What is it?
Xylitol (pronounce the “x” like a “z”) is a natural sweetener that has 40% fewer calories than regular sugars. Although it tastes the same to humans, it has a different chemical composition than other sugars (sucrose, glucose, fructose, corn syrup, etc.), making it unrecognizable as a “food” to the oral bacteria that causes decay.
Why haven’t I heard of xylitol before?
There has been a lack of communication in this country that is inexplicable considering its positive dental effects, but that is slowly changing.
Is it safe?
Yes, and its use was approved by the FDA (Food and Drug Administration) in the 1960’s. It is safe for virtually everyone – even diabetics. Pregnant women can take it too (in fact, it will benefit the oral health of the unborn baby). Once swallowed, it is metabolically processed naturally by the human body.
So, what are the advantages in taking Xylitol?
• It has been shown to have a positive, protective effect by selectively targeting the specific bacteria that causes decay. Xylitol does away with these bad bacteria by interfering with the bacteria’s ability to recognize it as a food, even though it tastes sweet to us.
• It increases and stimulates salivary flow, which is very healthy!
• Xylitol restores the pH of the mouth to basic levels. Bad bacteria thrive in an acidic mouth and cannot tolerate an alkaline (basic) environment.
• Xylitol shifts the bacterial makeup of your mouth away from an imbalance of decay-causing bacteria to bacteria associated with health.
• The benefits of xylitol are NOT dependent on eliminating other sugars from your diet. There is simply no need to change the way you eat. Finishing any food intake with xylitol will eliminate acidity in the mouth and provide you with the above mentioned benefits.
And how much should I take?
• To be specific, 6-10 grams of xylitol is recommended for daily consumption for the best anti-bacterial effect.
• Multiple exposures on any given day is preferable to ingesting all 6-10 grams at one time.
• It is also preferable to let it dissolve in your mouth rather than chew it up. The longer xylitol sits in your mouth, the more damage it can do to the cavity-causing bacteria. If you don’t normally let mints dissolve (you are a “biter”), still use and enjoy it – any exposure to xylitol helps.
• Xylitol comes in mints and candies. They usually have about 0.5 grams of xylitol per piece (if 100% xylitol sweetener is used). Xylitol also comes as a gum, which usually has 1 gram per piece. Xylitol can also be obtained in a granular form; when used as a sugar substitute, one teaspoon of it has 4 grams.
What else do I need to know?
• Expect your new xylitol habit to cost you about $.50 to $1.00 a day - an inexpensive insurance policy for dental health!
• Culver Ridge Dental recommends using xylitol every day for the rest of your life! We do not have any affiliation with any company that manufactures, distributes or sells xylitol.
Are there any potential problems if I use xylitol?
• The vast majority of patients have no adverse side effects from using xylitol. That being said, xylitol does cause some people to get an upset stomach when they first start using it. When one is not accustomed to xylitol, it may also have a mild laxative effect during this initial introduction simply because it is absorbed slowly in the digestive tract, but this rarely occurs. However, if it does happen to you, do not be surprised. Do not shy away from using it – its health benefits far outweigh the small chance of initial sensitivity. As your body gets familiar with it, these effects will subside.
• Xylitol should be kept away from dogs. It is toxic to them. Before you get overly concerned (that if it’s not good for your pet, it might not be good for you), remember that chocolate is also toxic to dogs and most of us certainly don’t avoid chocolate just because our dogs can’t eat it!
I strongly urge you to make the use of xylitol a priority in your life!
If you're interested in brighter, stronger teeth, then you need to be sure to make fluoride and brushing a regular habit, morning and night.
An over-the-counter fluoride rinse freshens your breath, tastes good, strengthens your teeth, and does not burn... overall, it is REALLY good for you. Fluoride is most effective when it can remain, topically, on the surfaces of your teeth. Do not rinse, eat, or drink for 30 minutes after using for maximum benefit. This should be in your cabinet for use daily. It can only help.
The reason dentists suggest brushing for two minutes is not just for thorough cleaning, but also to allow a full two minutes of fluoride contact with teeth. Fluoride, applied topically, is the best way to deliver its positive benefits.
However, none of these suggestions will work if you don't do an adequate job of removing plaque. Take responsibility to do it right. Brush the gumline. Hit all surfaces. Brush for two minutes. Look closely in a mirror. If you still see plaque, you need to do better.
Sonic toothbrushes can be a great addition to your oral routine. A built in two minute timer and the sonic vibrations enhance the effectiveness of the brush, and can make up for shortcomings in your brushing technique. When combined with a good fluoride toothpaste and rinse, you'll be well on your way to stronger, healthier teeth.
The following is our recommended over-the-counter regimen to decrease dental sensitivity. This regimen was formulated by my colleague, Dr. Ellie Phillips, and I have found it to be far and away the most effective method for controlling sensitive teeth (and improving oral health in general).
Here are the steps:
1. Floss. We all know regular flossing is tremendously important. Of course, there are those who will never floss. If you're not a flosser, please don't write off the rest of this regimen. Just skip this step and go to step #2.
2. Closys Rinse. Rinse for 30 seconds with Closys rinse. Closys can be reliably located at Walgreen's and CVS pharmacies, and is easily obtained online. This step that kills bacteria and restores pH to neutral levels, making it safe to brush.
3. Brush. Brush your teeth with regular toothpaste for two minutes. By REGULAR, I mean no special "marketing" claims – no tartar control, no whitening formula, no special flavorings. These ingredients may make your toothpaste more abrasive, which can worsen sensitivity. Just find a basic paste or gel, and use it for two minutes. (Hint: time yourself... most people are not brushing for two minutes!) Make sure you brush all surfaces of the teeth, concentrating where the tooth meets the gum, on both the outside (cheek side) and inside (tongue side).
4. Listerine Rinse. Rinse for 30 seconds with regular Listerine (no tartar control, no fluoride added, no extra additives, as some Listerine products have; just one of the five or so flavors that are labeled "antiseptic"). This may burn; you can rinse out with water to quell this burn. This step kills bacteria and acidifies the mouth, priming it for...
5. Fluoride Rinse. Rinse with fluoride for a minimum of one minute. Fluoride works on teeth TOPICALLY. This means it has to be in contact with teeth; it cannot be swallowed like a medication (actually, swallowing fluoride is unhealthy, avoid swallowing any fluoride products). If you have the time, you can rinse for much longer than one minute. It will strengthen your teeth more effectively the longer it is in contact with teeth. Once you spit the flouride out, DO NOT rinse, eat or drink for 30 minutes. This allows a thin film of fluoride to stay on the teeth, and the advantages of fluoride will continue to work for you.
WHY IT WORKS
The science behind why this works is simple and logical, and it all relates to managing the pH levels in your mouth.
The first Closys rinse kills bacteria (most rinses will), but more importantly, it restores the pH in the mouth to neutral levels. This is critical, because the mouth can often be acidic, which is bad for teeth and favorable to harmful bacteria. Also, if the pH is acidic, teeth will be slightly softened, so that when they are brushed microscopic layers of tooth structure are eroded, making sensitivity worse.
Once pH is restored to neutral, you can brush safely. Follow this with another rinse to kill more bacteria, but also to acidify the mouth. This seems counter-intuitive (acidity is bad in the mouth), but an acidic oral environment actually facilitates the uptake of fluoride into the tooth structure, leaving a stronger, more decay-resistant tooth, which is less sensitive.
Hopefully, within a couple of weeks, you'll start to notice a significant decrease in your sensitivity. If not, seek professional advice. You may have an infection that is simply too entrenched and resistant to the modest effects of this over-the-counter regimen. There are other solutions that absolutely will work for you, but they require prescription products under the guidance of a trained dentist.
1. If you take any medications at the same time as your oral care routine, TAKE THEM BEFORE starting this regimen. That way, you don't have to swallow meds with water, flushing out the fluoride.
2. For your night-time routine, do it right at bedtime. When you sleep, your saliva production decreases, and the fluoride will be even more effective at strengthening your teeth.
3. In the morning, do either after you eat breakfast, so you can avoid rinsing, eating and drinking for 30 minutes, or do it a half hour before eating, so you can allow the full 30 minutes of fluoride effectiveness before eating.
4. Doing this regimen two times a day increases the speed with which it will work. And notice how clean your teeth feel!
While this regimen may not work for absolutely everyone, it does work better and more consistently for more people than any other over-the-counter anti-sensitivity regimen or product I have encountered. The challenge is to follow all the steps in the regimen, conscientiously and consistently.
It is so easy to challenge oneself to be better, but it is harder to follow through and actually do it. This also applies to improving oral health. But with persistence and knowledge, shifting the balance in one's mouth is actually very simple and attainable. And you will enjoy the rewards of a stronger, healthier smile for years to come.
People who have inadequate salivary flow (a common side effect of medications, but also can be due to radiation therapy, diseases, or for genetic reasons) find it difficult to impossible to create enough saliva to buffer the mouth's acids after eating, leading to an acidic mouth. Acidic mouths favor and harbor unhealthy bacteria.
If your mouth is often dry, make a homemade solution consisting of eight ounces of water, one teaspoon of baking soda, and two to three teaspoons of granulated xylitol (four grams of xylitol in one teaspoon). Flavor oils (easily purchased) can add flavor as you like. Then sip as needed throughout the day. Notice how it coats and soothes. It may not taste great, and nothing replaces natural saliva satisfactorily, but this is one option that is inexpensive, works moderately well, and creates a more favorable oral balance.
Dr. Marc Rossow, DDS
2971 Culver Road
Rochester, NY 14622