Is Xylitol Better During Orthodontic Treatment?

It is well known that those undergoing orthodontic treatment are much more prone to diseases of the oral cavity. They are more likely to experience tooth decay and gum diseases as well. To avoid these problems, dentists usually suggest the use of xylitol, or birch sugar instead of refined, white sugar. But is xylitol really better for us?

chewing gum
Chewing gum

New research

A newer study examining the workings of xylitol has been published in the orthodontic journal Progress In Orthodontics. They researched what effect xylitol has on teeth, how the plaque found on teeth reacts to it, and how streptococcus mutans, the bacterium mostly responsible for tooth decay.

The details of the experiment

41 men and women were examined. The participants of the experiment were between 12 and 30 years of age, and all of them received their fixed braces between January and December of 2009. The first group had to eat 6 pieces of chewing gum that contained xylitol for three months after every meal. This means they had roughly 6 grams of xylitol in their mouth every day. The second group had to eat 12 pieces of xylitol chewing gum a day, which also had around 6 grams of xylitol in it.The third group was the control group, and did not receive xylitol at all.

Results of the experiment

The participants were given proper oral hygiene tips, and also got regular hygiene sessions, and got fluoride treatments from time to time, too. The third, sixth and twelfth months saw them go to clinical screenings, during which it was established that the plaque index for all participants had decreased. This means that much less plaque was found on the tooth surfaces. The three groups had no real difference between them in terms of oral health, though. But what of the levels of streptococcus mutans? First, when trying to look for the presence of this bacterium, they decided that the groups that had xylitol did much better than the control group. But after three months, it seemed that the control group was doing better, as they had the lowest readings consistently. Aside from this, the DMFT index and the conditions of the brackets also showed no appreciable difference, so it seems that xylitol does not exacerbate the possibility of tooth decay, and does not affect the stability of the braces either.


Since most bacteria found in the mouth cannot survive on xylitol, and thus cannot produce by products that harm the tooth enamel, birch sugar can be said to stop the proliferation of bacteria. This is why those in the industry support the consumption of xylitol as opposed to regular sugar. The Dentists Association of California recommends eating around 3-5 xylitol chewing gum or candy, thus eating around 5 grams of xylitol a day. But the researchers conducting the study do not recommend eating xylitol at all, until the beneficial effects of the material can be better shown. Experts do agree that with regular at home oral care and fluoride treatments in conjunction with eating xylitol, the health of the oral cavity can be improved.

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