Xylitol – what is it? What are the implications of its use for me?

Xylitol is a sugar alcohol (or polyol) that is used as an alternative to sugar. Xylitol is more commonly used than you think being found in honey, jam and chocolate as well as medications and oral care products. Xylitol also naturally occurs in small amounts in some fruits.

A general Health benefit of Xylitol is it has a lesser effect on blood sugar levels than sugar, due to its slow absorption rate. It can be useful as an alternative to reduce sugar consumption for people with diabetes as it does not raise blood glucose or insulin levels.

It has a reduced caloric value which can be helpful in weight control. One spoon of sugar contains 16 calories versus 10 calories from xylitol. It is however not recommended to consume more than 50 g xylitol per day, due to it reducing absorption leading to water retention and diarrhoea.

Benefits to Dentistry?

• Xylitol is not metabolised by bacteria in the mouth and so it does not contribute to tooth decay.
• It also helps remineralise tooth enamel.
• Chewing sugar-free gum stimulates the flow of saliva through the chewing action; stimulated saliva helps to reduce acidity in the mouth by washing away plaque acids and contributes to their neutralisation by providing an important buffer, bicarbonate.
• Stimulation of saliva flow through the use of sugar-free gum results in a 10–12-fold increase over a resting saliva rate, which helps wash away debris of food particles and sugars from the mouth and restores optimum pH levels in the mouth faster than without sugar-free gum.
• Saliva also has an important role in the maintenance of tooth mineralisation as it provides the calcium and phosphate ions used to repair damaged enamel and it encourages the remineralisation of early cavities.
• Chewing gum sweetened with xylitol also helps reduce oral Streptococcus mutanslevels, a key pathogen responsible for cavities.

Xylitol is a useful alternative to sugar but moderation in the quantity consumed is important. Sugar-free chewing gums using xylitol are a convenient, simple and effective means of improving dental health through the stimulation of saliva when used regularly throughout the day.

This article has been altered from Gardner, E. British Dental Journal, 2017 Aug, Vol.223(3), pp.141-141. DOI: 10.1038/sj.bdj.2017.650