Xylitol is a natural, low-calorie sugar substitute that has been approved and used during
the last few decades. Chemically, xylitol, is a pentitol (five carbon polyol) or as they are
alternatively called a sugar alcohol. It is produced mainly from birch and beech wood and
this is the reason that xylitol is alternatively called birch or wood sugar. Xylitol has the
same organoleptic properties as sugar, meaning that it looks and tastes like sugar, however
it has a number of advantages over sugar. One of the main advantages is that it inhibits the
creation of dental caries.
The first evidence of xylitol’s beneficial effects in preventing dental caries came from a
study conducted in Finland that was published during the seventies. After the publication
of that study, several clinical trials have been performed to evaluate the potential
beneficial effects of xylitol in dental care. Today, we have enough evidence to say with
confidence that the use of xylitol, and especially the substitution of sugar with xylitol
has beneficial effects for dental health.
The mechanisms through which, xylitol exerts these beneficial effects are both direct and
indirect. First of all xylitol is not fermentable by the bacteria that inhabit the oral
cavity, in contrast with sugar. That means that by substituting sugar with xylitol the
bacteria that are responsible for the creation of dental caries are deprived from one of
their main sources of energy.
In addition to that, one of the main reasons that the consumption of sugars and
carbohydrates cause dental problems is that they reduce the pH of the mouth causing enamel
demineralization. The consumption of xylitol on the other hand has the exact opposite
effect, it raises the pH of the mouth, protecting tooth enamel from demineralization. It
should also be noted, that since the pH of the plaque is not reduced by the consumption of
products sweetened with xylitol, remineralization is promoted.
Another important attribute of xylitol is that it has bacteriostatic effects. That means
that xylitol inhibits the growth of bacteria like mutans streptococci, that are the main
culprits for the creation of plaque and dental caries. This effect of xylitol is attributed
to the fact that when these bacteria take up xylitol it is converted to xylitol-5-phosphate
which results in the formation of intracellular vacuoles and the degradation of their cell
Finally, a few recent studies have demonstrated that the habitual consumption of xylitol products and to be more precise habitual chewing of xylitol gum by the mother can have a
preventive effect for their children dental health. This is attributed to the fact that xylitol consumption by the mother can reduce the mother to child transmission of bacteria that are responsible for dental problems.
All the above make xylitol a very attractive sugar substitute. Especially since it’s natural
and it doesn’t have any known side effects. The most common way of consuming xylitol is by
chewing xylitol sweetened gum. However, any xylitol sweetened product will have almost the same beneficial effects.