Xylitol - A sweetener that helps your teeth

matthias on 2015/06/13

Disclaimer

I’m not a dentist nor do I play one on TV. Whatever conclusions you draw from this writing are your own and you alone bear the responsibility for your actions.

Introduction

I am using Xylitol for almost three years now because I believe it improves my dental health. Confronted with questions from people who wondered what I was doing, I’d always point to the Finnish research and that I would at some point put together a collection of what I had read to justify Xylitol consumption.

I cannot find the notes I made 3 years ago before I started this, so I did a quick new review that I am presenting now. Consider in addition the post about dental care I wrote last year.

Main Takeaways

  • Xylitol is one of the few substances I’m aware of that seems to make caries retreat not just slow its progress. There’s also CHX, but that has plenty of side effects.
  • It appears that Xylitol works because it creates an environment in your mouth that is unfavorable for caries bacteria. This environment can be sustained by consuming large amounts of Xylitol or by keeping the Xylitol there as long as possible (or comfortable).
  • Research suggests that the minimum daily consumption is three times with a daily dose of 5-6g (see Söderling article).
  • Xylitol is entirely specified by its chemical formula (see wikipedia).
    • The production method should thus not matter. You may question the purity of some sources, but I wouldn’t worry too much.
    • There is no company behind Xylitol. I have only seen arguments that the corn industry is pushing it.
  • Xylitol consumption should be entirely safe and better than sugar with regards to diabetes. However, there is a clear risk of “we don’t know what we don’t know” here and I am therefore mainly dissolving Xylitol and spitting it back out after a couple of minutes.

Research

The first findings on Xylitol were in the Turku sugar studies where people consuming Xylitol instead of sucrose or fructose remained caries-free. This could of course also demonstrate the harmfulness of the other two substances.

Later studies cleared this up. In the early 90s, a 40-month double-blind study with 1270 school kids in Belize, Central America demonstrated that Xylitol gum reduced caries rates significantly compared to No-gum, sucrose gum and even Sorbitol gum.

In a 6 month clinical trial published in 2013 with 204 school kids at high-risk for caries, it was found that those who consumed Xylitol gum only 3% developed initial lesions compared to 16% in the control group.

Söderling discusses “Controversies around Xylitol” in her 2009 journal paper. It summarizes the findings and explains why its difficult to perform studies that satisfy all the critics.

What calms my mind is that the main critics do not even claim that it doesn’t work at all. They consider it unclear whether xylitol works better than just chewing gum and not consuming sugar without replacement. The also want more comparisons with other substances like sorbitol or fluoride, the latter of which I wouldn’t forgo under any circumstance.

For further reading, epicdental.com has a huge list of papers that support Xylitol use.

Cost Evaluation

I pay about 10 EUR/kg of Xylitol powder. At 5-10g / day this lasts me for at least 3 months. The cost can thus be below 4 EUR / day. It is higher of course with gum or bonbons.

Where to buy

My preferred form for home use is Xylitol powder or rather grains that I dissolve in my mouth. This is the cheapest form and has the advantage that you are not forced to digest any Xylitol. Gums are the most convenient form that I use on the go. They are a little more pricey, but still very affordable.

I’m not affiliated with any of the following companies, but this where I buy or would buy Xylitol.

United States

I have not actually bought Xylitol here because I arrived with a reasonable amount from overseas. I would go with Xlear Spry gum that comes at .72g of Xylitol per 1.08g pellet and contains no other sweeteners (click “More Info” on their web site).

Xlear and Now Foods sell bags of Xylitol on Amazon for less than 7 USD per pound. Looks good to me.

Germany

Most of the Xylitol I used so far has been from xucker.de. I usually get the 1kg packs for 10 EUR. They are selling gum as well, but it is rather pricey. I prefer the gum from the discount supermarkets even though they mix in other sweeteners. At this point, Aldi’s gum has more Xylitol than Lidl’s.

Singapore

Better4U is an online supplier in Singapore that sells Xylitol at a reasonable 18 SGD / kg. I never ordered from them however. I believe that was because I never got a reply to an email I had sent or because I never received the free sample they offer
(Update from early 2016) I have in the meantime received the free sample I wrote about here and an apology that it got lost. I suppose this was just a little mishap and I didn’t follow up either. Anyhow, as far as I could tell, the product is fine. I am no longer in Singapore, however, so I didn’t get around to ordering something. Still, this is what I’d try first based on my current knowledge.

Cold Storage has Xylitol from Xylosweet for an exorbitant 23 SGD per pound. That might actually still be a good option considering that this will last for about 6 weeks.

Gum cannot be bought in Singapore, of course.

Almost Everywhere

iherb.com should be an option. They’re selling the Xlear Spry gum I mentioned before and the Now Foods powder among others and I had good experience with their affordable shipping to Singapore.

In practice, I mostly brought it over from Germany on the plane.