Xylitol is a low-calorie sugar substitute derived from birch bark or corn cobs that was discovered by Finnish scientists during a postwar sugar shortage. Studies show xylitol reduces the risk of ear infections in children by 40% and helps maintain bone density in women who have had their ovaries removed. It has a low glycemic index of 7 compared to sugar's 100 and may help control blood sugar levels and weight. Xylitol inhibits plaque formation, creates an alkaline environment inhospitable to bacteria, and has cavity prevention benefits. The recommended daily dose is 6-10 grams through products like gum.

1. Xylitol- How Sweet It Is!

2. Brief History of Xylitol
• After World War II, the country of Finland was faced with a servere sugar shortage.
They had no supply of their own, so their scientists began to search for an alternative.
That is when they discovered xylitol, which is a low calorie sugar made from birch
bark or corn cobs.
• The Finnish people began using xylitol on a regular basis as a substitute for sugar.
As the years went by, it was noted that Finnish xylitol users had much improved
health.
• Since then, Russia, Japan, Germany, Italy and China have all been producing and
using xylitol , with obvious health benefits.
• It has not been used as much in this country because of the abundant and cheap
supply of cane sugar. (Sellman, 2002)

3. Sugar is the bad guy!
• It is estimated that Americans eat about 150 pound of sugar each year! No wonder
we have so many health problems.
• Those directly relating to sugar consumption include hypoglycemia, weight gain, and
diabetes. Sugar also leaches the body of vital minerals, raises blood
pressure, increases the risk of heart disease and increases bad cholesterol (LDL).
• It also contributes to tooth decay as well as periodontal disease.
• It has been shown to make it difficult for a child’s brain to learn and can cause
autoimmune and immune deficiency disorders like allergies, arthritis and asthma.
(Sellman,2002)
• With a list like this, we need to come up with a solution to solve our “sugar crisis”

4. • Xylitol has been studied extensively, especially
in Europe where it is used much more than in
the US.
• Being in the dental field, we think of xylitol as
combatting decay, but the following slides will
show some of the research done and other
benefits of xylitol.

5. Prevention of ear infections
(AOM)
• AOM (Acute Otitis Media) is one of the most frequent diseases of childhood. Many
children suffer needlessly, and xylitol has been shown to reduce the occurance of
AOM by 40%!
• In an article entitled National Survey of Pediatricians’ Opinions about and Practices
for Acute Otitis Media and Xylitol Use, the authors state:
• “The treatment groups were administered xylitol five times a day in chewing gum or in syrup
given after meals and snacks resulting in a daily cumulative dosage of 8 to 10 g/day of xylitol
while the control groups received a placebo.
The results at a high level of evidence from two high-quality double-blinded
randomized, controlled clinical trials, considered to be the “gold standard” of medical research
strongly suggest that xylitol is an effective prophylactic when administered to healthy children in
the specified dosages. Moreover, xylitol also appears to have few if any side effects, is easily
administered to and tolerated by young children, is a low-risk and low-cost alternative to
antibiotics and tympanostomy tubes when appropriate, and seems to be a prophylaxis worthy of
further investigation.” (Danhauer, et al, 2010)

6. Xylitol and Osteoporosis
• Another new (at least for us in the US) and exciting benefit from xylitol is the reversal
of bone loss in women who have had their ovaries removed. Without
ovaries, estrogen levels decrease and so does bone density. Xylitol was shown to
maintain bone density in these situations. It has also been shown to reduce age-
related bone loss. This study was done on rats, but shows conclusively that there is
increased bone density, which may lead to further use in aging humans.
(Mattila, Svanberg, & Knuuttila, 2001)
Fig. 2. Representative cross-
sectional views of the femur distal
metaphysis of an aged rat without
dietary xylitol supplementation (A)
and of an aged rat fed a xylitol-
supplemented (10%) diet (B)

7. • Diabetes has been on the rise since the mid-1900’s. This coincides directly
with our increased consumption of sugar. Studies show that excessive
sugar intake is the “single most important dietary risk factor for heart
disease in women and men.”
• Xylitol is very slowly metabolized. It is a natural insulin stabilizer and
therefore one does not get the ups and downs that one gets with sugar.
• The glycemic index of sugar is 100 while xylitol is a mere 7! (Sellman 2002)
• If we can’t convince our patients to use xylitol products for their teeth
perhaps we can educate them on the many other benefits that have been
shown. I think it is good that we know “the whole story” and not just that
relating to our profession of dental hygiene.

8. • As previously stated, xylitol use in Finland was directly correlated with
decrease in tooth decay.
• Tooth decay and periodontal disease are serious problems in today’s world.
It is estimated that 75% of American adults over the age of 35 suffer from
some form of periodontal disease. (Sellman 2002)
• As we all know, there are more problems related to periodontal disease
than just losing teeth and bone. These include increased risk of
stroke, heart attacks, pneumonia and emphysema.
• Eating sugar causes tooth decay by creating an acidic environment in the
mouth. This weakens the enamel, which leads to tooth decay or
demineralization.

9. (cont’d.)
• Xylitol reverses all these destructive effects!
• Xylitol :
– Is non-fermentable
– Cannot be converted to acids by oral bacteria
– Creates an alkaline environment which is inhospitable to oral
bacteria, especially Strep Mutans
– increases saliva flow
– Inhibits plaque formation (Sellman ,2002)
– Compliments fluoride in oral hygiene products
– Tastes good, with no unpleasant aftertaste
– Has one-third fewer calories than sugar- about 2.4 C/gram vs. 4 C/gram
for sugar. ( What is Xylitol?, 2010)
– May aid in weight control

10. • Many health food stores carry products containing xylitol. The
recommended daily dose for cavity prevention is 6-10 grams/day. Don’t be
fooled by products that are “jumping on the bandwagon” by putting xylitol in
their products. It needs to be one of the first ingredients and in large
enough quantity to do some good.
• Spry gum, a product of Xlear, is produced in Orem, Utah. Their gum
contains 0.72 g of xylitol per piece of gum. Thus, for the most benefit,
about 10 pieces of gum or mints should be consumed daily. One
speaker I heard recommended that a person (what child wouldn’t love this!)
have two pieces of gum or candy when they get dressed in the morning, two
after breakfast, lunch and dinner and two more when they get ready for bed.
• To contact Xlear for any of their products call (877) 599-5327 ( I don’t work
for them, I just love their products) If the order is over $100 you get
wholesale prices. Also, they are sometimes at conventions, where the
prices are even better.

11. • Xylitol has been shown to be fatal in dogs and cats.
• “ While xylitol consumption is considered safe in people, dogs
can develop serious, even life-threatening, signs from xylitol
ingestion. Xylitol's ability to cause hypoglycemia in dogs has
been recognized for almost 40 years, but a recent study has
found that xylitol also can cause acute hepatic necrosis.”
(Dunayer, 2006)
•

12. Side effects and warnings
• The only side effect noted for humans was that in high dosages 30-
50 grams (that’s a lot of gum!) it may cause gastrointestinal
problems such as nausea, bloating and watery feces. (Story, Lee
Bornet and Brouns, 2007)

13. References
• Danhauer, J., Johnson, C., Rotan, S., Snelson, T., & Stockwell, J. (2010). National Survey of
Pediatricians' Opinions about and Practices for Acute Otitis Media and Xylitol Use. Journal of the
American Academy of Audiologists , 329-346.
• Dunayer, E. (2006). New findings on the effects of xylitol ingestion by dogs. Veterinary Medicine .
• Mattila, P., Svanberg, M., & Knuuttila, L. (2001). Increased Bone volume and Bone Mineral
Content in Xylitol-Fed Aged Rats. Gerontology , 300-305.
• Sellman, S. (2002, Sep/Oct). Xylitol- Our Sweet Salvation. Total Health .
• Story, D., Lee, A., Bornet, F., & Brouns, F. (2007). Gastrointestinal tolerance of erythritol and
xylitol ingested in a liquid. European Journal of clinical Nutrition , 349-354.
• What is Xylitol? (2010). Retrieved February 8, 2011, from Dentist.net:
http://www.dentist.net/xylitol.as