of xylitol helps patients with diabetes to maintain a constant level of glucose. Although in in vitro and animal studies this quality of xylitol has been proven, it has yet to be proven in humans. Paradoxically, recent animal studies with artificial sweetener consumption reported hyperglycemia and intestinal dysbiosis. It was revealed after careful inspection of evidence that these reports could be due to misinterpretation of the original references or flaws in the methodology of the study. Any systemic benefits of xylitol intake should be weighed with the well-established adverse gastrointestinal effects. Further research is warranted by the contribution of xylitol to gut dysbiosis that may affect systemic immunity.