Xylitol's Effects on Your Oral Health

What is Xylitol?

Xylitol (pronounced: zai-luh-taal) is a sugar alcohol or polyol that naturally occurs in some fruits and vegetables such as cauliflower, mushrooms, oats, plums, raspberries, and strawberries. It can also be found in nutritive fibers like husks, corn cobs, and plant stalks.

Commercially, xylitol is extracted and processed from fibrous plant materials such as corn husks and sugar cane bagasse and from hardwoods such as birch bark. It is widely used as a sugar substitute, food additive, and low-calorie sweetener for people with elevated blood sugar (e.g., diabetes).

Xylitol is not an actual sugar. It is a carbohydrate with a chemical structure similar to alcohol and sugar. It looks and tastes like sugar, but it doesn’t affect the body like alcohol.

Is Xylitol an Artificial Sweetener?

No. Xylitol is not an artificial sweetener. Artificial sweeteners such Aspartame and Sucralose are synthetically produced in laboratories. They are considered non-nutritive sweeteners because they have zero calories and don’t provide energy when consumed.

Xylitol is a naturally occurring plant-based product and a nutritive sweetener. Unlike artificial sweeteners, it provides some calories as well as energy when consumed.

Is Xylitol a Healthy Substitute? Does it Spike Blood Sugar?

Yes. Xylitol is a healthy sugar substitute for three reasons:

  1. It is a low-calorie substitute to both white and brown sugar
  2. It doesn’t cause your blood sugar to rise significantly
  3. It offers the same level of sweetness as sugar

Calories in Xylitol — Nutrition Information

Xylitol has fewer calories than sugar. There are about 9 calories per teaspoon of xylitol compared to 16 calories per teaspoon of sugar.1 

Xylitol is a healthy alternative to sugar for people who want to:

  • Lose excess weight
  • Maintain normal body weight
  • Decrease their calorie consumption
  • Reduce their sugar intake

Sugar alcohols such as xylitol are often used as food additives due to their low-calorie content.2

Helpful for Diabetics

The glycemic index (GI) is used to measure how much food affects your blood sugar on a scale of 0 to 100. It tells you how slow or fast the body metabolizes food into simple sugars for energy. Foods can have a low, medium, or high glycemic index:

  • Low GI: 0 to 55 (good)
  • Medium GI: 56 to 69
  • High GI: 70 and above

Brown and white sugar have a medium glycemic index ranging from 60 to 65. Xylitol has a low glycemic index of 12.2 This means that, compared to sugar, the body takes longer to metabolize xylitol.

Individuals with diabetes can benefit from xylitol because it doesn’t cause a drastic increase in blood sugar levels. Studies show that it also helps maintain a stable blood sugar.3,4

The Sweetest Sugar Alcohol

Xylitol is just as sweet as sugar. It has a relative sweetness of 0.97, which is only 3% less than actual sugar. 

Currently, it is the sweetest sugar substitute among sugar alcohols. Xylitol is often used with other sweeteners to mask their bitterness.2

Is Xylitol Beneficial for Dental Health? 

Yes. Xylitol is tooth-friendly. In fact, it is one of few sugar alternatives that are good for your teeth. It also offers unique benefits for your oral health that other sugar alcohols don’t.2,5

6 Oral Health Benefits of Xylitol

Xylitol-containing products provide the following benefits for dental health:

1. Prevents plaque buildup

Xylitol can’t be metabolized by acid-forming bacteria or used as a nutrient. Instead, bacteria convert xylitol into xylitol 5-phosphate (X5P), which inhibits their metabolism and acid production. 

Since oral bacteria such as Streptococcus mutans and Streptococcus sobrinus need an acidic environment to thrive, the non-acidic nature of xylitol prevents their growth (along with plaque formation).6

Sugar-free chewing gums containing xylitol further prevent plaque by stimulating saliva production. The increased saliva neutralizes plaque pH and washes out the excess sugars, acids, and bacteria that pool in the mouth shortly after eating sugary food and drinks.6

2. Effectively removes plaque

Xylitol reduces the bulk and stickiness of pre-existing plaque, resulting in an overall decrease in plaque mass. This is because xylitol interferes with Streptococcus mutans

According to one study, xylitol can cause a slowed production of polysaccharides. It can also prevent the collection of bacteria cells and reduce the adhesiveness of bacteria to teeth.6

3. Actively stops tooth decay

Xylitol is non-cariogenic like other sugar alcohols. This means that it inhibits S. mutans from breeding in your mouth. 

The sugar alcohol also stops the growth of bacteria in the mouth by increasing saliva production. These combined effects give xylitol the ability to prevent dental caries.2,5

4. Protects against dental caries for years

What makes xylitol unique from other polyols is that it offers long-term protection against tooth decay

Clinical researchers investigated people who used xylitol chewing gums for 2 to 3 years. A follow-up was conducted several years later. They found that xylitol continued to protect against dental caries even though participants stopped chewing gum a few years earlier.7

5. Great for kids’ dental health

Xylitol provides even more benefits for children’s oral health. Children that chew xylitol-containing gum for at least one year before their permanent teeth erupt are better protected against tooth decay.7 

Studies have also shown that mothers pass on their oral microflora to infants.8 Consumption of xylitol chewing gum while pregnant enables the mother to pass its teeth-protective qualities to their children.5 

The same children experienced fewer dental caries than those whose mothers did not use these products.8

6. Promotes remineralization

The effectiveness of xylitol goes beyond the prevention of dental caries. Evidence suggests it can also repair teeth. While the ADA still recommends fluoride toothpaste, xylitol is a great alternative to help fight tooth decay. 

When you consume food and drinks that are high in sugar, acids accumulate in the mouth and cause the plaque pH to drop below 5.5. The acidic environment reduces the saturation of phosphate and hydroxyl ions in the mouth and dissolves tooth minerals.

Xylitol chewing gum increases the production of saliva. Saliva contains calcium and phosphate ions which perform minimal repairs on damaged enamel. 

This process is known as remineralization. Remineralization reverses the progression of dental caries and prevents their development.8

What Dental Products Contain Xylitol?

Some xylitol-containing products for dental health include:

  • Breath fresheners
  • Breath mints
  • Chewing gum
  • Dental floss
  • Dry mouth sprays
  • Mouthwash
  • Toothpaste

Foods That Contain Xylitol

Besides dental products, there are many foods and beverages containing xylitol as a sweetener. It is widely used in food as an additive or as a sugar substitute, especially in people with elevated blood sugar levels (e.g., diabetes).

Food products containing xylitol include:

  • Sweeteners
  • Sugar-free candies
  • Chewable vitamins and dietary supplements
  • Over-the-counter medications (e.g., cough syrups)
  • Diabetic foods (e.g., sugar-free desserts)

Xylitol can also be used to substitute sugar when making baked goods like cakes and muffins.

5 Other Health Benefits of Xylitol

Xylitol does more than prevent dental caries and maintain normal blood sugar. Based on clinical evidence, it offers other benefits as well.

1. Keeps the skin healthy and hydrated

Applying 5% xylitol and 5% glycerol to dry skin for 14 days increases skin hydration, reduces moisture loss, and improves the thickness of the skin so it’s better protected against injury. 

A higher concentration of xylitol (8.26%) was also shown to reduce skin irritation. Furthermore, xylitol is proven to have antimicrobial and cooling effects on the skin, which shows its potential application in wound care.4 

2. Improves bowel function

Xylitol is a prebiotic that promotes healthy gut flora. Clinical evidence shows that a xylitol chewing gum helps relieve constipation and encourages bowel movement, especially after undergoing a Caesarian section or elective proctectomy.4

3. Strengthens bones

Xylitol ferments and is not digested in the intestines. As it ferments, it produces short-chain fatty acids which improve the digestion and absorption of minerals such as calcium. This, in turn, helps strengthen the bones.4

4. Supports respiratory health

Nasal sprays that contain xylitol prevent the growth of certain bacteria in the airways. It also improves the quality of life in patients with sinusitis and non-allergic nasal congestion.4

5. Prevent ear infections

Xylitol consumption in children lowers their risk for ear infections by up to 25%. It didn’t matter whether they received xylitol as a chewing gum or lozenge. They continued to enjoy the same protection against acute otitis media (AOM).9

Xylitol: Is it Healthy or Safe?

Xylitol is safe for humans. Dental products and food that contain xylitol are approved by the Food and Drug Administration (FDA) for human consumption.

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