It’s hard to grasp the idea that chewing gum and eating candy, which are typically considered “bad” for your teeth, can now be beneficial when Xylitol is the sweetener. This goes against conventional wisdom, but it’s true. Xylitol is the “good sugar” that now makes it possible to treat dental disease with candy and chewing gum.
We now know that chewing xylitol based gum four to five times a day, after meals and snacks, will reduce plaque biofilm accumulations. According to research, eating xylitol sweetened candies over a four day period with no oral hygiene leads to a 50% reduction in plaque. Recommending candy and gum as a first line approach to the prevention of decay and periodontitis rather that focusing on toothbrushing may seem like a stretch, but when you look at the evidence, you will likely get better results with xylitol than with brushing.
Caries (dental decay) research shows that the addition of xylitol several times each day can result in the reduction in the need for restorative care by 70% compared to controls. This level of caries reduction is also seen when mothers chew xylitol based gum which changes the oral flora they pass on to their children.
Just how xylitol works to accomplish these impressive clinical results is interesting. It has to do with the cell wall transport system of the bacteria in dental plaque and the chemical structure of xylitol. Xylitol is a 5 carbon sugar compare to the 6 carbon structure of most other sugars. This smaller structure allows the xylitol molecule to easily enter the outer cell membrane of the bacterium but is not allowed through the inner cell membrane because the cell does not recognize it as a nutrient source. The cell must therefore expend a considerable amount of valuable energy to pump the xylitol molecule back out of the cell. Repeating this pumping action over and over expends so much energy that the cell is essentially exhausted and does not have enough energy for normal metabolism which produces acids and plaque components. Further research may reveal that xylitol has other effects on cell metabolism that contribute to its effectiveness as a plaque reducer.
Who would have thought that gum or candy could be so good for our dental health?!