Dentist recommends xylitol to reduce cavities

PLYMOUTH, Mich. – Diane Rosetti of Ann Arbor has always taken brushing and flossing seriously.

"My mother lost all her teeth in her early 20s, so she was a real stickler for dental care.  But even with that, I still had a propensity toward cavities, so I'm always having some issues," said Rosetti.

When her dentist, Dr. Doug Callow, suggested she try using products containing xylitol to reduce her risk of cavities, she was pleasantly surprised.

"It tastes good, so it is not like a medicine type of product. It's a good thing," said Rosetti.

Xylitol is a naturally occurring sugar. Our body produces it in very small amounts, and it's also found in various trees, fruits, and vegetables.

Callow started recommending xylitol products to patients at his Plymouth dental office earlier this year, after researching the benefits. 

"The results are just incredible. Unbelievable really," said Callow.

Xylitol is already a common ingredient in sugarless gums, but some dentists say many patients could benefit from using it more regularly, when brushing and flossing don't seem to be enough.

"There is a group of patients that will just have cavity after cavity after cavity," said Callow.  "It is indeed a disease and it needs to be treated like a disease."

Here's a little science lesson.

Cavities are formed when bacteria that live in our mouth eat the sugar that we eat and turn that sugar into acid.  The acid weakens the enamel of our teeth, creating soft spots or tiny holes. 

Studies suggest xylitol helps disrupt that process. To cavity-causing bacteria, xylitol looks like any other sugar.

"The bacteria that eat the sugar that produce the acid that causes the cavities.  They'll also eat the xylitol," said Callow.

But the bacteria can't digest xylitol.

"The bacteria will eat the xylitol, and they'll get a belly full of xylitol, but they can't produce the acid to cause the cavities," explained Callow. "If you feed them the xylitol often enough on a regular bases, that particular species of bacteria will die out and be extinct and will no longer be in your mouth."

Some research suggests xylitol might also make it harder for bacteria to stick to your teeth, essentially giving you a "slippery smile."

So how effective is it? 

Results vary depending on the group being looked at, the dosage of xylitol and the delivery method.  A Finnish study of children aged 10 and 11 found those who chewed xylitol gum daily had nearly 50 percent less tooth decay.   A study in children in Belize found students who chewed the gum several times a day had 73 percent fewer cavities after 40 months.

Xylitol may also reduce the spread of cavity-causing bacteria from mothers to their babies. 

Researchers followed new moms who were instructed to chew xylitol gum two to three times a day.  By age five, more of their children were cavity-free than kids whose moms did not use xylitol.

In 2011, the American Academy Of Pediatric Dentistry came out in support of recommending xylitol for patients at moderate to high risk for cavities. There is also some evidence that xylitol may be helpful in preventing ear infections, but more research is needed.

Callow says xylitol may also be especially helpful for people who don't have dental insurance and for older patients suffering from dry mouths.

"Elderly patients often time have dry mouth, and they'll use sugar-containing mints and gums to stimulate the salivary flow and to help with dry mouth and that leads to cavities," said Callow.  "We recommend now strongly for elderly patients who have a lot of cavities that they switch to use xylitol mints and xylitol gum."

If you don't care for mints or gum, xylitol also comes in toothpastes, rinses, suckers and candies.  You can even add it to your coffee.

There is a lot of debate about the best dose, but Callow recommends about 6 grams a day for adults.  Other experts suggest about 5 grams a day for children.

The tricky part is the xylitol needs to be spread out throughout the day to be effective. You can't consume it all at once.

And a word of warning -- more is not better. Too much xylitol -- in the range of 45 to 60 grams -- can cause gastrointestinal side effects, including diarrhea. 

It's also very important to keep all products away from your pets, because xylitol is poisonous for dogs and cats.

Rosetti has been using xylitol for a few months.  She says it's been easy to get her six grams a day.

"When you start out brushing your teeth, there is the one gram, try to chew some gum after meals, there is another gram," said Rosetti.  "I do believe it is going to help.  Nobody wants cavities. Nobody likes toothaches, so this is a wonderful thing."

Xylitol products are available at drug stores, Walmart, the Better Health Store, and various websites. 

  • To learn more about xylitol, click here.  
  • For read more about using xylitol to reduce cavities, click here. 
  • To download the guidelines on xylitol use issued by the American Academy of Pediatric Dentistry (AAPD), click here.