Xylitol is a naturally derived sugar alcohol, found in many fruits, vegetables, hardwoods, and even in the human body. Because it has a structure similar to sugar (crystalline and granular), the same level of sweetness as sugar, and no unpleasant aftertaste, it is commonly used as a sugar substitute. The World Health Organization has given xylitol its safest rating for food additives. It has 40% fewer calories and 75% fewer carbohydrates than sucrose (table sugar) and is very low on the glycemic index, as it is absorbed and metabolized very slowly, reducing measurable changes in insulin and blood sugar levels.
Xylitol has many health benefits through a few different effects. Studies have shown that xylitol can benefit the mouth by preventing cavities and reducing the risk of periodontal disease. Clinical trials even have proven xylitol to be effective in treating and preventing ear, nose, and throat infections and aiding in keeping nasal passages and sinuses clear of bacteria, allergens, and other contaminants.
In normal bacterial metabolic processes, bacteria feeds on carbohydrates (sugars) in the mouth, then produces acid as a byproduct. This acid can damage and dissolve our enamel, producing cavities. Xylitol is unique in that it has a five-carbon structure, unlike most sugars with six-carbon structures. Because of this, specific “bad bacteria” groups, like Streptococcus mutans, a primary cavity causing bacteria, cannot digest or ferment this sugar. Therefore, less acid is being produced in the mouth, and as the pH balance of the mouth rises, enamel strengthens, and cavities are prevented. Due to inability to digest xylitol, bacterial growth and reproduction is reduced-some studies show a 90% drop in acid producing bacteria after xylitol use!
Xylitol also blocks the communication amongst bacteria, which reduces their production of polysaccharide films that help create bacterial colonies and plaque. Because of this, bacterial adherence is diminished and overall biofilm (plaque) buildup and total bacterial levels decrease. Bacteria outside of a biofilm colony are more susceptible to natural immune system defenses and antimicrobial agents.
Xylitol has the ability to slow dental demineralization, and enhance remineralization, or rebuilding of enamel, thereby not only assisting preventing new cavities, but also in reversing early decay areas. It also increases salivary flow, which aids in cavity prevention by rinsing away bacteria, stabilizing oral pH, and by introducing calcium, phosphate, and fluoride ions that rebuild and strengthen our teeth. Xylitol compliments these remineralization minerals by neutralizing an acidic oral environment, therby increasing the uptake of these necessary building blocks. Therefore, xylitol can help not only in prevention, but treatment and arresting existing enamel damage. In many trials, low decay rates persist even years after they were completed. The benefits are benefit is long-lasting, and possibly even permanent.
How is xylitol best utilized? Studies have shown that frequency of exposure to xylitol, versus total quantity, is the most important factor for effective use. For cavity prevention, experts recommend using xylitol five times per day, with as little as 6-10 grams of total xylitol total daily, ideally following meals or snacks. Xylitol is widely available from your dental professional, in grocery stores, health food stores, and online in a variety of forms such as candy, toothpaste, mouthwash, floss, gums, mints, sprays, gels and as a bulk sweetener. Ask Dr. Bloomquist, or your hygienist about your unique xylitol recommendations at your next checkup. We look forward to seeing you!
–Alexa, your friendly neighborhood hygienist!