Q&A with Dr. Ellie: Xylitol Dosage

Dear Dr. Ellie:
I am a little confused about the use of xylitol. Your book recommends 6.5 to 10 grams of xylitol per day, which seems to indicate that the amount of xylitol consumed is the important factor. But I also got the impression from reading your book that the xylitol does its repair work by being in contact with the enamel, the longer the better. If that is true, what does it matter how many grams are involved? Can you clarify this issue?

Hi DC,
Thanks for your message.
Xylitol works in two ways – 1) helping to control harmful bacteria and 2) stimulating minerals into the mouth to repair and strengthen teeth.In order to limit plaque and virtually eradicate the bacteria that cause cavities, studies in 2002 ( P. MIlgrom, U. Washington) showed that you needed a dose in this range ( 6.5- 10 grams) to achieve this.
The effect is through absorption into the bacteria cell – and this makes the bacteria unable to reproduce and unable to stick together ( because xylitol does not provide them any energy for these processes).
In this way, xylitol limits plaque formation and makes plaque slippery – so it falls off teeth more easily when you next brush or rinse your teeth.Dr. Milgrom showed that above 10 grams you did not get any additional benefits – so eating half a pound xylitol each day would not make your mouth any cleaner!What was discovered was that frequency seems important for the speed of this effect – so strive for five exposures a day – is a good suggestion.
Since plaque bacteria multiply after mealtimes Рeating some xylitol after meals is a very good time to consume it ( one gram, six times a day Рfor example).If you want to have stronger teeth Рxylitol helps since xylitol (as a mint or gum) stimulates a flow of alkaline saliva around teeth Рand these minerals strengthen teeth. There are no studies that show any benefit from duration of xylitol in the mouth Рalthough if you can keep stimulating a flow of alkaline saliva Рthat is going to be helpful. For this, the best would be to nibble one or two mints throughout the day.I hope this explains the two ways that xylitol works and why it seems confusing.
-Dr. Ellie

Categories: Q&A with Dr. Ellie, Xylitol