Xylitol is a natural sweetener that is found in many fruits. Bacteria inhabiting our oral cavity are unable to break it down, unlike crystalline white sugar. Therefore, after ingestion of xylitol no acid attacks occur, that could weaken the tooth surface. Moreover, the bacteria that cause caries fall into energy shortage and will not multiply.
Xylitol has been used for decades and it is especially popular in Finland, where consumption of xylitol products after meals, both in schools and, in recent years, also in kindergartens, is organized at the national level as part of a caries prevention program.
Most clinical trials have specifically been carried out on children, the most susceptible age group to caries. Freshly erupted teeth need to “ripen”. It takes approximately a year to strengthen the tooth enamel. During this time it is much easier for the caries-producing bacteria to get through the tooth enamel. The age group to benefit most from xylitol are children.
The most effective way to use xylitol is after a meal. Xylitol rids the plaque of sugars that enable caries formation. The surface of the tooth, which would otherwise lose the strength provided by calcium and phosphorus moieties, retains its hardness. Studies have shown that xylitol-containing tooth plaque helps to bring in minerals beneficial to tooth enamel from the saliva.
In the food industry, xylitol is primarily added to snacks, as they that are most often consumed between the meals. Too many snacks in between meals is the main reason for caries formation. Under normal circumstances, the tooth surface is mineralized from saliva in between the meals and thus the strength of the tooth is restored, but in case of snacking, a new acid attack will occur and the enamel will weakened. Snacks that contain xylitol or other non-caries-producing substances instead of table sugar are safe for the teeth.
The longer teeth are exposed to xylitol, the better. Chewing gums containing xylitol, which increases salivation and thus improves its cleaning effect, and suction pastilles, that are held in mouth over a period of time, are therefore equally beneficial. Pastilles usually have a larger quantity of xylitol than any other product (up to 98%) and therefore they are effective.
It is characteristic of most natural sweeteners belonging to the same chemical class with xylitol to have a mild laxative side effect. The daily recommended dose of xylitol, 7–10 grams per day, taken after 4–5 meals, is tens of times smaller. With regular use the tolerance of xylitol increases.
Xylitol has also been used to sweeten medicines. During illness, the oral cavity tends to dry and teeth are without usual protection from saliva. Xylitol is also recommended for children who often experience ear, nose and throat infections, for the same reason as preventing dental caries. The xylitol-fed bacterium attaches more weakly to tooth surface or mucous membrane and the body can cope with its removal more easily.
All this might leave an impression that xylitol is a means for solving all problems. This is quite not the case – nothing can substitute a healthy diet and good oral hygiene, but xylitol is a great supportive tool to your health regime
Dentist, Lector at Faculty of Oral and Dental Diseases, University of Tartu