The End of Decay- A Lesson in Oral Ecology

SCMC 12-1-2013by Chris Edwards, DDS

December/January 2012

What if there was something to eat that was good for you, something as sweet as sugar that stopped and even reversed tooth decay? Well, there is! And it’s called Xylitol, a natural sweetener that comes from plants and trees. To fully appreciate Xylitol, you need to understand a little bit about what goes on in your mouth.

It’s all about the oral ecology, specifically the “bad boy bacteria,” Streptococcus Mutans. Everyone’s mouth has a mixture of bacteria, which is called the oral flora. Feed them sugar and the Strep Mutans have a party, they can’t get enough of that good stuff! They feast and reproduce like crazy, ultimately dominating the flora, and create a sticky byproduct that adheres to the teeth. Mix in bacteria and you have dental plaque. Another byproduct of this feeding frenzy is acid. Once the acid lowers the pH below 5.6, conditions are right for the demineralization of the enamel of the tooth. As demineralization progresses, it creates a latticework that enables the bacteria to get through to the dentin, which is the inner part of the tooth. There the party continues. The bacteria feast on the dentin, the more organic, softer part of the tooth. This is the disease process we call dental caries. As the process continues, the latticework collapses, enamel falls apart (cavitates) and then we have a cavity, which needs drilling and filling. If left untreated, the bacteria march on until they reach the dental pulp, infection ensues, and the tooth dies. This causes pain, and you will need either a root canal or an extraction. Ouch!

Relatively good brushing and flossing, even adding mouthwash, were still no match to the bacteria, and decay could still be found. Enter Xylitol, “the good guys”! We now feed the bad bacteria something they love, but they can’t metabolize it. Xylitol stops the acid secretion and decreases the sticky substance that we call plaque. The numbers of Strep Mutans dwindle, good bacteria fill in, the pH starts rising and the same minerals that were dissolved out of the enamel are now able to return and rebuild the tooth, thereby warding off any future bacterial invaders. The bad bacteria inside the tooth die. The enamel of the tooth can now heal itself and early stages of caries can actually be reversed!

Xylitol is the natural sweetener that makes this happen. If enough of it is fed to the bacteria for an extended period of time, the Strep Mutans bacterial population is drastically reduced. When you use a maintenance dose, the population remains low and a more beneficial flora establishes itself. The use of Xylitol is a significant part of a program to reduce and even reverse dental disease. The cornerstone of oral health is brushing and flossing to remove the plaque from the teeth. Combine home care with regular professional cleaning by a dental hygienist; add toothpaste with fluoride and bioavailable minerals and the bad bacteria don’t have a chance. The party is over!

How much Xylitol to use and for how long is still being researched, but it is believed that between 4-12 grams a day in spread out doses is the amount needed. A recent study in Washington has recommended a minimum of 6 grams a day. In as short a period as a few weeks, the flora can change. To accomplish this, the Xylitol has to be in high enough levels, which is why products designed for this use are usually not mixed or diluted with other sweeteners, as are Trident and Orbit gums. Gums and mints are the easiest way to get the doses during the day, and Xylitol toothpaste or gel and mouthwash are a logical addition. A program that fits your budget and lifestyle can be designed with the help of Dr. Xylitol and his team.

Just imagine a world without cavities, dental pain, root canals, and extractions! It’s now possible and can be true for you. As an added benefit, Xylitol is used to prevent and help treat ear and nasal infections without antibiotics. Streptococcal cousins to Strep Mutans in the mouth are the cause of these infections. When you use Xylitol, these bacteria lose their ability to adhere, their population drops and healing sets in. Xylitol nasal spray can place the helpful solution right where it’s needed most. This can be a godsend to all the young children who suffer from middle ear infections.


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

Leave A Reply