Xylitol is a natural, low-calorie sugar substitute that has been approved and used during the last few decades. Chemically, xylitol, is a pentitol (five carbon polyol) or as they are alternatively called a sugar alcohol. It is produced mainly from birch and beech wood and this is the reason that xylitol is alternatively called birch or wood sugar. Xylitol has the same organoleptic properties as sugar, meaning that it looks and tastes like sugar, however it has a number of advantages over sugar. One of the main advantages is that it inhibits the creation of dental caries.

The first evidence of xylitol's beneficial effects in preventing dental caries came from a study conducted in Finland that was published during the seventies. After the publication of that study, several clinical trials have been performed to evaluate the potential beneficial effects of xylitol in dental care. Today, we have enough evidence to say with confidence that the use of xylitol, and especially the substitution of sugar with xylitol has beneficial effects for dental health.

The mechanisms through which, xylitol exerts these beneficial effects are both direct and indirect. First of all xylitol is not fermentable by the bacteria that inhabit the oral cavity, in contrast with sugar. That means that by substituting sugar with xylitol the bacteria that are responsible for the creation of dental caries are deprived from one of their main sources of energy.

In addition to that, one of the main reasons that the consumption of sugars and carbohydrates cause dental problems is that they reduce the pH of the mouth causing enamel demineralization. The consumption of xylitol on the other hand has the exact opposite effect, it raises the pH of the mouth, protecting tooth enamel from demineralization. It should also be noted, that since the pH of the plaque is not reduced by the consumption of products sweetened with xylitol, remineralization is promoted.

Another important attribute of xylitol is that it has bacteriostatic effects. That means that xylitol inhibits the growth of bacteria like mutans streptococci, that are the main culprits for the creation of plaque and dental caries. This effect of xylitol is attributed to the fact that when these bacteria take up xylitol it is converted to xylitol-5-phosphate which results in the formation of intracellular vacuoles and the degradation of their cell membranes.

Finally, a few recent studies have demonstrated that the habitual consumption of xylitol products and to be more precise habitual chewing of xylitol gum by the mother can have a preventive effect for their children dental health. This is attributed to the fact that xylitol consumption by the mother can reduce the mother to child transmission of bacteria that are responsible for dental problems.

All the above make xylitol a very attractive sugar substitute. Especially since it's natural and it doesn't have any known side effects. The most common way of consuming xylitol is by chewing xylitol sweetened gum. However, any xylitol sweetened product will have almost the same beneficial effects.