Tooth decay is a common problem in childhood that can be prevented. If left untreated, cavities in both baby and permanent teeth can cause pain and affect the appearance and function of the teeth.

Some children are particularly prone to tooth decay, even with regular dental visits and good oral hygiene at home. The American Academy of Pediatric Dentistry (AAPD) has recently recognized the advantages of xylitol, a natural substance, in the fight against childhood tooth decay.

What is xylitol?

Xylitol is a naturally occurring substance found in various fruits and vegetables, such as berries, mushrooms, corn, and lettuce. Research indicates that a daily intake of 4-20 grams of xylitol, spread across three or more servings, can reduce tooth decay and cavities by as much as 70%. To give you an idea, a single cup of berries contains just under one gram of xylitol.

It can be difficult to encourage children, especially toddlers, to consistently eat four or more cups of fruits or vegetables each day. For this reason, xylitol is also available as a sugar substitute, in chewing gum, and as a concentrated ingredient in numerous health foods. No other sugar substitute has demonstrated the same level of benefit for young teeth.

It's important to understand that consuming more than the recommended amount of xylitol doesn't provide "extra" protection against tooth decay. Adhering to the recommended daily intake is sufficient to enhance other cavity-prevention efforts, and the positive effects can last well into the future.

How does xylitol work?

A combination of factors increases a child's likelihood of developing tooth decay and cavities. These factors include their oral hygiene practices, diet, carbohydrate intake, sucrose (table sugar) consumption, saliva flow rate, and the natural resistance of their teeth to plaque.

Specifically, harmful oral bacteria thrive on sugar and carbohydrates, producing acids as a byproduct. When sugary foods are consumed, these acids attack and weaken the vulnerable tooth enamel. Xylitol works by neutralizing these acids, reducing the destruction of enamel and thereby minimizing the risk of cavities. Xylitol also stimulates the production of saliva, which helps to continuously remove food particles, plaque, and bacteria from the teeth. When used alongside fluoride, xylitol helps to remineralize teeth, strengthening the enamel and reducing the formation of new cavities.

When should my child start using xylitol?

While xylitol gum is not appropriate for very young children, infants can still benefit from their mothers' use! Studies have shown that mothers of children between three months and two years old who chewed xylitol gum several times daily protected their children from tooth decay until they were five years old. In this case, xylitol reduced the transmission of harmful microorganisms from mother to child.

Once a child reaches toddlerhood, xylitol can be incorporated into their diet as a sugar substitute or naturally through the consumption of fruits and vegetables. Older children can reduce their risk of new cavities by chewing xylitol gum.

If you have any questions or concerns about xylitol or tooth decay, please reach out to your pediatric dentist.