The Xylitol Controversy: Is This Natural Sweetener Really Safe for Your Teeth?

I’ve read several articles over the years raising concerns about the safety of the sugar alcohol xylitol. While I thought these concerns were mostly put to rest, I recently heard an interview from a well-respected source suggesting that xylitol is NOT recommended for oral care products.

Sometimes my crunchy-granola-holistic peeps ruin all the fun. I think this might be one of those times.

Xylitol is a sugar alcohol and plant-based sweetener. It is so similar in structure to sugar that cavity-causing bacteria, like Streptococcus mutans, ingest the xylitol. However, they can’t properly metabolize it, causing the bacteria to die and slip right off the tooth structure (or ear canal, or anywhere biofilm exists). Xylitol also immediately raises the pH of the area, reducing acidity that can erode tooth enamel. The combination of biofilm reduction and pH increase makes xylitol an incredibly useful tool in the fight against tooth decay.

How Does Xylitol Prevent Cavities?

Scientific studies highlight the effectiveness of xylitol in reducing cavities. One study found that when pregnant mothers chewed xylitol gum daily, their children experienced 50% fewer cavities by age five compared to those whose mothers did not【1】. In another study, therapeutic levels of xylitol were found to be as effective, if not more effective, than fluoride at reducing cavities【2】.

Potential Risks of Xylitol

So, what’s the hang-up some people have with xylitol? While the benefits are significant, there are a few downsides to consider:

  1. Toxic to Dogs: Xylitol is extremely dangerous for dogs, even in small amounts. It must be kept completely out of reach, especially if you have a smaller dog or a particularly curious one.
  2. Digestive Sensitivity: Xylitol acts as a prebiotic in the intestines, which can cause bloating, gas, or diarrhea in some individuals. People who are sensitive to prebiotics or unaccustomed to xylitol may experience gastrointestinal discomfort if consumed in large quantities.
  3. Sourcing Issues: Many xylitol products are made from corn, which is often genetically modified. For those seeking cleaner options, look for xylitol sourced from birch trees or labeled as non-GMO.

Choosing the Right Xylitol Products

To mitigate these risks and still enjoy xylitol’s benefits, follow these tips:

  1. Keep xylitol products away from pets. This is non-negotiable.
  2. Start small. If you’re worried about digestive discomfort, avoid baking with xylitol granules initially. Start with one daily exposure through toothpaste, gradually increasing to gum or mints after meals.
  3. Opt for high-quality products. Brands like Risewell, Boka, Spry, Xlear, and Zellies use birch-based or non-GMO xylitol, making them safer and cleaner options.

Why Xylitol Still Belongs in Oral Care

Dental caries (tooth decay) remains widespread, despite decades of fluoride use. As my concerns around fluoride safety grow (feel free to explore more at www.fluoridealert.org), I believe xylitol comfortably sits among my top three cavity-fighting tools. Its effectiveness, coupled with a favorable risk profile, makes it a valuable addition to any oral care routine.

Curious about incorporating xylitol into your oral care routine? Ask your biological dentist or explore trusted brands to experience the benefits for yourself.

References

  1. Mäkinen, K. K. (2010). Xylitol: Its properties and dental benefits. Caries Research. https://www.karger.com/Article/Abstract/321102.
  2. Milgrom, P., Ly, K. A., Roberts, M. C., Rothen, M., Mueller, G., & Yamaguchi, D. K. (2006). Mutans Streptococci Dose Response to Xylitol Chewing Gum. Journal of Dental Research. https://journals.sagepub.com/doi/10.1177/154405910608501009.
  3. Söderling, E. (2009). Xylitol, Mutans Streptococci, and Dental Plaque. Advances in Dental Research. https://journals.sagepub.com/doi/10.1177/0895937409335596.
  4. Vadeboncoeur, C., & Trahan, L. (2007). Xylitol in caries prevention: An overview for clinicians. Journal of the Canadian Dental Association. https://jcda.ca/article/b39
  5. Fluoride Action Network (FAN). Health Effects of Fluoride. http://www.fluoridealert.org.
  6. https://risewell.com/
  7. https://www.boka.com/
  8. https://xlear.com/
  9. https://zellies.com/
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  • Medically Reviewed
Dr. Toni Engram

Dr. Toni Engram

Dr. Engram grew up in Hillsboro, Texas, where she met her future husband, and graduated second in her high school class. She attended Texas Christian University, and graduated Magna Cum Laude with a Bachelor of Science degree in biology. She earned her doctorate degree at Baylor College of Dentistry.

After her own personal health struggles with an autoimmune disease, Dr. Engram shifted her practice philosophy to focus on whole-body health, and the prevention and safer treatment of oral disease.

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