The Fluoride Debate: Why xylitol is a better ally when it comes to preventing cavities

In the US we have an epidemic of cavities in children’s teeth, but the facts are that fluoride has no power to prevent cavities. Cavities are caused by bacteria that erode holes in teeth, and fluoride does nothing to help us fight these bacteria (except at dangerously strong concentrations, when it works as a poison to kill them).

The usefulness of fluoride is to promote tooth repair, after damage has been done. If enamel crystals re-grow in the presence of fluoride, they become bigger, smoother, and more perfect, than enamel formed without fluoride. Big crystals have the opportunity to connect with each other, providing a way to bridge gaps and heal holes in the tooth’s outer layer. We know that a smoother outer layer will reflect light, to make teeth shinier and appear whiter. More importantly, a strong outer layer will better resist future attacks by mouth acidity.

Enamel repair and re-building happens every time a weak solution of fluoride is in contact with damaged tooth enamel. There is no reason to drink fluoride, since the benefits are from the interaction of fluoride with the tooth surface. Toothpaste and rinses offer these benefits without the risks that come from ingesting a toxic kind of fluoride, or too much of it.

Most fluoride in tap water is a silico-aluminum fluoride compound, a product of industry that has never been approved by the FDA for human consumption. If someone regularly drinks a lot of water, they may ingest too much of this, and it can concentrate in bones to make them brittle. Fluoride toxicity is a real concern for young children or if you have damaged kidneys or delicate bones. Formula milk has fluoride in the powder and so it should never be mixed with fluoridated tap water. The American Academy of Pediatric Dentistry warns fluoride-free bottled water should always be used to mix formula milk. In the same way, fluoridated toothpaste should not be recommended for small children, since they usually swallow paste. Xylitol granular crystals on a toothbrush would be a much better alternative to toothpaste for young children. (The only time we recommend a tiny amount of fluoridated paste for a young child is if they have cavities).

A study from Environmental Health Perspectives in July this year showed ingesting high levels of fluoride may harm children’s brain development. The study was a systematic review and showed children in high fluoride areas had lower IQ scores than peers in low fluoride areas. These studies were in China where fluoride levels are extremely high (as a contaminant from industry). You cannot extrapolate this study to fluoridation in the US, but neither should you believe that a lack of fluoride causes tooth decay.

A comparison of the oral health benefits of xylitol and fluoride

The synergistic effects of Xylitol & Dilute Sodium Fluoride

The effect of xylitol and fluoride is synergistic. This means that when you use xylitol it is beneficial, and fluoride can also be beneficial (if you have damaged teeth). When you use these products together for oral health, the effects are greater than you expect by using each product alone.

The following picture shows the cavity-healing effects of using both xylitol and fluoride. The complete study from the Journal of Oral Science can be found HERE. One of the conclusions of this specific study showed that remineralization is accelerated when xylitol is used with fluoride.

How to use xylitol for oral health

We have a number of articles in the Ultimate Oral Health blog that talk about how to best use xylitol for oral health. Here are some quick tips as well as some links to past articles.

  • Zellies Granular Xylitol can be wiped on infant teeth to protect them
  • Zellie Bears can be used to protect toddlers and young children from cavities, by cleaning their teeth after meals and before sleeping
  • Zellies can help prevent cavities in adult teeth. Eat Zellies Mints or Gum after meals, snacks or drinks as all their new teeth erupt.

Approximate conversion: (1 teaspoon xylitol = 5 grams of xylitol = 5 pieces Zellies gum = 10 Zellies mints= 3 ZellieBears/Polar Bears)

Remember best results are seen when you have at least 5 exposures to xylitol throughout the day, with a total amount of 5-10 grams per day.

For more information on fluoride, click HERE to read the chapter dedicated to this topic in Dr. Ellie’s book “Kiss Your Dentist Goodbye“.

For more information on xylitol, please check out the following articles:


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For more information on oral health and xylitol, please visit all of Dr. Ellie’s web-sites: – learn more & order your Zellies Xylitol & the Complete Mouth Care System
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Categories: Cavities, Fluoride, Fluoride Treatment, Natural Solutions, Remineralization, Xylitol

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7 replies

  1. I was told that xylitol will cause damage to the digestive system I have been careful to buy xylitol only made from birch trees can you help me with this thank-you

    • There are lots of misconceptions about xylitol, even by dentists and doctors. Xylitol is often confused with “artificial sweeteners” and xylitol could not be more opposite from an artificial sweetener! In cheap commercial products xylitol is mixed with artificial sweeteners because xylitol is expensive and sorbitol, mannitol, and Splenda (sucralose) are cheap. In Europe, for example, Wrigleys makes a pure xylitol gum, but in the U.S. their chewing gum is mainly sorbitol, advertised as “with xylitol”. “Ideal Xylitol” is a granular brand advertised as “mostly xylitol” but when you look you will see xylitol is being mixed with cheaper six carbon sugar alcohols and that 10% by weight is Splenda!

      I mention this, because this trickery is confusing and many people have bad stomach problems from sorbitol, mannitol and artificial sweeteners – yet blame xylitol. They get gas and bloating etc. from these horrible ingredients mixed in with xylitol. Splenda changes the pH of the gut and can damage gut bacteria. There are lots of problems with these other products that are often mixed with xylitol. You must look for pure 100% xylitol – like Zellies.

      Pure xylitol does not upset the gut, but actually makes the gut healthier! Xylitol breaks to a short chain fatty acid – butyrate – which helps repair the gut lining. Some people, with poor gut health, can have loose stools as they first use substantial quantities of xylitol. Xylitol pulls water to itself ( hygroscopic) and especially those with a weak gut lining will experience water in their gut – which loosens stools. The secret for these people is to start slowly. I suggest a small amount ( like one Zellies mint) after meals, then gradually increase as the gut lining heals.
      I hope this answers your question!

      • thank-you for your response. I will slowly introduce xylitol into my 5 year old sons regimen. I guess I should bring him to dentist and see what stage his pain in his teeth are at before I move on to the whole protocol of closysis Listerine crest and act rinse. Even if his first teeth have problems I want to concentrate on laying the preventative foundation for the permanents. Would you have any input on how the fluoride affects the teeths ability to remineralize when you add fat soluble vit like k2 d3 and A in food forms ex. ( fermented cod liver oil, high mineral supplement )? I would assume these nutrients help the saliva to rebuild the teeth.

  2. You say to only use bottled water for formula, what about BPA leeching into the water from the plastic? I am more concerned about that than flouride.

    • Mixing formula milk powder with fluoridated water will give an infant too much fluoride – and this may have developmental effects on teeth and possibly other areas of the child’s body. I agree BPA is another big concern, which is why we need to prevent children from ever needing a filling or sealant.
      You may want to find out if your local water supply is fluoridated or not – and campaign to get fluoride out of your drinking water ( or you may be lucky and live in a non-fluoridated area). Today some companies offer non-fluoridated water in glass or non-BPA containers, although this may be more costly and only available through stores like Whole Foods. I always suggest if you use formula milk, you should do everything to mix it with the healthiest water available. Most of all we must realize that putting fluoride in water damages teeth of many infants in poor families, since many do not understand this danger exists and do not have resources to buy good water for their infants.

  3. Can a mother to be rid her body of this bacteria so she does not pass it to her UN- born child???

    • If you were my daughter and let’s suppose you had unfilled cavities and gum disease. The first thing I would do is have you begin to use the Complete Mouth Care System, try to keep drinks and meals to mealtimes as much as possible – and end every meal with either a piece of Zellie’s gum or a couple of Zellie’s mints. Obviously the less sugar your consume, the better – but you would soon notice improvements in your mouth health – just limiting sugar to meal times, and also using xylitol frequently after meals – eating a small amount preferably 5 or 6 times a day.
      We have reports of reducing the inflammation caused by mouth bacteria in about 8 weeks with this program, but studies show if you do consume adequate amounts of xylitol for 6 months – you will limit transmission of bacteria to your baby. If you work at this this for 2 years – you can limit the risk of cavities in your baby by 85-95%
      This is certainly the easiest and probably the very best way to improve your family’s oral health – I hope you will give it consideration!

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