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A natural sugar found in plums, strawberries, and raspberries, xylitol is used as a sweetener in some "sugarless" gums and candies. Not only does xylitol replace sugars that can lead to tooth decay, it also appears to help prevent cavities by inhibiting the growth of bacteria that cause cavities, such as Streptococcus mutans. 1 Xylitol also inhibits the growth of a related species, Streptococcus pneumoniae, which is a cause of ear infections . 2 Gums, toothpaste, and candy containing high levels of xylitol are beginning to become available in the United States.
Many studies, including several under the auspices of the World Health Organization, have evaluated xylitol gums, toothpastes, and candies for preventing dental cavities, with good results. 3 4 5 6 7 8 In all of these studies, xylitol users developed fewer cavities than those receiving either placebo or no treatment.
Xylitol is thought to prevent cavities by inhibiting the growth of the Streptococcus mutansbacteria. 9 Since a related bacteria, Streptococcus pneumoniae, can cause ear infections, xylitol has been investigated as a preventive treatment for middle ear infections , with some success. 10 11 In addition, preliminary evidence suggests that use of xylitol may offer some protection against periodontal disease (gum disease). 12
Xylitol is believed to be safe, but doses higher than 30 g per day can cause stomach discomfort and possibly diarrhea. In studies, children taking xylitol syrup tended to have more such side effects than those using other forms, possibly because it reached the stomach in a more concentrated dose.