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Xylitol

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The Sweet Truth: Xylitol Lowers Risk Of Tooth Decay

Just in time for Children’s Dental Health Month, the “Today” show earlier this week broadcast a segment promoting the oral health benefits of xylitol, a natural sweetener found in Oxyfresh dental products.

The popular sugar substitute Xylitol, which has 40 percent fewer calories than sugar, is approved in more than 35 countries, including the United States, for use in food products, pharmaceuticals, and oral health products.

Because of the undeniable role of fermentable carbohydrates in dental caries, sugar substitutes are always examined for their ability to reduce or eliminate dental caries. A considerable body of research indicates that substituting sucrose (table sugar) with Xylitol reduces the incidence of dental caries in humans, according to an article published in Dimensions™ of Dental Hygiene.

Xylitol-containing products are more expensive than products with other sugar substitutes, but many dental companies recognize the higher cost is offset by the advantages of a lower risk for tooth decay.

According to the Dimensions article, authored by Diana M. Catt, PhD and Margherita Fontana, DDS, PhD, the use of sugar substitutes instead of sugar results in reduced demineralization and caries prevention. When recommending a product with Xylitol, the dental hygienist must determine whether Xylitol is being used as a sugar substitute or at therapeutic doses for a prescribed length of time in order to produce additional protective effects.

Evidence

Dimensions reports that 16 separate studies (length of Xylitol use ranging from 25 days to 40 months) show the protective effects of Xylitol use by either reducing S. mutans numbers in plaque and saliva or reducing DMFS (decayed, missing, filled surfaces) scores following Xylitol use.

In addition to reducing S. mutans levels in both oral biofilm and saliva, Xylitol use can reduce the level of lactic acid produced by these bacteria, according to the article.

Xylitol may also decrease the rate of transmission of S. mutans from mothers to their infants. These benefits appear to last several years after the mother has stopped Xylitol use.

In children examined 2 ½ years to 12 years after the mother stopped using Xylitol, the mean DEFS (decayed, extracted, filled surfaces in primary teeth) scores were lower than those whose mothers consumed a mix of sodium fluoride/xylitol/sorbitol.

Xylitol’s Dual Action

Xylitol provides benefits in two ways: First, Xylitol is a sugar substitute. Its action is similar to other sugar substitutes that are nonfermentable by oral bacteria. Bacteria break down a variety of carbohydrates (glucose, fructose, sucrose, maltose, mannose) for use as sources of energy and carbon. The bacteria have multiple systems in their cell wall that are each responsible for the transport of a specific carbohydrate into the cell. Bacteria cannot use a carbohydrate as a food-source if it does not have a compatible system to transport the sugar into the cell. Xylitol, while not used as a food source, can still be transported into some types of bacteria but the enzymes are not present for breaking it down. Thus, no lactic acid is produced from Xylitol. This is why Xylitol is an excellent sugar substitute and does not promote demineralization, according to Dimensions.

Second, when used at high enough doses, Xylitol is an antimicrobial. Inside the bacterial cell, most of the different transport systems are linked through a common set of enzymes in the phosphorylation pathway. Bacteria that have a fructose transport system are able to use it to transport Xylitol into the cell but then Xylitol locks the shared phosphorylation pathway enzymes in a nonproductive loop. During this process, Xylitol is not broken down and the cell cannot effectively use other carbohydrate transport systems. So Xylitol uptake by a cell affects cell-wide energy use and slows down metabolism and bacteria’s survival. In other words, Xylitol prevents the susceptible bacteria from simultaneously using other available sources of nutrients and directly leads to the death of the bacteria, authors Catt and Fontana wrote.

Long-Term Benefits

In conclusion, an abundant amount of evidence exists to support the benefits of using Xylitol to prevent caries, according to Dimensions. Xylitol use presents an exciting solution for those in the dental profession who wish to provide an acceptable alternative to patients at high risk for caries. However, dental hygienists need to remember that to gain the antimicrobial benefits, Xylitol needs to be used at an appropriate dose over long periods of time (6 g to 10 g daily, administered three to five times, chewed for 5 minutes each time).

Diana M. Catt, PhD, is an instructor and a postdoctoral fellow in the Department of Preventive and Community Dentistry at Indiana University School of Dentistry, Indianapolis.
Margherita Fontana, DDS, PhD, is an international speaker on cariology. She currently lectures on cariology in the dental and dental hygiene programs at Indiana University School of Dentistry.

Oxyfresh Fortifies Its Rinses, PowerPaste With Xylitol

Each of Oxyfresh’s five exclusive, alcohol-free mouthrinses and the gel toothpaste Power Paste contains Xylitol. Xylitol is a natural sweetener, found in many fruits and vegetables, and has been shown to inhibit the formation of plaque, as well as the bacteria implicated in tooth decay.

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Fresh tasting lemon-mint flavored Power Paste is a low-abrasion gel toothpaste. Like the other Oxyfresh Toothpastes, Power Paste is formulated with the exclusive bad breath fighting ingredient Oxygene® and does not contain any dyes so it is non-staining.

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All five Oxyfresh Mouthrinses contain Oxygene®, are alcohol free and do not contain any dyes.

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Oxyfresh’s Fluoride and Super Relief Gels are odorless and tasteless and formulated with Oxygene®. These gels soothe, cleanse and deodorize your gums.

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Formulated with our exclusive bad breath fighting ingredient Oxygene®, Breath Spray has a refreshing zesty lemon-mint flavor that will give you complete breath confidence wherever you go.

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