The Truth About Xylitol for Teeth | Risks & Health Benefits

sugar substitute xylitol, a glass jar with birch sugar, liefs and wood

If you’re considering using xylitol as an alternative to sugar, there are some important things you need to know before you make your decision. Xylitol, which is derived from plants like corn and certain types of trees, has been used for years. But only recently it has started to gain traction as a natural sweetener and dental hygiene supplement.

You’ve probably heard of xylitol being mentioned alongside other natural sweeteners like stevia and agave nectar– but what does it actually do? Is it healthy for your teeth? Here’s everything you need to know about xylitol – including its effects on your teeth to how it compares to sugar.

What Is Xylitol?

Xylitol is a naturally occurring “polyol” (AKA “sugar alcohol”) that can be found in small amounts in certain types of fruits and vegetables, but it’s most commonly extracted from various types of hardwood trees. Without getting too scientific, the chemical structure of xylitol is a lot like glucose—but it has far fewer calories.[1]

Since xylitol has fewer calories, it’s used as a sugar substitute in certain circumstances. Especially when it comes to chewing gums and even oral care products. However, it is rarely used as a sweetener that’s going to be ingested in large amounts (more on that later.)

But here’s what you really need to know. When it comes to your teeth, xylitol has an amazing ability to prevent plaque from sticking and building up on your tooth enamel. It all has to do with the way the molecules stick to each other and the way xylitol gets in the way of it all.

What Is A Sugar Alcohol

Sugar alcohols include things like xylitol, sorbitol, mannitol, and similar sweeteners. You’ll find them naturally in really small amounts in some fruits and vegetables such as plums, corn, mushrooms, and cauliflower. 

Technically, sugar alcohols are classified as carbohydrates, so if you’re someone who has to count carbs, be sure to include them. The number of calories in sugar alcohol varies, but one gram typically has 2-3 calories, making them much less than regular sugar (4 calories per gram). And because they are absorbed more slowly by your body, sugar alcohols can help you feel fuller for longer. Yum, cauliflower!

Sugar vs. Xylitol 

As a general rule, we all know that sugar is bad for our teeth. Drinking sodas or tea with sugar, eating a lot of sugary candy, and chewing bubble gum with sugar in it is like a ticking time bomb for cavities.

Xylitol is often touted as a replacement for sugar since it’s better for your teeth. After all, it physically lowers plaque levels in your mouth which can improve your oral health.  You will occasionally see xylitol in sugar-free candies, chocolates, and baked goods. Chewing gum containing xylitol is a great sugar-free alternative. Although these sweeteners may appear healthier than refined white sugar, they come with their own set of potential side effects and dangers (yes, dangers.)

Xylitol Has A Low Glycemic Impact 

Regular white sugar has a high glycemic impact and triggers sharp increases in blood glucose levels. But xylitol is absorbed more slowly and is lower on the glycemic index. It also stays in your body longer than sugar does. This slower absorption rate helps blunt your hunger cravings by keeping insulin levels stable so you don’t crash mid-morning after your cereal or mid-afternoon when you snack on fruit with peanut butter.  

Because of that, people with diabetes may consider using xylitol as an artificial sweetener at certain times. However, it's worth noting that a lot of people—diabetic or not—will experience digestive discomfort from ingesting moderate to large amounts of xylitol. Even though it’s great for chewing gum or breath mints, swallowing too much xylitol can cause an upset stomach or diarrhea.

Since most oral care products or mints contain very little xylitol, you shouldn't have any issue with your stomach unless you tend to have an extremely sensitive GI tract.

Is Xylitol Good For My Teeth?

Xylitol is a naturally occurring sugar substitute that’s made from plant materials. Because it doesn’t contribute to tooth decay, you might think xylitol would be good for your teeth. However, there are some facts you should know about xylitol before assuming it’s safe. Xylitol may be good for your teeth because it cannot easily be digested by bacteria in your mouth. This means those bad guys can’t use xylitol as food and reproduce quickly; as a result, they can’t produce acids capable of eroding your enamel and causing cavities. [2]

Years ago, a team of dental students performed an experiment where they—essentially—didn’t brush or floss their teeth for a week. They read all of the bacterial levels before they started, and then again after the week was over. What did they do instead of flossing? Supplement with xylitol. Their goal was to determine how the xylitol impacted plaque levels inside of their mouths and if it could be used as an oral hygiene aid. The results? They actually had lower dental plaque levels after the week was over than they did before it started.

Now does that mean you can toss your toothbrush and floss? Absolutely not. But it does mean that incorporating xylitol into you and your family’s oral hygiene routine could make a big long-term impact on the health of your teeth and gums.

PRO TIP: Always use sugar-free chewing gum! It is a super-easy way to improve your dental health and prevent tooth decay.

Is Xylitol Better Than Fluoride? 

 Xylitol is a popular alternative for people looking for healthy ways to improve their oral health in general. But it doesn’t replace the need for fluoride. You see, fluoride contains hydroxyapatite crystals.  These tiny granules work to create a stronger, smoother surface on your tooth enamel and make your teeth less prone to tooth decay. Essentially, they strengthen weak teeth to make them more resistant to acids.

On the other hand, xylitol helps repel plaque by preventing it from accumulating on teeth to begin with. It doesn’t remineralize enamel that has already been coated with buildup. So, although both xylitol and fluoride can be used for preventative purposes, they serve two totally different goals. A lot of dentists and hygienists recommend pairing both of them together for optimal results. One repels the plaque, the other repairs the areas damaged by it (preventing dental caries before they start.)

Dental Products Products Containing Xylitol

Xylitol isn’t just in chewing gum and breath mints. You can also find it in things like toothpaste, mouth rinse, and oral sprays. Not all of them contain xylitol—particularly because you still have fluoride as a main ingredient—but they’re quickly gaining popularity.

The thing is, you don’t necessarily need dental products with xylitol in them to get the perks of this sugar substitute. Chewing a piece of gum might be just as good. Some dentists will recommend their patients use products with xylitol (such as gum) at least a few times per day. There have been proven studies that show xylitol exposure can significantly lower the amount of dental plaque in your mouth, and as such, it decreases your risk of tooth decay.

Just remember that even though xylitol interferes with dental plaque buildup, you can’t give up brushing and flossing. You still want to do those things daily. And if your toothpaste has xylitol in it, all the more power to you!

Warning! Xylitol Is Highly Toxic to Dogs

If you’re a pet owner, listen up. Just like you don’t want to feed your chocolate to your dog, you shouldn’t let them get a hold of anything with xylitol in it either.

In dogs, xylitol has been shown to be life-threatening causing liver failure or death when it is consumed in large amounts. Due to its harmful effects, it’s best not to share any foods containing xylitol with your dog—even in small amounts. As a general rule, always check ingredient labels of any products you feed your pet just to be sure they don’t contain xylitol. And if your pet accidentally gets access to such items, look for warning signs of vomiting, lethargy, weakness, etc. If you notice your pet acting weird and you think they maybe ate something with xylitol, contact your vet immediately.

Side Effects of Xylitol

The biggest potential side effect of xylitol (aside from being toxic to dogs) is how it affects your intestines. Xylitol just doesn’t “go down very well” to put it bluntly. Swallowing some here and there isn’t a big deal, but if you’re using it to bake a cake or completely substitute all of the sugar in a recipe, you’re going to notice. Shortly after everyone eats it, there’s probably a good chance that you’ll need to get out the Gas-X or Imodium. There’s just really not an easy way to phrase it. Your stomach is not going to be happy with you. If you’re only eating a little bit, you could be perfectly fine. More than that, you may start to notice a sour feeling in your stomach. But after a few big, hefty servings, you’re probably going to be staying home for a few hours.

Other Health Benefits of Xylitol

The health benefits of xylitol are not only limited to sugar-free chewing gum! Below are 7 health benefits xylitol may help with.

1. Ear infections 

You can find xylitol sprays at health food stores for other non-dental-related purposes. Such as applying xylitol in a drop form to the inside of your ear if you already have an ear infection. Researchers note that this method probably won’t help very much if it’s already past the eardrum and in your middle ear. However, recent studies show that taking xylitol lozenges beforehand may actually prevent ear infections before they start, particularly in young children. But it’s worth noting that the lozenge option doesn’t seem to help with treating ear infections after you already have a respiratory infection (it’s more of a preventative.)

2. Diabetes

Many diabetics are concerned about how xylitol impacts their blood sugar. The idea is that it raises it like regular sugar. That’s not the case. Usually, it doesn’t cause spikes in blood sugar levels since it has a low glycemic index. Your body absorbs it more slowly than regular sugar, which means a flatter insulin response after you’ve eaten it. If you already have problems regulating your blood sugar levels, check with your doctor before using xylitol.

 3. Upper Respiratory Infections

A recent 2019 study showed that xylitol in nasal sprays helped with non-allergy-related sinus congestion. There have even been some studies that suggest using xylitol can even decrease the spread of COVID-19. Since we already know that people with oral diseases like periodontitis are more prone to respiratory illnesses, pneumonia, and requiring a ventilator if they have COVID-19, and we take into account that xylitol physically lowers bacterial levels in the mouth, it’s easy to see how the connection is made. When you have fewer bad bacteria floating around in your mouth, there’s less of a risk for you to inhale them into your respiratory tract comprising your immune system.[3]

4. Anti Aging

Xylitol has been linked with anti-aging and skin benefits in some studies. One showed that when ingested, it promoted collagen production in the skin. Just remember what happens if you’re ingesting too much xylitol (hint: it involves the bathroom.) The good news is that what studies have been done so far seem promising. [4]

5. Gut Health

Despite the side effects, xylitol also has some good benefits for intestinal health—making it an important ingredient in certain dental probiotic supplements. For example, some research has found that supplementing with xylitol can help relieve symptoms of Irritable Bowel Syndrome (IBS) by promoting good gut bacteria when the dosing is performed correctly.[5]

6. Protective Against Osteoporosis

Studies have found that xylitol has a protective effect against osteoporosis. Osteoporosis occurs when bone density is low, and bones become more fragile and breakable. Researchers suspect that xylitol stimulates bone regeneration because of its effects on insulin levels. In the experiments that have been conducted so far, taking xylitol as a supplement showed slower bone resorption (dissolving). The older we get, our risk for developing osteoporosis increases, so supplementing with xylitol earlier could potentially help to avoid bone-related injuries as we age.

7. Yeast Infections

Xylitol also offers anti-fungal benefits. If you have “thrush” (a type of oral yeast infection) then using supplements with xylitol may improve your recovery or prevent recurring infections. If you’re experiencing symptoms, you might be able to treat your yeast infection with xylitol in conjunction with proper hygiene. Prefer to make your own xylitol mouth rinse? Start by dissolving xylitol (see packaging for dosing) in 8 ounces of water, then rinse with it once or twice a day.[6]

Talk To A Dentist

The majority of dentists love what xylitol has to offer to their patients. Why? Because it works. Your dentist may recommend specific types of xylitol supplements in conjunction with your home hygiene routine, depending on your particular oral condition. The closer you communicate with your dental team, the better long-term results you’ll see.

Dental Health Benefits of Xylitol

Studies show that using dental products containing xylitol daily, along with standard brushing and flossing, significantly increases both oral and overall health because of its antimicrobial properties. The benefits of xylitol in gum or lozenge form helps with plaque buildup, respiratory and ear infections, thrush, and more. But it doesn’t replace brushing and flossing! To make sure you’re doing everything you can to maintain healthy teeth and gums, talk to your dentist about which products are best for you.