Does erythritol powder have an antimicrobial effect on oral biofilm?

Yes, erythritol powder demonstrates antimicrobial properties relevant to oral biofilm management. It is described as a non-metabolized, non-cariogenic sugar alcohol that is safe and well-tolerated in the oral cavity, with documented antimicrobial properties, though it is limited in removing large or firm calculus deposits ^[1]. With a particle size of 14 μm, it is less abrasive than glycine, and can remove biofilm while exhibiting antibacterial effects during periodontal treatment ^[2].

Evidence from a clinical microbiome study supports a direct impact on subgingival pathogens: in patients with stage III-IV periodontitis, the addition of subgingival erythritol-chlorhexidine air-polishing led to a statistically significant decrease in several periodontal pathogens - including Filifactor alocis, Porphyromonas endodontalis, Selenomonas sputigena, Tannerella forsythia, Treponema denticola, and Treponema socranskii - along with an increase in health-associated species such as Abiotropha defectiva, Capnocytophaga sputigena, and Lautropia mirabilis ^[3]. This shift was more pronounced than in the control group receiving conventional treatment alone, suggesting that subgingival erythritol air-polishing helps re-establish a more eubiotic microbiome in deep bleeding periodontal pockets ^[3]. Both erythritol and glycine air-polishing powders have been reported to have no adverse events ^[2].