XYLITOL: The Health Benefits in Dentistry By Shirley Gutkowski, RDH, BSDH, FACE L ong ago at the beginning of the last century, the people of Finland found themselves isolated. World War I had blocked the transportation of staples from other countries. Finlan- ders were forced to find substitutes for things like cane sugar, and they used xylitol. Once the transporta- tion lanes were again open, sucrose was once more used to the delight of the people of Finland. Although xylitol measured the same and tasted the same as sugar, they wanted to be like the others, they wanted to fit in and use sugar for their sweetening agent. After a few years, the dental decay rate in Finland was notice- ably decreasing in one group and increasing back to the old normal in the younger age groups. Actuar- ial researches found the deciding factor to be the use of xylitol during that dark period in Finland’s 36 May/June 2010 JAOS history. Study after study on this finding has proven them to be right —- xylitol reduces the dental decay rate.1, 2 Articles about xylitol usually start with a mention made about the 5 carbon structure. If you know that regular sugar is a chain of 12 carbon atoms, that detail still doesn’t say much. You’ll also hear xylitol referred to as a sugar alcohol, which is another confusing factoid. You could eat a pound of xylitol and not feel intoxicated, even if you ate it all in 15 minutes. The alcohol in the name is a chemistry notation refer- ring to a little OH molecule hanging off the side of the chain of carbon molecules. None of that will matter when you speak to your patients. The Exciting Beginning The real beginning of the xylitol conversation with patients starts with xylitol as a natural sugar that is manufactured by the liver as a function of carbohydrate metabolism. The xylitol sugar you can get at the store (in candy or gum) comes from plants. It is not created in a lab with beakers of chemicals, xylitol is all natural. Almost all plant cells contain a component called xylan which accounts for much of the plant cell walls in wood and grasses, corn and bamboo, being two plants in the grass category. The manufacturing process takes plant pulp from corn, coconut shells or wood from hardwood trees, and then converts the xylan to xylose, glucose and various other components. The xylose then is treated to extract xylitol. You’ll need to know this to assuage the angst patients have over sugar substitutes. Xylitol is not a sugar substitute, it is a sugar derived from plants. XYLITOL: Xylitol is a very hot topic in dentistry today. Since the majority of research (over 50 years worth) is done in Europe, acceptance in the American dental market has been slow. Most dental professionals know xylitol is a sugar, not a sugar substitute.
Journal of the American Orthodontic Society May-June 2010: Page 36
