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xylitolXylitol – a sugar alcohol that may actually help fight tooth decay – isn’t quite the silver bullet some have touted it to be.

Though a recent study found some positive results in using xylitol lozenges, there’s not too much to write home about. Following up on earlier research, this study aimed to see if xylitol had different effects on different tooth surfaces (e.g., the biting surface, roots and so on).

Participants in the xylitol arm developed 40% fewer root caries lesions…[but] there was no statistically significant difference between xylitol and control participants in the incidence of smooth-surface caries, occlusal-surface caries, or proximal-surface caries. (emphasis added)

cariesCommon in older adults, root caries (“caries” is the clinical term for cavities) involves decay on exposed root, where gum tissue has receded due to brushing too hard or too much, chronic bruxing (clenching and grinding) or other factors. That sucking xylitol lozenges helps prevent them is a good thing: 40% is significant, and it certainly wouldn’t hurt to use them as an adjunct to regular brushing and flossing.

Then again, we might ask: Is it really the xylitol? Studies of xylitol-sweetened gum have suggested that saliva may actually make the difference. As a paper published in Community Dentistry and Oral Epidemiology put it, “The results indicate that the caries preventive effect of chewing sugar-free gum is related to the chewing process itself.”

Why saliva? It has several roles in preventing caries:

buffering capability; the ability. . .to wash the tooth surface, to clear bacteria, and to control demineralization and mineralization; saliva’s antibacterial activities; and perhaps other mechanisms all contribute to its essential role in the health of teeth.

Clearly, promoting saliva is beneficial to your oral health, and both chewing and sucking increase its flow.

There’s also an inherent danger in exalting any one substance as beneficial. We may misread the claims and see that product as a quick fix or a viable alternative to the tools we know will help us stay healthy. We can’t fall victim to the “health halo” effect and assume all things xylitol will be good for our teeth.

Also keep in mind that xylitol is a sugar alternative, so may sustain our natural preference for sweets. Feeding it may only beget eating more sugar and sweeteners of all kinds. Sugar, in turn, may encourage us to eat more food beyond overall because, in the words of one research paper, “chronic consumption of sugar blunts activity of pathways that mediate satiety.”

Xylitol lozenges or gum alone are just not enough to prevent caries. Even pro-xylitol dentists believe you need to practice good oral hygiene to maintain good oral health. Instead of looking for a panacea, just hang on to that toothbrush, toothpaste, and floss – and use them! Regularly!

Xylitol image by HeatherMG, via Flickr;
caries illustration by Nerdture, via Wikimedia Commons

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