Sugar is Killing Us, Xylitol is Here to Help
We all know of the diseases and conditions associated with heavy sugar intake:
Diabetes, obesity, cancer, cardiovascular disease, cavities, the list goes on.
What if I told you there was a natural, low-carb sugar alternative that prevented cavities and other diseases without a weird aftertaste?
You’d probably ask “what’s the catch?”
Xylitol is a miracle compound with a long list of healing properties extending beyond just cavities. It’s also one of the main ingredients in the toothpaste I developed. Here are some of the known health benefits of xylitol:
Increases salivary flow
Prevent dental cavities
Treat respiratory tract and middle ear infections
Stimulates lipid and bone metabolism
Improve diabetic status
Help with weight loss
Stimulate the digestive and immune system
Side note: Xylitol is extremely dangerous for pets, keep it far away from them!
What the Heck is Xylitol Anyway?
It’s a naturally occuring compound found in many fruits and vegetables such as strawberries, raspberries, mushrooms and cauliflower.
It’s classified as a polyol, or sugar alcohol and is considered to be a carbohydrate. The weirdly named xylitol comes from “xylose” which translates to “wood sugar” since it is extracted and process from birch trees.
There are many different types of sugar alcohols that are widely used, but none of them have a sweetness equivalent to sugar.
Xylitol has the same sweetness as sugar, and has 2.4 calories per gram compared to 4 calories per gram of sugar.
Modern refined sugar is like a drug, quickly and efficiently absorbed by the large intestine causing a quick spike in blood glucose. Xylitol is actually not digested by human enzymes. Approximately 50% of it is absorbed through the small intestines by passive diffusion. Because it is non-digestible and fermentable by the gut, it can cause some gastric distress (diarrhea, gas pains) when consumed in large amounts (more than 50g per day)
When considering consumption of sugar substitutes for food items like dessert, erythritol is a much more gut-friendly alternative to xylitol.
Xylitol is typically found as a granulated powder, looking almost identical to sugar. It’s found in many products such as chewing gum, lozenges, toothpaste, spray bottles, mouth rinses, and gummies.
Many xylitol products are marketed as “dental products” rather than candy you’d find at the store.
Most sugar free chewing gum is sweetened with xylitol, but not all of them (PUR, Spry, and Epic Dental Gum have the highest amounts of xylitol). Links can be found below:
Xylitol lozenges are a great option for people with dry mouth.
Those of you who have an oral fixation and want something sweet with some benefits for your teeth, here are my favorites:
Xylitol Mouth Rinses
Many dentists will prescribe or recommend a fluoride mouth rinse for those with cavities or classified as “high cavity risk”.
Here’s the thing, xylitol mouth rinses were proven to be just as effective as a fluoride mouth rinse. Both rinses significantly reduce the levels of bacteria that cause cavities.
Xylitol candy is also a thing, but to be honest I don’t really mess with these. These are probably best suited for children or those with an insatiable sweet tooth. Here are a few notable products:
Xylitol and Bacteria
Xylitol inhibits the amount of streptococci mutans in the mouth, which is the bacteria responsible for cavities. The chemical compound disrupts their energy system, causing cell death.
Normally, Strep mutans grabs on to your tooth and sticks to it (biofilm). It hangs out there and eats the sugar from inside your mouth, and poops out acid. This acid destroys your precious enamel, leading to a cavity.
Sugar is the perfect food for Strep mutans because its easily digested (fermented) allowing the bacteria to become an acid-producing machine. Xylitol ruins this process, because Strep mutans literally can’t digest it. No digestion = no acid production = no cavity.
Xylitol prevents the ability for these bacteria to adhere to the surface of your teeth, as well as reduces the acid production. With no acid, and dying bacteria that can’t hang on to your teeth, cavities simply can’t progress.
Helicobacter pylori is another bacteria in the mouth (H. Pylori is commonly known for ulcers in the stomach), and it is one of the bacteria responsible for progression of periodontal (gum) disease. Xylitol also inhibits the growth of this, reducing the incidence of gingivitis and gum disease.
Xylitol also has an antifungal effect. Candida albicans is a normal fungus found in the mouth, but when it becomes too prevalent, it can cause fungal infections.
High sugar intake can cause dysbiosis and lead to candida overgrowth, often presenting as thrush (candidiasis) or irritated corners of the lips (angular cheilitis). Xylitol inhibits the production of acetaldehyde which is a byproduct of candida albicans.
Clostridium difficile, known as “C. diff” is a bacteria that causes diarhhea and colitis. It can become life threatening, and is usually brought on by certain antibiotics like clindamycin. Xylitol has been shown to reduce the germination of C. diff spores, slowing the outgrowth and allowing your natural immune defenses to kick in.
Just when you thought these were enough of benefits, xylitol also stimulates salivary flow, and saliva has a multitude of protective elements for the teeth and gums.
There are plenty of other products that will inhibit or destroy the bad microbes of the mouth; chlorhexidine, alcohol-containing mouthwashes, peroxide, fluoride, and more.
The problem with some of these other methods is that they tend to disrupt the good bacteria, causing dysbiosis in the fragile oral microbiome.
Xylitol is unique in that it doesn’t kill all bacteria indiscriminately. It spares the good bacteria in your mouth which promote health, while disrupting the acid producing bacteria.
Pregnancy and Cavities
Pregnancy is a turbulent time. Hormonal changes can wreak havoc on the gums and teeth if oral hygiene isn’t dialed in properly. What many expecting mothers don’t realize is that cavities can be transmitted to the child. This is what we call vertical transmission.
Pregnant mothers can pass on cavity risk to their children. The unborn child does not have a fully equipped immune system, and the bacteria that cause cavities can be transmitted to the child, and effect the body’s protection against cavities for life.
Xylitol is completely safe for consumption during pregnancy, and has very little downsides.
Pregnant women with high cavity risk that used xylitol chewing gum showed a 71% reduction in childhood caries 5 years after birth.
Xylitol consumption during pregnancy was shown to be almost twice as effective than fluoride at preventing cavities in children (you shouldn’t be using fluoride when pregnant anyway).
TLDR: Xylitol kills the bacteria that cause cavities and gingivitis while sparing the good bacteria that promote a health mouth. It also raises the pH of the mouth, prevents your unborn child from being at risk for cavities and stimulates salivary flow.
Xylitol and Illness
Before we start, let me get this out of the way: xylitol is probably not going to cure you of illness, but it’s a great adjunct for wellness and prevention. It will likely improve outcomes, but it will not replace traditional methods of treatment for disease and illness.
Bacteria use something called quorum sensing, it’s a way these little buggers communicate. Quorum sensing allows bacteria to sense and respond to members of their own species, and make changes based on population density.
Xylitol interrupts this process, which is the equivalent to cutting off cell service for bacteria. For the nerds out there: it is hypothesized that xylitol inhibits biofilm formation, reduces prodigiosin production, blocks protease activity, decreases swimming motility, and increases sensitivity to hydrogen peroxide.
In english: if bacteria are a bunch of high schoolers at a house party, xylitol is the cop busting down the door.
Xylitol nasal sprays have been shown to reduce the viral load from COVID-19, act as an antiviral, and improve symptoms. Early research shows that it prevents viral adhesion in the nasal passage, but it’s an inexpensive and low-risk treatment for COVID.
In addition, there is evidence of xylitol nasal irrigation having greater improvement the symptoms of those with chronic sinus infections, strep throat, and the flu when compared to saline irrigation.
Does Dose Matter?
You may be wondering what kind of dose and frequency is needed to get the beneficial effects of xylitol.
The studies show that between 5-10g per day, throughout the day as “fractioned doses” provides the optimal benefit.
Each piece of chewing gum contains around 1g of xylitol, so that means around 5 to 10 pieces of gum per day. Things get a little messier when using other xylitol products.
As you can tell, I’m a big fan of xylitol. As a dentist, it’s a powerful tool in preventing cavities in those that are high risk with very little downside. There are a lot of exciting questions about xylitol, as it has a lot of promising effects on a systemic level.
I didn’t go into detail of the benefits of xylitol in other parts of the body because, well… I’m just a dentist. Either way, incorporating xylitol in some fashion into your diet is likely going to help. Even if that boost only comes in the form of preventing cavities, it’s worth trying.
As with anything in life, start small and work your way up so you don’t shock your system and get an upset tummy.
My love for xylitol is expressed directly in the toothpaste tablets I developed with. NOBS is over 30% xylitol by weight, and it starts shipping December 18th. You can preorder yours today at brushwithnobs.com
This some HEAT doc