Xylitol and Your Teeth

Like most sugar substitutes, xylitol is a non-cariogenic sweetener because it does not promote tooth decay. However, xylitol goes one step beyond other sweeteners in that it is actually anti-cariogenic, meaning it is highly effective in suppressing caries production.

Clinical studies show that supplementing a normal diet with regular consumption of xylitol (xylitol chewing gum 2 times a day) is beneficial for teeth. Research clearly established that the use of xylitol sweetened foods provides additional help in the battle against tooth decay by significantly decreasing plaque accumulation.

How does Xylitol Fights Tooth Decay?

When carbohydrate or sugars are consumed acid is produced in the mouth and the pH drops rapidly below pH 5.7, causing demineralization of tooth enamel and potential cavities. Since xylitol is a five-carbon polyol, oral bacteria do not metabolize it and therefore no acid is produced. This means that xylitol reduces the quantity of plaque, creating additional caries(decay) protection between periods of brushing and flossing. It also inhibits the growth of streptococcus mutans, the main bacteria associated with dental caries (decay). Xylitol actually decreases the amount of insoluble plaque polysaccharides that actually make plaque less adhesive to the tooth surface. When xylitol products are used the pH balance in the oral cavity is quickly returned to a safety level above pH 5.7, minimizing the erosion of enamel and enhancing the remineralization process. Remineralization is the process of reversing superficial cavities confined to the enamel surface.

When xylitol is consumed habitually for several months, the streptococci mutans bacteria are shed from plaque to the saliva. Although high numbers may still be found in saliva, they are less virulent and do not adhere as tightly to the teeth, and this means acid attack is not occurring at the tooth surface.

Studies have shown that Xylitol gum and Xylitol candy prevent the development of new carious lesions (cavities) in both children and adolescents. Research suggests that the value of xylitol may be highest during periods of high dental activity such as the eruption of new teeth especially when the first and second molars erupt. One landmark study showed that chewing a Xylitol gum 3-5 times a day actually stops the transmission of Streptococcus Mutans from mother to child. It’s use is recommended for mothers with children from birth to age 2 which is the age when the bacteria that cause cavities colonize the mouth. Using Xylitol during this stage can actually prevent colonization of those cavity-causing bacteria in an infant and prevent future dental cavities for the child.

Research suggests that xylitol and fluoride act synergistically to increase the efficacy of oral hygiene products. Fluoride reduces demineralization of the tooth surface and helps to promote remineralization process of enamel. Regular use of a fluoride toothpaste and fluoridated water is recommended as the first step in caries (decay) prevention. Xylitol should be added in high risk individuals who are more susceptible to caries. When fluoride and Xylitol are combined in products such as toothpaste, the two together are complementary. Those at high risk would be those who have exposed root surfaces, suffer from xerostomia (dry mouth), oral cancer survivors, diabetics and anyone suffering from a compromised immune system because they are at higher risk of caries. By sucking on Xylitol candy or Xylitol gum, rather than other sugar-filled products, their risk of decay will decrease.