Xylitol and Dental Health

SCM-COVER-040512-photo-only.inddby Chris Edwards, DDS

April/May 2012

Inhibits Bacteria That Causes Tooth Decay

XYLITOL is just one part of a multipronged strategy to have a healthy mouth. Excellent oral hygiene of daily brushing and flossing is important as well as regular visits to the dentist and dental hygienist

It is a well-documented fact that Xylitol reduces decay in the mouth. Th e method of action is clear. The main cause of decay is the Mutans Streptococcus (MS) bacteria. It is the primary bacteria involved in decay (dental caries) and the formation of plaque, the sticky substance that forms on the surface of the tooth. Th is enables the bacteria to replicate. As the MS bacteria ingest the foods we eat, particularly refi ned sugars and carbohydrates, they secrete acid. As the pH of the mouth decreases (becomes more acidic) the enamel of the tooth decalcifies. Eventually the bacteria can get through the enamel and start infecting the softer inner portion of the tooth. The enamel cavitates (crumbles) and becomes a “Cavity.”

The Sweet Truth

Xylitol, also used widely as a sugar alternative, is unique in its 5-carbon structure. Th e bacteria ravenously consume the Xylitol, but cannot replicate it, which renders them unable to secrete the sticky substance of plaque or the harmful acid. As the MS population decreases, more beneficial bacteria take over, which changes the ecology of the mouth.

The pH increases (becomes more alkaline), which facilitates the process of mineralization and strengthens the enamel, creating greater resistance to the oral bacteria.

The Natural Choice

Xylitol products include the bioavailable minerals of calcium and phosphate to aid in this process. Thanks to Xylitol, we now have a way to reverse early decay and prevent future decay. Xylitol is a natural substance and comes from the plant cell wall. It is found in many fruits and is a natural part of our normal glucose metabolism.

Younger Patients

In a recent New York Times article, March 6, 2012 entitled, Preschoolers in Surgery for a Mouthful of Cavities by Catherine Saint Lois, it was noted that there is an increase in caries in young patients.

The Center for Disease Control and Prevention also noted an increase, the first in 40 years, in the number of preschoolers with cavities in the first five years of life. Preventing the transmission of the MS bacteria and both mother and child using Xylitol products is an easy an inexpensive and natural way to reverse this alarming trend.

Early Exposure

New research exposes the fact that it is primarily the mother who transmits the MS bacteria to a child in the first 2 years of life. Th is happens by transmission of saliva from sharing food and kissing. If early colonization by cariogenic bacteria is prevented, the children will have a healthier oral ecology of better bacteria and reduced caries incidence. Regular use of Xylitol by mothers in the first 2 years of a child’s life, does block early colonization of cariogenic bacteria in their children. Of course regular preventive care of the mothers mouth is also important. This leads to a reduced risk of caries in these children that can have lasting effects in the long-term resistance to decay.

A Safe Alternative

Xylitol is well tolerated and accepted for at home use and in preschool groups. It can be used as soon as the teeth erupt into the mouth. Many kinds of Xylitol have no fluoride, which can be a problem with young children when swallowed and ingested.

Another benefit of Xylitol is the reduction of ear infections and even upper respiratory infections. The theory is that the oral use of Xylitol is also reducing the Strep Pneumococcus bacteria that are responsible. This results in less need for antibiotics.

Selecting Products

All Xylitol is not created equal. Not all products that contain Xylitol produce the same results. In order for the product you use to be effective in preventing cavities, it must contain a high concentration of Xylitol. Many manufacturers dilute the benefits of Xylitol by using smaller, ineffective amounts.

Recommended Dosage

Six grams a day is the recommended dosage. Xylitol toothpastes, gum, mints, candies and mouthwashes are commercially available. Look for chewing gum and mints that are 100 percent Xylitol sweetened. Most mints and gum in this category contain about 1 gram of Xylitol per piece. A healthy habit of at least five “pulses” each day can be established by using Xylitol toothpaste and mouthwash morning and night, mints between meals and chewing gum after meals and snacks.

In addition, some Xylitol products contain ingredients, fillers or other sweeteners that are not natural. These are not recommended for those seeking the benefits of an all-natural product like Xylitol.

Complete Oral Care

Of course Xylitol is just one part of a multipronged strategy to have a healthy mouth. Excellent oral hygiene of daily brushing and flossing is important as well as regular visits to the dentist and dental hygienist. Diet is very important not only minimizing the intake of sweets but also minimizing the frequency of ingestion. For example: Don’t sip on a can of soda over a period of a few hours. If you have to have it, it is better to just drink it over a short period of time.

Prevention Techniques

Dental disease is largely a preventable condition that may adversely affect overall systemic health. Improving and maintaining dental health is important to overall health and wellbeing, and Xylitol is an important addition.


Dr. Edwards graduated from the United States Merchant Marine Academy and Temple University School of Dentistry. He completed a general practice residency at the Queens Medical Center in Honolulu. To reach Dr. Edwards you may call 321-751-7775 or visit