Tooth Decay: The Natural Sugar With Proven Benefits In Reducing Tooth Decay And Plaque Build-Up

Now it's official. Chewing gum is good for you. In fact, chewing the right kind of gum is one of the best things you can do to promote oral health.

HSI Panellists have been reviewing exciting new research into a natural alternative to sugar - xylitol - present in a number of health products, most notably Orbit sugar-free gum. Their conclusion is that xylitol provides some incredible health benefits, particularly its ability to help maintain good oral hygiene.

Xylitol is a sugar that occurs naturally in many fruit and vegetables but, for commercial purposes, it is mainly derived from wood. Silver birch has a very high yield of xylose, which is the sugar precursor of xylitol (a hydrogenated, more stable form). For this reason, xylitol is known as birch sugar in some countries.
Research shows that xylitol is extremely effective in helping to prevent both tooth decay and harmful plaque from building up on your teeth.

Xylitol prevents harmful bacteria from releasing acid that destroys your teeth
Xylitol's ability to protect gums is due to the fact that, unlike most natural sugars, it contains 5 carbon atoms per molecule instead of 6.

'5-carbon sugars are not that common in nature, so when types of oral bacteria try to break down xylitol, they find they are unable to process it. It 'blocks' them up and has an inhibiting effect on their activities,' according to Nicholas Dunning, business director of Danisco Sweeteners, a company that makes xylitol.

It's well known that consuming large amounts of sugar greatly increases your risk of tooth decay. This is because oral bacteria thrive on sugar. The main culprit is a bacterium called Streptococcus mutans.

This bacterium consumes sugars and excretes acid into your mouth, which is what damages your teeth and causes decay. Fortunately, xylitol is especially effective against Streptococcus mutans.

In addition, clinical studies have shown that xylitol has a long-term protective effect against tooth decay - its effects persist long after you have chewed gum. 'It seems that xylitol modulates the oral bacteria to make them less virulent,' Mr Dunning adds.

Xylitol can lower your risk of tooth decay by up to 60%
The latest and most impressive findings into xylitol's health benefits, follows a study conducted by Dr Catherine Hayes of the Harvard School of Dental Medicine in the US. She reviewed all the published evidence accumulated over 30 years on sugar substitutes and dental caries [tooth decay].

Her analysis of the data found that there was a consistent decrease in dental caries, ranging from 30 to 60 per cent, among participants using sugar substitutes, as compared with participants in a control group. The highest reductions in dental caries were observed in those participants using xylitol.

Dr Hayes concluded: 'Since the evidence suggests a strong protective effect of xylitol, it would be unethical to deprive people of its potential benefits. xylitol can significantly decrease the incidence of dental caries.'1

One research paper reviewed by Dr Hayes detailed a Finnish study of 11- to 12-year olds. It found that those using a xylitol gum had 53 per cent less tooth decay.

Chew your way to clean and healthy teeth
Obtaining your xylitol from chewing gum is, in the opinion of many experts, the most effective means of preventing tooth decay. This is because chewing is itself a natural mechanism for ridding your mouth of harmful acids. It stimulates your saliva production and increases oral pH (makes your mouth environment less acidic).

'Use of xylitol also reduces plaque build-up,' says Mr Dunning. 'Strep. mutans normally excretes a polysaccharide matrix that facilitates plaque sticking to individual teeth. Xylitol decreases the adhesivity of the matrix, meaning that plaque becomes less stable and more easily removed.'

Studies have shown that consumption of approximately 3g-10g a day of Xylitol can substantially reduce caries. This is the amount you would get from chewing one or two packs of xylitol gum a day.

Xylitol could reduce childhood ear infections by as much as 40%
With its powerful antibacterial action, xylitol also has an important contribution to make in reducing the incidence of acute otitis media (middle ear infections). Young children are particularly susceptible to recurring ear infections, which doctors typically treat with repeated courses of antibiotics that can soon overload a child's system.

Steptococcus pneumoniae bacterium are a major factor in these infections, but the structure of a child's ear also plays a part. In a child, the ear canal tends to lie at less of an angle than it does in an adult and so doesn't drain to the back of the throat as well. This allows an accumulation of infective pus, prolonging infection and blocking up the canal.

According to a recent study, xylitol not only inhibits Strep. Pneumoniae, it also reduces the adhesivity of the infective pus and helps it to drain away.2

A study of children regularly using xylitol (in gum, lozenge and syrup forms) has already shown that xylitol can reduce the occurrence of ear infections by up to 40 per cent.

The research focused on whether the presence of xylitol made a difference to the incidence of ear infections, rather than the mechanism involved - which is still unknown. However, xylitol appears to be carried in saliva from the throat to the ear (via the eustachian tube) more easily in infants than in adults. And, as mentioned, xylitol is effective in inhibiting bacteria and reducing their adhesiveness.

How to benefit from xylitol
Xylitol has the same sweetness as sugar but only 60 per cent of the calories. For this reason, in some countries, xylitol is not only used in chewing gums and toothpastes but also in confectionery.

Xylitol has been approved by the WHO's Joint Expert Committee on Food Additives and has been passed as safe by the EU. It has also been approved by the former Ministry of Agriculture, Fisheries and Foods in the UK. It has no similarity to aspartame.

In addition, Xylitol is safe for diabetics to use. This is because it is metabolised independently of insulin and doesn't trigger the pancreas to release insulin into the blood supply.

Products that contain xylitol include: Boots dental gum and dental mints, a range of Orbit chewing gums, Tesco mouthwashes, Totalcare Fresh Breath Spray from Superdrug, and a wide range of toothpastes.

1. Dr Catherine Hayes (2001) The Effect of Non-Cariogenic Sweeteners on the Prevention of Dental Caries: A Review of the Evidence. Journal of Dental Education, Vol 65, No 10.
2. Uhari M, Kontiokari T, Niemela M (1998) A Novel Use of Xylitol Sugar in Preventing Acute Otitis Media. Pediatrics, Vol 102, No 4