This Grandma just went for her quarterly teeth cleaning. In the treatment room was a new large box of individually wrapped sugar free Xylitol SPRY by GUM. The wrapper said “Dental Defense System.” Of course, I asked about it. My long (we never say old) dentist said that the gum was wonderful as it killed step germs in the mouth and I should try the gum and chew about five pieces a day. This dentist, who I respect immensely, then said that it was also great for children, especially those with recurrent ear infections. It seems more of the grandchildren then not have ear infections, and our youngest just got the second set of tubes in his ears and was just recovering from strep throat. Yes, this Xylitol caught my attention.
Chewing a sample of two small pieces of Xylitol gum, which look like Chicklets for those of us who remember them, and taste pretty nondescript, I immediately hit the internet and WedMD, and realized why it was sugarless gum: “Xylitol is a naturally occurring alcohol found in most plant material, including many fruits and vegetables. It is extracted from birch wood to make medicine. Xylitol is widely used as a sugar substitute and in “sugar-free” chewing gums, mints, and other candies. However, sorbitol is the most commonly used sweetener in sugarless gums because it is less expensive than xylitol and easier to make into commercial products.”
WebMd did mention its uses as a medicine:
“As a medicine, xylitol is used to prevent middle ear infections (otitis media) in young children, and as a sugar substitute for people with diabetes. Xylitol is added to some chewing gums and other oral care products to prevent toothdecay and dry mouth. Xylitol is sometimes included in tube feeding formulas as a source of energy.”
If there are animals in the household, it seems there is grave concern about its use:
“Dog owners should know that xylitol can be toxic to dogs, even when the relatively small amounts from candies are eaten. If your dog eats a product that contains xylitol, it is important to take the dog to a veterinarian immediately.”
So, according to WebMd, how does it work?
“Xylitol tastes sweet but, unlike sugar, it is not converted in the mouth to acids that cause tooth decay. It reduces levels of decay-causing bacteria in saliva and also acts against some bacteria that cause ear infections.”
Of course, I called the mother of the grandchild with the ear and strep issues. She had never heard of Xylitol or its use for children.
A dentist, Stefanie Shore, has a website that tells about Xylitol in language we can understand and gives advice as to dosage:
“Xylitol: What Everyone Should Know About this Sugar Substitute”
“Xylitol is a naturally occurring plant sugar that has recently found its way into widely distributed gums, candies and mouth rinses. What makes xylitol so unique is the way your body processes it. While it tastes sweet, just like sucrose (table sugar) and fructose (corn syrup), it does not cause cavities. Normally, the bacteria in your mouth will feed on those sugars, which helps them to grow and multiply. Xylitol is different because the bacteria can’t ingest it. Xylitol basically “starves” the bacteria so they can’t grow and multiply. Xylitol also keeps your mouth alkaline, which is the opposite of acidic. . . .Xylitol can prevent your mouth from becoming too acidic.”
“Xylitol is great for adults and is very effective in a 5 gram per day dose. Children can also use xylitol, but the dose must be cut in half. If used excessively, xylitol can cause stomach upset. You can find xylitol in the following products:”
“Ice Breakers cube gum. One piece has 1.55 grams. Dr. Johns “simply xylitol” candies, www.drjohns.com Nature’s Sweet Life mints. Available online or in health food stores. Spry gum. Available at Whole Foods. Xylimelts. www.orahealth.com Carifree xylitots lollipops. www.carifree.com”
This Grandma has seen Ice Breakers gum in the regular supermarket. My dentist said Whole Foods carried the children’s forms of Xylitol, which I would assume have a correct dosage. Spry also makes a toothpaste for children. On www.amazon.com the toothpaste gets five stars and one review says, “As a dental hygienist myself, this is the only children’s toothpaste I recommend to my patients. Xylitol is the key….even helps prevent ear infections when they ingest it!” Of course, I considered it for purchase for the youngest grandchild, but needed to know more.
There was a link for “Is Xylitol Safe for Kids?” Clicking on it brought to a retailer of products. They are selling xylitol gum and candies and say:
“Xylitol is Safe for Children. Xylitol has been approved for use by people of all ages. Studies suggest that children especially can benefit from using xylitol. Ideal exposure time is best determined by the family’s dentist or pediatrician. Dosage amounts will vary as children age, but in most cases 6 grams a day will provide tremendous benefits. Some dentists also recommend that the parents of young children regularly use xylitol gum or mints to reduce the spread of tooth-destroying bacteria. Studies have shown tremendous benefits for children whose mothers used xylitol gum during the first few years of her child’s life.”
The website also says that there are virtually no side effects with use of Xylitol: “ Our recommendation: Moderation. A little time and patience. You with us? Good! Xylitol is considered a healthy alternative to sugar and lacks major side effects. In fact, most users experience no side effects when using the recommended dosage (usually 6-8 grams/day) for dental benefits. However, beware too much too soon. For example, when using Epic’s xylitol-powered products for cooking and baking, some people who use xylitol in large quantities (usually more than 40 grams/day) may initially experience diarrhea. Many of these people report that the diarrhea subsides even as they continue to use large quantities of xylitol.
Their digestive systems adjust to the xylitol. Because it is a low glycemic sweetener, xylitol has only small effects on blood sugar and insulin release. Many diabetics consider it a safe alternative to sugar and many dieters use it in low carb diets.”
I then searched studies about Xylitol and children, and got to the American Academy of Pediatrics Policy Guidelines for Xylitol, revised 2010.
I went right to their recommendations for “caries prevention,” (had to look it up to find out the dentists were talking about tooth decay) the purpose of the study:
Policy statement The AAPD: ● Supports the use of xylitol as part of a preventive strategy aimed specifically at long term caries pathogen suppression and caries (dmf ) reduction in higher risk populations. ● Recommends that, as further research and evidence-based knowledge is available, protocols be established to further clarify the impact of delivery vehicles, the frequency of exposure, and the optimal dosage to reduce caries and improve the oral health of children. ● Encourages xylitol-containing products be labeled clearly with regard to their xylitol content to enable dentists and consumers to ensure therapeutic levels of exposure.
So, clearly dosage is a significant concern for children and adults. Too much is way too much and when and how to chew for the benefit sought seems to be an art, one that you should use cautiously after consultation with a pediatrician and pediatric dentist.
Since this study related to tooth decay, this Grandma then researched Xylitol for children for ear infections. I love this next article on NPR site. It just about covers Grandma’s philosophy on child rearing:
Nancy Shute, in “Chew On This: Some Gum May Ward Off Ear Infections,” November 11, 2011, on NPR’s blog on line, said:
“Giving children xylitol in gum, syrup or lozenges twice a day reduces the risk of ear infections by 25 percent. The finding come from an analysis by the Cochrane Collaboration, an independent group that combs the medical evidence to figure out what works and what doesn’t. But to get any xylitol benefit, parents and their kids are going to have to work at it. “The catch is how you have to take it,” says Rochard Rosenfeld, chairman of otolaryngology at SUNY Downstate Medical Center in Brooklyn, N.Y. The children in the studies chewed the gum five times a day for five minutes. “You can’t just sort of swallow this like a pill.”
Ms. Shute addresses ear infections and Xylitol”:
“Otitis media is the most common infection in young children, prompting almost 16 million office visits in the U.S. and health care costs of $3.8 billion a year. Children with repeated infections are often referred for surgery to insert ear tubes. So you could see how parents eager to avoid antibiotics and ear infections would be intrigued. Xylitol has been touted for decades to prevent tooth decay, but that’s never really caught on in the United States.
Unless you’ve been reading the labels closely, you might have overlooked gums, such as some varieties of Trident, that contain xylitol. About a decade ago, scientists got interested in it as a potential treatment for ear infections, when a study showed that xylitol reined in the growth of strep bacteria in petri dishes. Streptococcus pneumoniae has been blamed for up to half of all ear infections.”
She then tells us details about the studies, that they were all in Finland and it worked for well children, but not if the children were already sick. I love the comment of Dr. Rosenfeld:, “In Finland,they do this all the time,” Rosenfeld says. “It’s all over the culture.” But he doubts if American parents would be able to stick with “kids chomping away, five times a day”, through the cold and flu season.”
Ms. Shute is quick to explain disclaimers as to the benefits of Xylitol. “What’s more, ingesting too much xylitol can cause diarrhea and other stomach upsets, and xylitol gum and candy can be expensive. Some caveats: In all four trials, the gum and lozenges were donated by industry, and the study authors have a U.S. patent for using xylitol to treat respiratory infections. But the authors claimed no conflict of interest. The studies were relatively small, and came mostly from the same labs.”
What is best is Dr. Rosenfeld’s conclusion:
“So if a kid in the course of a year gets four ear infections, you start ’em in October and get ’em chomping the xylitol, instead of four infections you get three. That’s a 25 percent decrease. Heck, if I’m a parent I’d rather have an ear infection. Most ear infections don’t need antibiotics. You give ’em Tylenol for day or two and they get better on their own.” HIs final word: “To me, it doesn’t make sense.”
This Grandma loves the conclusion. It is the same about all parenting. Every parent worries that he or she is not doing enough, is not the best parent in the world. The working parents of today have double guilt about everything. I must call the mother of my grandchildren immediately. Unless you are compulsive obsessive “helicopter parent” who is going to hover over the child five times a day and time five minutes of chewing, don’t bother asking the pediatrician or pediatric dentist.
I will still buy the children’s Xylitol toothpaste, however. I would love to think the grandchildren brush their teeth often enough and long enough to get diarrhea from the Xylitol content!
Joy,
Mema
#theAmericanAcademyofPediatricsPolicyGuidelinesforXylitol #XylitolSPRYbyGUM #NancyShuteChewOnThisSomeGumMayWardOffEarInfectionsNovember112011 #WebMdonXylitol #NPRblog
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