Why is it that some subjects like xylitol are heralded as so positive by some experts and thrown under the bus by others?
Like our recent article on the safety of using baking soda, today let’s explore whether using xylitol in the mouth on a regular basis is a safe and wise choice.
Quick personal disclaimer, for years we have been rather anti xylitol. Like many that have been on the health food bandwagon for decades, there was a point where we wondered if we should replace any sugar in our diets with xylitol. Then one day we did a simple experiment and forever changed our perspective on xylitol. However, that story will have to wait for another day.
In order to really give this discussion the attention it deserves, we will share what we consider being the primary risks and benefits of using xylitol. It’s our hope that you’ll gain some insight to assist you in determining whether xylitol deserves a place in your oral hygiene routine.
For clarity, this discussion is only going to focus on the use of xylitol in the mouth, not on the broader issues of using xylitol as a sugar substitute. While it’s true that ‘what goes in the mouth goes into the whole body’, the sheer quantity of any substance, xylitol, in this case, is much, much greater if we consume it as compared to just using it in the mouth.
Risks of using xylitol…
We see three distinct risks with the use of xylitol on a regular basis.
Potential GMO product:
Most of the xylitol produced is made from corn. Unfortunately, most corn grown is genetically modified. Now, I’m sure there are some scientists out there who would argue that xylitol made from corn (whether GMO or not) is molecularly identical to xylitol made from birch or other wood pulp. (Historically, xylitol was made from birch sap.)
Being staunchly on one side of the GMO subject, we prefer to not participate in any experimentation with the relative safety of any genetically modified organisms.
Thankfully, there’s an easy workaround to the GMO issue with xylitol. You can still purchase xylitol produced from birch. In fact, here’s a source for birch based xylitol produced in the US. 🙂
Highly processed product:
This is true. Yes, xylitol is naturally occurring in many fruits in small amounts. However, the production of xylitol we know as consumers is accomplished by hydrogenating xylan, a plant cellulose. In other words, xylitol isn’t ‘natural’ like honey or maple syrup that we can just tap a birch tree and boil down the sap into xylitol.
While having the word ‘hydrogenation’ in this explanation of how xylitol is produced may seem scary (after all, we are all afraid of hydrogenated vegetable oils like margarine by now), does that necessarily mean that xylitol is out?
Diving deeper into the production of xylitol shows that hydrogenation is commonly done using the metal catalysts, nickel, palladium or platinum. However, we think the risk of metal residue toxicity is minimal to nonexistent provided that the xylitol is being manufactured in the US, Canada or Europe.
The rub is most of the xylitol produced is coming out of China and is corn based. Nothing personal with China, but their manufacturing standards have historically shown to be less than ideal. (Remember the 2007 stories of Chinese toothpastes contaminated with whatever crazy toxin?) So, to help ensure that the xylitol you use is free from metal residue, be sure the xylitol is birch based coming out of North America or Europe.
Prebiotic – feeds bacteria:
One of the main negatives proponents against xylitol will quote is how xylitol will ‘rip apart your insides’ and ‘cause leaky gut’. (1) Digging into the research suggests that these claims are exaggerated.
It’s true that if someone eats too much xylitol it will cause diarrhea, gas and bloating. But this isn’t from it ripping apart our digestive tracts. Xylitol is a prebiotic. A prebiotic is food for the bacterial colonies in our digestive systems. So, if a person consumes too much xylitol at once, this can result in an overgrowth of bacteria in the small and large intestine which results in the gas and bloating.
This is why people who are looking to recover from leaky gut are warned to avoid eating xylitol. You see, xylitol is a sugar alcohol, also known as a polyol. Experts involved with FODMAPs, SIBO, the Specific Carbohydrate Diet, and GAPS diet, suggest anyone with compromised digestion avoid eating xylitol. A big component to healing this bacterial overgrowth is to not feed the resident bacteria in our bellies which result in a reduction of their populations.
As we consider leaky gut to be extremely widespread and undiagnosed, anyone with a digestive challenge would be wise to avoid eating xylitol.
(As a side note, we should mention that xylitol can be toxic to dogs. Without going into the details of this, research suggests that unlike humans and many other mammals, dogs absorb xylitol extremely quickly and this can challenge the capacity of their livers to process the xylitol. Here’s a detailed peer-reviewed article on xylitol and dogs if you are interested.)
Benefits of using xylitol…
We also see three distinct benefits to using xylitol on a regular basis.
Wait a second… How can the fact that xylitol is a prebiotic be both a risk AND a benefit?
It’s precisely because xylitol IS a prebiotic that contributes most of the benefits which xylitol offers. Like so many substances, dosage defines whether xylitol will support or undermine our health.
Proponents of xylitol suggest 5 ‘exposures’ a day to promote improved oral health.
Here’s our concern with this constant xylitol drip…
Just because something seems good for us doesn’t mean that more of it will be better.
The ‘sugar demon’ each of us has within us (provided you grew up on earth in the 20th or 21st century) constantly lures us to eat more sweet foods. So, even though xylitol doesn’t negatively impact insulin production like sugar, the more sweet foods we consume, the more sweet foods we crave. Sweet is sweet (yes, even if it’s stevia).
So, we liken eating xylitol to a ‘gateway drug’. Having regular xylitol (in your diet) will increase your cravings for sweet foods. So, a little xylitol gum here and there seems fine and offers the mouth support toward a healthier balance.
Just be watchful for your sugar demon’s attempts to increase your sweet consumption as a result. The research very clearly shows that our systems function most efficiently with very, very little to no sweet foods.
Reduces risk of tooth decay:
This has been exhaustively established in the scientific literature. The main ‘bad bug’ implicated with tooth decay is called Mutans Streptococcus or strep mutans for short.
In the mouth, xylitol is consumed along with fermentable carbohydrates like sugar by strep mutans. However, because xylitol is a polyol (sugar alcohol), it doesn’t ferment the same way as most sugars. As such, xylitol doesn’t contribute to the proliferation of strep mutans.
In fact, when xylitol is used over time less virulent strains of strep mutans are selected for which means that the bad bugs are getting weaker over time. (2)
The second way xylitol helps us address tooth decay is due to the fact that in the presence of xylitol, the dental plaque formed from the bad bugs implicated with tooth decay was less adhesive.
Some studies show up to a 50% reduction in plaque accumulation from using xylitol in the mouth.(4) Adhesion is a big deal when we’re talking about tooth decay. So, the fact that xylitol helps make plaque less adhesive alone is a real benefit.
Supports remineralization of tooth tissue:
This is big. As we have discussed here for years, we approach this path to optimal oral health from two perspectives, an ‘in the mouth’ approach and a ‘system-wide immune’ approach. While there is much we can do to support greater remineralization system wide by understanding what causes decay, what foods undermine our oral health and what foods support greater oral health, having tools to help remineralize ‘in the mouth’ add yet another strategy for optimizing our oral health.
From the ‘in the mouth’ approach, remineralization occurs because calcium and phosphorus are held in an available state to chemically remineralize tooth tissue.
An article in the International Journal of Dentistry titled Sugar Alcohols, Caries Incidence, and Remineralization of Caries Lesions: A Literature Review states that xylitol helps maintain calcium and phosphorus in a stable state, available to be used to remineralize our teeth.
“It is important to observe, however, that the stabilizing effect of polyols (xylitol) on the Ca phosphate systems of the oral cavity is predominantly directed to the solubility of salivary Ca and phosphate, rendering their prolonged, dissolved, supersaturated state possible, compared with the presence of, say, sucrose, which tends to initiate instantaneous precipitation of Ca and phosphate in saliva (thus eliminating a part of those substances from remineralization). The polyols’ role in saliva and plaque fluid is one of stabilization; Ca and phosphate salts are stabilized in the presence of polyols”(3)
More scientific evidence supports that not only does xylitol support surface remineralization but xylitol even supports remineralization of deeper dentinal layers of tooth structure. (4)
Supports a healthier pH in the mouth
We will mention that xylitol does support a healthier pH balance in the mouth. However, the literature suggests that the support comes not directly from the use of xylitol, but from the fact that the presence of xylitol in the mouth causes increased salivation. It’s the saliva that balances the pH in our mouths.
If you’d like to read more about the role of pH in the creation or destruction of oral health, here’s an article on tracking your saliva pH. Also, here’s a video tutorial where we share a simple (free) technique to increase your saliva, what we call ‘Mouth Probiotics’.
Putting together the pros and cons…
With this extensive review of the literature, we have changed our stance on xylitol being used in the mouth. The benefits of reduction of tooth decay, plaque adhesion reduction and remineralization support clearly point toward the use of xylitol in oral hygiene routines.
Just make sure the xylitol you choose isn’t coming out of China or from the GMO agri-biz industry.
Please remember this! We love our family pets! Of course we want to help them keep their teeth healthy and clean too. Xylitol can be fatally dangerous to dogs. Please never use a human toothpaste or toothpowder containing xylitol on your dog’s teeth.
How about you? Do you use xylitol? Do you consider xylitol safe? Please share your stance so we can all continue to learn from one another.
Helpful, Related Resources:
Is Baking Soda Safe to Brush with? [article]
What’s the Real Cause of Tooth Decay? (and how to stop it) [article]
What Foods Undermine Our Oral Health and Why? [article]
What TO Eat to Support Optimal Oral Health [article]
Tracking Your Saliva pH: How to Know You Are Heading in the Right Direction [article]