Xylitol, effective protector and antibacterial agent

What is xylitol

Xylitol is a sugar alcohol extracted from birch trees, corn cobs, sugar cane, or various fruits and vegetables. Therefore, we can find it in nature, and for the same reason, our body also produces it on its own during metabolic processes.

Xylitol was first linked to dental care in 1970, when its benefits for oral hygiene were studied by the University of Turku; the "Turku Sugar Studies" was the first study conducted on humans.

Since the benefits of xylitol have been known, it has been used as an alternative in many hygiene and food products. Unlike other ingredients, xylitol is considered safe in Europe, so there are no restrictions on its use as an additive. Furthermore, it can be seen labeled on European Union products as E967.

Properties

• Anti-cavity action
• Enamel protection
• Prevention of osteoporosis
• Increases collagen production
• Improves the digestive system
• Stimulates saliva production and its defense mechanisms
• Controls the pH of saliva and dental plaque
• Slows demineralization and promotes remineralization
• Facilitates vitamin B absorption

Cavities, a common problem

One of the great properties of xylitol is its ability to reduce the appearance of cavities and to fight them once they have formed. These appear due to not properly cleaning up food debris (sugars and starches), which serve as food for bacteria in the mouth. If not removed, the bacteria ferment them and immediately create plaque on the teeth, which can only be removed by professionals.

Image 1. Tooth with a cavity

Once the plaque is created, the bacteria eliminate tooth enamel by producing acids, thus causing cracks on the surface of the teeth. As can be seen in the image, the cavity penetrates from the surface until it reaches the interior, to the dentin, where the damage is greater. One of the symptoms that occurs when it reaches this area is dental sensitivity.

If this problem is not addressed, the cavity penetrates even further until it reaches the dental pulp, where the nerves are located.

As the acids and bacteria arrive, this area becomes inflamed, causing pain as it nears the bone. This problem is aggravated if bone loss begins, including the possibility of reaching the rest of the teeth and acting on them as well.

How do traditional toothpastes work to reduce cavities?

You already know that there are many harmful substances used in our cleaning products. Here is how they are used in oral hygiene:

• Parabens: used as a preservative in toothpastes.
• Artificial sweeteners: the most important part of these sweeteners is not their calories or the danger they pose regarding cavity formation, although that is also a factor. It must be taken into account that there are two very frequently used ingredients: saccharin and aspartame. What happens with these? When used together, they result in a kind of "poison," methanol, produced by the reaction of the acids that both generate.
• Triclosan: used as an antibacterial and preservative. It is ideal because its effect is noticeable, although it is also dangerous for the environment and the endocrine system.
• Diethanolamine: its use is purely for marketing, as there is a social myth that believes a hygiene product that produces foam cleans better. Today, we know scientifically that this is not reliable and that the only thing that produces foam in commercial products are toxic chemicals.
• Formaldehyde: this is used as an antibacterial and as a cleaner after eating.
• Paraffin: it is used to achieve the texture that was marketed when toothpastes first began to appear.

And the most used ingredient: fluoride, a substance under regulation due to its toxicity in non-recommended doses. Currently, its quantity is measured in ppm because it is used in small doses, so a toothpaste with 1,500 ppm or more of fluoride could not be on sale for everyone. Although its use is recommended for people with a tendency to suffer from cavities, we believe it is essential to reinforce certain oral hygiene habits before rushing to use toxins as a solution, which could lead to dental or skeletal fluorosis in the long term.

Today it is known that there are other types of natural ingredients that can achieve even better results. For example, in In vitro activity of xanthorrhizol against Streptococcus mutans biofilms (2005) by Y. Rukayadi and J.-K. Hwang, it was demonstrated that when exposing the Streptococcus mutans biofilms bacteria to xanthorrhizol (turmeric extract) and chlorhexidine for 1 hour, both had almost the same result.

However, it is notable that the use of chlorhexidine is not safe in high concentrations, so the best option is definitely the use of natural ingredients.

Xylitol becomes the best alternative

We have already talked about its properties, but let's explain it better. This sugar does not act like other sugars, as it is not as easily fermented, which helps to reduce and avoid cavities. It also balances oral pH, thereby reducing gingival inflammation and increasing salivary flow, which allows for proper cleaning and the repair of tooth enamel. It also helps to decrease oral candidiasis due to its ability to break the bacteria's reproductive chain.

In other words, xylitol has the ability to reduce the appearance of cavities (between 30-80%). But that is not all; it also has the power to reverse those that have already formed, given that the saliva it stimulates is alkaline. If the pH is greater than 7, calcium, together with phosphorus salts, begins to regenerate the damage caused by bacteria. And this does not only happen when xylitol is consumed, but also in the long term, even if it has not been ingested in years.

This anti-cavity effect can be enhanced with the use of natural essential oils such as peppermint, lime, or cinnamon. In the study In Vitro Anti-Cariogenic Plaque Effects of Essential Oils Extracted from Culinary Herbs (2020) by Kornsit Wiwattanarattanabut, Suwan Choonharuangdej, and Theerathavaj Srithavaj, the anti-cavity and plaque reduction effect was studied using these against the S. mutans biofilm bacteria.

After 24 hours of exposure, only 25-40% of the bacteria reproduced compared to the previous day, which undoubtedly proves that essential oils are very effective against this problem and that when combined with xylitol, the results improve.

Image 2. Benefits of using xylitol

According to Chunmuang Jitpukdeebodintra in their study Effect of xylitol and fluoride on enamel erosion in vitro (2011), enamel was exposed to orange juice (acidic and sweet) and then to xylitol (40%) and it was observed that there was a reduction in mineral loss.

Furthermore, it is known that with a lifestyle that includes the habit of using xylitol, a change in the production and reproduction of bacteria can be observed directly. So much so that after approximately 6 months, they become undetectable in the mouth.

It is worth mentioning that some of the bacteria that xylitol acts against are Streptococcus pneumoniae and Haemophilus influenzae. These are dangerous because they can travel through the nasal cavity from the mouth to the ear, potentially causing acute otitis media (AOM), seriously affecting the eardrum. Several studies have been conducted on this; three trials performed in Finland on healthy children, as well as those with infection, demonstrated that xylitol consumption would lead to a reduction in these infections and would also lessen the impact once the child is sick. (Azarpazhooh A, Lawrence HP, Xylitol for preventing acute otitis media in children up to 12 years of age)

Despite the very credible advertising generated by traditional toothpaste brands, their effect on cavities is no different from the effect xylitol has on them. The University of Queensland in Australia demonstrated with Caries preventive efficacy of a xylitol-containing toothpaste: a double-blind, randomized, controlled clinical trial in high caries-risk adults (2016) that it effectively reduced the incidence of cavities. Therefore, the argument of efficacy is not valid for continuing to consume those abrasive products.

Complete your oral hygiene routine

Now surely you are asking yourself "why isn't xylitol added to oral hygiene products then?". Well, we can answer that xylitol is expensive compared to other sweeteners and antibacterials. Unfortunately, something we all know is that business is business and it does not pay to help people when the goal is to sell more (with the highest possible profit).

At Banbu, we don't believe in that modus operandi. We believe that what really matters is the well-being of people and everything that surrounds us.

Our toothpastes (in tablet, powder, or refill form) are vegan, eco-friendly, and contain xylitol. We know and promote the use of this natural ingredient to improve our oral health. In addition, we combine it with others such as: natural essential oils (mint, cinnamon), probiotics, and ingredients such as betaine, Iris root, turmeric, aloe vera... with anti-inflammatory and healing properties.

We use sodium lauroyl glutamate to generate foam without irritating mucous membranes or skin using plant-based ingredients, and beetroot to protect cells against environmental stress and help decrease oral mucosal dryness. We also add precipitated calcium carbonate (Mohs hardness scale of 3, average particle size less than 2 microns) and kaolin (Mohs hardness scale of 2-2.5, average particle size less than 10 microns) as cleaning agents.

In toothpastes, abrasives with a hardness equal to or less than 3 and with an average particle size of less than 20 microns are recommended.

Do you want better oral health? Combine them with these habits:

• Reduce consumption of acidic, carbonated, and cold soft drinks
• Reduce sugar consumption
• Go to your dentist regularly
• Use a tongue scraper to remove toxins
• Use dental floss to remove food debris
• Brush after eating, preferably about 30 minutes later

Author: Nathalia Carrillo Jácome