Xylitol—Nature’s Own Sweetener Combats Cavity Formation

Kauko K. Mäkinen
Professor Emeritus (University of Michigan and University of Turku, Turku, Finland)
Affiliate Professor, University of Washington

Personal reminiscences

My experience with the outstanding health effects of the dietary sweetener xylitol dates back to 1969, when we began our scientific xylitol studies trials at my then-laboratory at the University of Turku, Finland, at the Institute of Dentistry. Our primary research target was the formation of cavities in the teeth.

Cavity formation (dental caries) persists as a major world-wide infectious disease that most people will experience at some stage during their lifetime. The caries infection is a bacterial disease that is strongly associated with the consumption of sugar. Too frequent and habitual consumption of regular sugar (sucrose) and several other similar carbohydrates, especially in their sticky form, can lead to cavities. Sugar is attacked by specific oral bacteria that are present in dental plaque, producing acids that can demineralize the enamel surface, leading to caries infection. Regular brushing, flossing, and visits to the dentist are prerequisites for proper dental health care, in addition to observing a balanced diet.

The scientific research we carried out in Finland more than thirty years ago showed that dietary carbohydrate sweeteners, or sugar substitutes, are not similar in their ability to cause cavities. Xylitol turned out to be perhaps the most promising sugar substitute in that it is fully “non-cariogenic,” meaning that it does not cause the caries that leads to tooth decay. Xylitol is a natural dietary sweetener that is as sweet as sugar, is found in fruits and vegetables, as well as in the human body itself. Xylitol is currently used all over the world as a dietary additive in countless food items, but especially in chewing gum and other chewable confectioneries. Several companies also make xylitol-containing toothpaste and mouthwash.

Because the metabolism of xylitol does not require insulin, diabetics have found xylitol a welcome addition to their daily diet. Various xylitol-containing food items and pharmacologic products are currently available in the U.S. in well-stocked health food stores. The consumer should, however, pay careful attention to the list of ingredients printed on the package. Some manufacturers mention that their product does contain xylitol, but unfortunately the amount of xylitol present is in many cases too low for effective cavity fighting. Xylitol should be the first ingredient on the list.

How to use xylitol?

Our own research and field experience on xylitol and the scientific studies of our colleagues have shown that people can best benefit from xylitol’s advantages by adhering to the following instructions:

• Use xylitol chewing gum three to five times daily. Experience has shown that best results are obtained by chewing two pieces of gum or one stick at a time (provided that the gum is a “high-xylitol” product).
  (Research has shown that suitable additional protection against cavity formation can be achieved in adults by consuming 5 to 7 grams of xylitol daily.)
• Chew the gum for at least five minutes; research has shown that it may be unnecessary to chew longer, since most of the xylitol present in the gum will dissolve during the first five minutes. Do not use other sugary items simultaneously.
• Use “high-xylitol” gum immediately after every meal and sugary snack.
• Use xylitol from early morning till the evening; you may chew high-xylitol gum also after your regular oral-care regimen at bedtime.
• You may complete the use of xylitol chewing gum by using xylitol-containing tooth paste twice a day.
  
  Xylitol mouthwashes are also available, but you should not rely on them solely; the exposure time of xylitol to the teeth in mouth rinsing may be too short for effective caries prevention.
• If you cannot chew or do not like chewing gum, use xylitol-containing lozenges or mints instead.
• You may also let your child use xylitol. The best time to start the use of xylitol gum is the age at which children normally learn the chewing habit. Smaller children should consume correspondingly smaller daily quantities of xylitol than older children and adults. There is no need to exceed the above-mentioned 5- to 7-gram daily quantity. Consult your doctor or your dentist, if you need more information.
• If you are pregnant or nursing, you may significantly improve your child’s dental health by systematically using xylitol chewing gum during pregnancy and nursing; research has shown that xylitol prevents the transmission of the caries infection from mother to child.
• You must continue to brush your teeth and to visit your dentist regularly; xylitol must be regarded as addition to your existing oral-care regimen, not as a replacement of brushing.

World-wide endorsements of xylitol support its unique role

In Finland, public health evaluation of xylitol as a caries-limiting agent has been carried out during the past thirty years. Following the first Finnish endorsements, national dental associations and other regulatory bodies in several industrialized and developing countries have followed suit. Endorsing organizations have also included government agencies (such as the Armed Forces in both the United States and Finland) and departments of public health. We constantly collaborate with authorities on issues related to dental health and use of xylitol.

Our research findings on xylitol brought me and my family to the U.S. as early as 1975.
I am personally delighted by the opportunity of having served in U.S. government agencies and public university-level institutions during three separate tenures, in Bethesda, MD, College Station, TX, and Ann Arbor, MI. These offices have given me a chance to further distribute the xylitol concept for the benefit of American consumers. I’m also pleased that scientific research on xylitol has now established new strongholds within U.S. research institutions, including the University of Washington Dental School in Seattle.

Learn about Xlear's xylitol dental products | Visit Xylitol.org | Browse xylitol studies