Xylitol

• Overview
• Uses
• Side Effects
• Precautions
• Dosing

Xylitol is a naturally occurring alcohol found in most plant material, including many fruits and vegetables. It is extracted from birch wood to make medicine.

Xylitol is widely used as a sugar substitute and in "sugar-free" chewing gums, mints, and other candies. However, sorbitol is the most commonly used sweetener in sugarless gums because it is less expensive than xylitol and easier to make into commercial products.

As a medicine, xylitol is used to prevent middle ear infections (otitis media) in young children, and as a sugar substitute for people with diabetes.

Xylitol is added to some chewing gums and other oral care products to prevent tooth decay and dry mouth.

Xylitol is sometimes included in tube feeding formulas as a source of energy.

Dog owners should know that xylitol can be toxic to dogs, even when the relatively small amounts from candies are eaten. If your dog eats a product that contains xylitol, it is important to take the dog to a veterinarian immediately.

How does work?

Xylitol tastes sweet but, unlike sugar, it is not converted in the mouth to acids that cause tooth decay. It reduces levels of decay-causing bacteria in saliva and also acts against some bacteria that cause ear infections.

Likely Effective for...

• Preventing dental caries (tooth decay). Use of xylitol-containing products such as foods, chewing gum, candies, and toothpaste that provide 1-20 grams of xylitol per day can significantly reduce the rate of cavity formation in both adults and children. But some national brands of chewing gum contain milligram amounts of xylitol, far less than the gram doses that prevent tooth decay. Xylitol products appear to be more effective than products containing sorbitol for preventing cavities.

Possibly Effective for...

• Reducing episodes of ear infections (otitis media) in preschool children. Xylitol given in appropriate doses after meals to preschool children seems to significantly reduce the number of ear infections they get and the need for antibiotics. However, giving xylitol at the onset of symptoms of an acute respiratory infection does not seem to prevent ear infections.

Insufficient Evidence to Rate Effectiveness for...

• Prevention of dry mouth.
• As a sugar substitute for people with diabetes.
• Other conditions.

More evidence is needed to rate the effectiveness of xylitol for these uses.

Xylitol is safe in the amounts found in foods. It seems safe as a medicine for most adults in amounts up to about 50 grams per day. Avoid higher doses. There is some concern that extremely high doses for long periods of time (more than three years) can cause tumors. Xylitol can cause diarrhea and intestinal gas. It is probably safe for children as a medicine in amounts up to 20 grams per day.

Pregnancy and breast-feeding: Not enough is known about the use of xylitol during pregnancy and breast-feeding. Stay on the safe side and avoid use.

The following doses have been studied in scientific research:

BY MOUTH:

• For reducing the risk of ear infections in preschoolers: total daily doses of 8.4 to 10 grams of xylitol in chewing gum, lozenges, or syrup given in five divided doses after meals.

APPLIED TO THE SKIN:

• For prevention of cavities in adults and children, a wide range of doses has been used. Typically, doses are from 7 to 20 grams per day divided into three to five doses, usually given as candies or chewing gum that contact the gums.