Xylitol, effective protector and antibacterial agent

What is xylitol?

Xylitol is a polyalcohol, extracted from birch trees, corn cobs, sugarcane, 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 through metabolic processes.

The first time xylitol was linked to dental care was in 1970 when its benefits in oral hygiene were studied by the University of Turku, with "Turku Sugar Studies" being the first human study.

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

Properties

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

Cavities, a common problem

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

Image 1. Tooth with cavities

Once plaque is created, the bacteria eliminate tooth enamel by producing acids, thus causing breaks in the surface of the teeth. As seen in the image, the cavity penetrates from the surface to the interior, to the dentin, where the damage is greater. One of the symptoms this produces 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 acids and bacteria reach this area, it becomes inflamed, causing pain as it approaches the bone. This problem worsens if dental bone loss begins, including the possibility of reaching the rest of the teeth and affecting them as well.

How do traditional toothpastes work to reduce cavities?

You already know that there are many harmful substances for our health used in our cleaning products. Now we'll tell you what these are used for 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 risk of cavity creation, although that is also a factor. It must be taken into account that there are two 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 purposes, as there is a social myth that a hygiene product that produces foam cleans better. Today we know that this is not scientifically reliable and that the only thing that produces foam in commercial products are toxic chemicals.
• Formaldehyde: used as an antibacterial and as a cleaner after eating.
• Paraffin: used to achieve the texture that was commercialized when toothpastes first appeared.

And the most commonly 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 sold to just anyone. Although its use is recommended for people prone to cavities, we believe it is essential to reinforce certain oral hygiene habits before resorting to introducing toxins as a solution, which could lead to dental or skeletal fluorosis in the long run.

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 shown that when Streptococcus mutans biofilms were exposed to xanthorrhizol (turmeric extract) and chlorhexidine for 1 hour, both had almost the same result.

However, it stands out 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 already talked about its properties, but let's explain it better. This sugar does not act like other sugars, as it is not as easy to ferment, which helps reduce and prevent cavities. It also balances oral pH, thus reducing gingival inflammation and increasing salivary flow, which allows for proper cleaning and repair of tooth enamel. It also helps reduce oral candidiasis due to its ability to break the reproduction chain of bacteria.

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

This anti-caries 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, Theerathavaj Srithavaj, the anti-caries 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 shows that essential oils are very effective against this problem and that if combined with xylitol, the results improve.

Image 2. Benefits of using xylitol

According to Chunmuang Jitpukdeebodintra in her 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 a reduction in mineral loss was observed.

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

It is worth mentioning that some of the bacteria that xylitol acts on 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. Various studies have been conducted on this, three trials in Finland on healthy children, and also with infection, showed that xylitol consumption would cause a reduction in these infections and would also lessen the impact once ill. (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 that of xylitol. 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 discourse of efficacy is not valid for continuing to consume those abrasive products.

Complete your oral hygiene routine

Now you're probably asking yourself, "why isn't xylitol added to oral hygiene products then?" Well, we can tell you that xylitol is expensive compared to other sweeteners and antibacterials. Unfortunately, something we all know is that business is business, and it doesn't 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 truly matters is the well-being of people and everything around us.

Our toothpastes (in tablets, powder, or refill) are vegan, ecological, 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 like betaine, Iris root, turmeric, aloe vera... with anti-inflammatory and healing properties.

We use sodium lauroyl glutamate to create foam without irritating the mucous membranes or skin with plant-based ingredients, and beetroot as a cell protector against environmental stress and to help reduce oral mucosal dryness. We also add precipitated calcium carbonate (Mohs hardness index of 3, average particle size less than 2 microns) and kaolin (Mohs hardness index, 2-2.5, average particle size less than 10 microns) as cleansers to the formula.

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

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

• Reduce the consumption of acidic, carbonated, and cold soft drinks
• Reduce sugar intake
• Visit 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