Xylitol and Oral HealthTooth decay and gum disease are serious problems. According to the American Dental Association, 75 per cent of American adults over the age of 35 suffer from some form of periodontal disease.1 Needless to say, diet plays a major role in dental heath. When there is an excess of sugar in the diet, this weakens the immune system and creates an acidic environment; thus oral health suffers. The mouth is home to over 400 strains of bacteria. Most of these are benign, but when sugar enters the scene it feeds the destructive strains, allowing them to proliferate.
Periodontal disease is basically caused by bacteria. These deposits permit the growth of bacteria that cause inflammation of the gums. The bacteria also release minute amounts of toxins that break down gum tissue, thereby helping the infection to progress. Plaque is an invisible, sticky film of saliva and food residue that constantly forms on the teeth. Ongoing low-grade bacterial infection also burdens the immune system.
Bacteria help to create plaque and they also thrive within it. Unless removed, plaque formed along the gum line can lead to gum disease. When left untreated, plaque at or below the gum line hardens into tartar. Periodontal disease takes two forms: simple gum inflammation, called gingivitis; and a more severe gum infection, called periodontitis, which may lead to tooth loss and receding gums.
Gingivitis results from the build-up of plaque and tartar which irritate the gum or periodontal tissue. The more advanced state of gum disease, periodontitis, occurs when inflammation of the gums is accompanied by bone and ligament destruction. Bleeding gums are usually the first indication that gum disease is developing, but obvious symptoms may not always be present.
Gum infection can also lead to other serious health problems. It doubles the risk of stroke, triples the risk of heart attack, increases the incidence of premature, low-weight babies and also contributes to bronchitis, pneumonia and emphysema. In fact, the same bacteria that cause gum disease end up either directly or indirectly infecting your heart and arteries. A study conducted at the University of Minnesota in 1998 found that rabbits injected with tooth plaque developed blood clots which led to heart disease.2 It seems that the bacteria first attack the bones and gums in the mouth and then enter the bloodstream through small cracks in the gums.
Eating sugar causes tooth decay by creating a highly acidic condition in the mouth. Acidity strips tooth enamel of minerals, causing it to weaken and making it more vulnerable to attack by bacteria, leading to tooth decay or demineralisation. Ordinarily, saliva bathes the mouth with an alkaline solution that neutralises all acidity and actually remineralises the teeth. Saliva also washes away leftover bits of food and helps the digestion process. But when saliva turns acidic because of too many sweets, bacteria in the mouth have a feeding frenzy. These nasty bacteria, along with carbohydrate waste, stick to the teeth and tongue and hold the acid close to the teeth where it eats away enamel. Virtually whatever food you ingest, the remaining particles become food for plaque-producing bacteria. Using xylitol helps to raise plaque pH, thereby reducing the time that teeth are exposed to damaging acids as well as starving harmful bacteria of their food source.
Xylitol is a dentist's dream. It reverses all these destructive effects of sugar on oral health. Xylitol is non-fermentable and therefore cannot be converted to acids by oral bacteria, thus it helps to restore a proper alkaline/acid balance in the mouth. This alkaline environment is inhospitable to all the destructive bacteria, especially the worst variety, Streptococcus mutans. It also inhibits plaque formation.
Using xylitol right before bedtime, after brushing and flossing, protects and heals the teeth and gums. Unlike sugar, it can even be left on the teeth overnight. With proper use, xylitol actually stops the fermentation process leading to tooth decay. Long-term use suppresses the most harmful strains of oral bacteria, making a long-lasting change in those bacterial communities. Xylitol even has the ability to enhance the mineralisation of the enamel. It is most effective in treating small decay spots. Although larger cavities won't go away, they can harden and become less sensitive.
Consistently using small amounts of xylitol tends to increase protective factors in saliva. Xylitol stimulates saliva flow and helps keep salivary minerals in a useful form. Prolonged xylitol use increases the buffering capacity and protective factors in saliva. Increased saliva production is especially important for people suffering with a dry mouth due to illness, ageing or drug side-effects.
Since the oral environment becomes less acidic with continued xylitol use, it is advisable to chew xylitol gum or suck a xylitol mint after every meal or after eating sweet snacks. The best news is that studies have shown that xylitol's effect is long-lasting and possibly even permanent.
Xylitol has recently received positive support in the Journal of the American Dental Association. "Xylitol is an effective preventive agent against dental caries ... Consumption of xylitol-containing chewing gum has been demonstrated to reduce caries in Finnish teenagers by 30&endash;60 per cent. Studies conducted in Canada, Thailand, Polynesia and Belize have shown similar results..."3 A study conducted at Harvard School of Dental Medicine concluded that "xylitol can significantly decrease the incidence of dental caries".
Another unexpected benefit came from a Finnish study which showed that children whose teeth are colonised between 19 and 31 months of age by Streptococcus mutans bacteria are more likely to have a large number of cavities. Most children acquire this bacteria from their mother's saliva through food tasting, sharing cups and kissing. The study showed a dramatic 70 per cent reduction in tooth decay among children whose mothers chewed xylitol gum.
Xylitol, however, isn't just for the young. In a paper published in the Journal of the American Geriatrics Society, researchers tested 111 adults aged 60 and older over a 12-month period. All were frail but healthy adults. In the study, one group of volunteers chewed no gum, a second chewed gum containing xylitol, and a third group chewed gum containing both xylitol and an antimicrobial. In the two groups receiving gum, the participants chewed two pieces for 15 minutes, two times per day. At the end of the study, the researchers reported that the group who received xylitol gum had substantially lowered their risk of developing thrush, a fungal or yeast infection that can cause mouth soreness. (The group who received xylitol plus the antimicrobial had equal benefits.) It had also reduced their risk of developing angular cheilitis, a condition in which sores develop in the corners of the mouth. The researchers noted that xylitol gum can provide a "real clinical benefit" to frail, elderly people.
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