New Sugar Protects Teeth

Sugar that can't be digested

Dentists Recommend New Sugar

Dentists Recommend New Sugar

As a practicing dentist interested in the latest advances in oral care, I’m always on the search for what can help my patients. If there was such a thing as a “miracle drug” to reduce cavities, xylitol would be it. However, xylitol is not a drug; it is as natural as the fruits and vegetation from which it comes.

It looks and tastes just like sugar, but the big difference with xylitol is that it can’t be digested by the bacteria in our mouths. Let me explain why that is so important. You see most people believe that sugar causes cavities—yet, that is not entirely true! Sugar feeds the bacteria in our mouths, and the by-product of that consumption is the acid that eats holes in our teeth. Without the bacteria, it’s almost impossible to get a cavity, and regular use of xylitol practically eliminates the cavity-causing bacteria. With fewer bacteria you will have less acidity in your mouth and, ultimately, healthier teeth.

Reduces Bacteria Counts

Studies prove this. At the Department of Operative Dentistry at the University of Florida, Gainesville, 61 children were randomly assigned into a xylitol group and control group. The xylitol group chewed gum sweetened only with xylitol three times a day for three weeks. “The shift from higher S. mutans scores to lower was greater in the xylitol group than in the control group… This study supports the suggestion that chewing xylitol gum may reduce salivary S. mutans levels. Xylitol chewing gum may provide a feasible caries-prevention method for preschool children.”

Fights Plauqe

Xylitol also reduces plaque formation by changing the morphology of the bacteria so it can’t adhere to teeth. Also, xylitol’s naturally cooling and sweet taste increases mouth moisture. Saliva keeps our mouths healthy by being a kind of washing machine for our teeth. Increased saliva combined with less-adherent bacterial plaque gives us cleaner, healthier mouths.


What really strikes home about xylitol is its ability to aid in the remineralization of teeth. In other words, when your child has an incipient cavity, this process can be halted or reversed if the tooth is able to remineralize. That’s exactly what xylitol facilitates.

Evidence for this important benefit comes to us from the Department of Cariology at the University of Turku, Finland, where researchers studied the ability of xylitol to aid in remineralizing teeth among Polynesian children with rampant untreated caries. Slabs of enamel were inserted for 8 to 12 days in their cavities and subsequently replaced by permanent fillings. Before use, the surface of each slab was polished, and one half predemineralized and tested for microhardness. The predemineralized halves showed “pronounced rehardening at exposure to xylitol…. The results indicate that the use of a noncariogenic sweetener might be of value in high caries risk subjects.”

Dr. J.M. Tanzer, of the Department of Oral Diagnosis at the University of Connecticut School of Dental Medicine, Farmington, reports, “There is extensive peer-reviewed literature on xylitol chewing gum as it pertains to effects on tooth decay in human subjects, on human dental plaque reduction, on inhibition of dental plaque acid production, on inhibition of the growth and metabolism of the mutans group of streptococci which are the prime causative agents of tooth decay… and on xylitol’s reported contribution to the remineralization of teeth.”

Part of Dental Care Routine

Besides toothpaste, be sure to give your children xylitol chewing gum. This is an important part of your child’s dental care program. Chewing gum with xylitol (a natural, “sugarless” sweetener) not only dramatically reduces new cavities—it helps to reverse the process of decay in already active cavities, according to a University of Michigan study of more than 1,200 children.

The gum must be chewed for at least five minutes, three to five times a day, to be effective, says Kauko K. Makinen, professor of dentistry and biochemistry and one of the world’s leading xylitol experts.

“When bacteria in the mouth metabolize sucrose, the standard gum and candy sweetener, they break it down eventually into acid compounds that create cavities in most individuals,” Dr Makinen said. The same process may occur with sorbitol, a sweetener commonly used in sucrose-free gums, although the amount of acid produced is much smaller.

“However, oral bacteria do not metabolize xylitol efficiently, so almost no acid is produced,” the researcher explained. “Also, regular chewing with xylitol gum stimulates the production of saliva—nature’s own mouthwash, which also reduces cavities.”

Also, be warned that other sweeteners like mannitol, sorbitol and maltitol in “sugar-free” products can promote decay because they feed the cavity-causing bacteria. Spry makes mints and chewing gum that are 100% xylitol-sweetened.

Use Recommendations

When using xylitol, it is important to remember that the number of daily exposures is more important than the quantity. Xylitol must be used regularly throughout the day. Studies show that 8 to 10 grams of xylitol per day are effective. When looking for xylitol products to use, make sure they are 100% sweetened with xylitol and you will be more than likely getting enough (one to two grams) for each exposure. By simply following the advice to chew two pieces of xylitol gum three times a day, almost everyone could avoid having another new cavity the rest of their lives. Yes, I like xylitol, and I do want people using it as part of their dental hygiene program.

Future of Oral Care

It may be hard to believe that xylitol is as good as it sounds here because most of the general public has no idea what it is. Mark my words that it will be talked about more and more, because it would be unethical for dental professionals to deprive their patients of its potential benefits. When people learn about xylitol, they get very excited and motivated to add this safe, natural and delicious ingredient into their homecare routine for a lifetime of better health.

Dr. Chris Kammer is the founder and past president of the American Academy for Oral Systemic Health ( He was profiled as the ABC World News Tonight’s Person of the Week and has performed dentistry on The Today Show. He has also been featured in The New York Times and USA Today. He developed the “Gums of Steel” protocols for inoffice therapies and home care systems and he lectures and mentors dental teams throughout the country on the oral-systemic connection.

Autio, J.T. “Effect of xylitol chewing gum on salivary Streptococcus mutans in preschool children.” ASDC J Dent Child, 2002;69(1):81-86.
Isokangas P, Soderling E, Pienihakkinen K, et al. Occurrence of dental decay after maternal consumption of xylitol chewing gum, a follow-up from 0 to 5 years of age. J Dent Res. 2000;79:1885-1889.
Scheinin, A., et al. “Xylitol-induced changes of enamel microhardness paralleled by microradiographic observations.” Acta Odontol Scand. 1993 Aug;51(4):241- 246.
Sintes JL, Escalante C, Stewart B, et al. Enhanced anticaries efficacy of a 0.243% sodium fluoride/10% xylitol/silica dentifrice: 3-year clinical results. Am J Dent. 1995;8:231- 235.
Soderling E, Isokangas P, Peinihakkinen K, et al. Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. J Dent Res. 2000;79:882-887.
Soderling E, Isokangas P, Pienihakkinen K, et al. Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci: 6-year follow-up. Caries Res. 2001;35:173-177.
Tanzer J.M. “Xylitol chewing gum and dental caries.” Int Dent J. 1995 Feb;45(1 Suppl 1):65-76
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