Xylitol—a sugar that’s good for you? 7/16/14
“Do I have any cavities?” is a question that I hear from almost every patient who sits in my chair. Parents are always relieved when, at the end of their child’s appointment, I tell them that their kids are cavity free. Sometimes, despite good oral hygiene, dietary choices can lead to an increase in decay. In addition to good home care, fluoride rinses or prescription fluoride toothpastes, there are times when we as dental professionals will recommend something called xylitol. It has gained support in the US in the last ten years; Europe has been widely been recommending xylitol products since the 1970’s.
So what exactly is xylitol and why do we recommend it? Xylitol is a naturally occurring sugar alcohol that our bodies actually can process from some foods we eat. It is found in berries, mushrooms, oats, and corncobs. It has gained popularity for those with diabetes because at a glycemic index of 7, it is much lower than sugar and does not affect insulin levels.
It is mandated as safe by the FDA, and it has no known toxicity or cariogenicity. It has 40% fewer calories than sugar, and 75% fewer carbs. Dentally, it has several benefits. Streptococcus mutans is the main bacteria that causes cavities. Strep mutans cannot metabolize xylitol to use it as a food source. It can inhibit the bacteria, but it also interacts with calcium and is transported in saliva where it helps to remineralize enamel that has been demineralized (an early cavity lesion). The best thing about xylitol is that within minutes, it can neutralize acids and give the mouth a neutral pH. This can be beneficial for people who are genetically prone to decay, or people who have lots of acid in their diets from soda, juice, wine, energy drinks, or foods that are naturally acidic.
In order to be effective, xylitol needs to be consumed in at least 5 grams per day, with some researchers recommending 8-10 grams per day. Chewing gum, mints, and lozenges are good ways to get xylitol. My personal favorite is Ice Cubes gum, which can be readily found in Target, WalMart, and grocery stores. Whole Foods carries an array of gums and mints, and other products can be found online. Some pharmacies such as CVS and Walgreens carry Xylimelts, which are lozenges that are put onto the cheek to deliver xylitol overnight. It is especially helpful for people who have dry mouth from medications or autoimmune issues. The best website for information is xylitol.org. A few warnings about xylitol use: as with other sugar alcohols, it can have a laxative effect if taken in too large of quantities. Also, as their bodies cannot metabolize xylitol, it is absolutely toxic to dogs and ferrets. Please feel free to ask your hygienist or Dr. DeLacey about xylitol products at your next appointment.