2017-06-21

cspinet.org`cut back on #xylitol? #dental #health

6.11: web.health/dental/diet/xylitol/
cspinet.org`cut back on xylitol?:
. some dentists refer to studies
showing how use of xylitol
can reduce the risk of getting cavities:
it actually heals them like fluoride does;
so, I was suprised to see a warning from
Center for science in the public interest
to cut back on xylitol;
however their only negative finding
was that large doses cause the runs;
and coincidentally, it is controversial because,
many of the studies that showed it works
had used doses that were too high.

cspi`XYLITOL? cut back:
"Sugar alcohols are sugar-free (and alcohol-free) sweeteners.
Some occur in plants, but are typically manufactured.
Most have about half as many calories as sugar.
They appear to be safe,
except that large amounts of most of them
may have a laxative effect.
XYLITOL
Like most other sugar alcohols (maltitol, mannitol, sorbitol),
xylitol is not well absorbed by the body,
so it has fewer calories than table sugar
(although slightly more than most other sugar alcohols).
Also, it does not promote tooth decay.
Large amounts may have a laxative effect, leading to diarrhea.
While xylitol is harmless to humans,
even small amounts can kill dogs."

is it really reducing cavities?
6.21:
Dr.ellie 2015:
". Dr. Ruchi Sahota, the spokeswoman for the
American Dental Association, agreed
“sugar-free chewing gum” combats harmful bacteria
in the mouth and certain studies show
xylitol adds minerals to tooth enamel.
Then came the “but” ….as Dr. Sahota explains
the evidence is not conclusive
to show xylitol prevents cavities.
I want patients to be aware of this “cause” argument,
because it is often used to muddy scientific waters.
...
The reason it’s so difficult to prove
something is a “cause”of a health problems
is because you’d have to create conditions
that give some in the study group
[the preventable disease].
For teeth, we’d have to give one group of test children
sugar candies to “cause” cavities
and compare with the kids eating xylitol.
Of course this would be unethical
and scientists know it.
The problem is that the public mis-interpret these statements
– assuming it means “there is no connection” –
which is grossly untrue.
I suggest you take what the ADA says about xylitol
with a grain of salt (or xylitol)
and although the ADA says
“nothing takes the place of your toothbrush
to keep your teeth and gums healthy”
I’d like to see some causal science to prove that!"
see Ellie 2013:
". researchers found that xylitol
did not significantly reduce cavities
in adults who are at high risk for decay.
... They experienced about 4 new cavities a year,
yet it does not appear anyone addressed
their lifestyle or other risk factors.
Xylitol’s main benefit is its alkalizing ability.
You can do a pH test in your own mouth
and show that 100 percent xylitol (like Zellies)
quickly alkalizes your mouth
to protect your teeth from acidity and sugars.
This is why we recommend you eat Zellies
after eating, after drinking and after snacking.
If you eat xylitol and then sip diet soda
or a 20 oz energy drink,
the xylitol will have no chance to protect you.
... Older adults with cavities usually have
acidic saliva due to hormonal change,
pregnancy, stress, medications,
or a depressed immune system.
In the age-range of this study,
many patients would have acidic or insufficient saliva
to counter acidic attacks from eating or drinking.
Only with the correct xylitol protocol
and correct home care regimen
could these patients have avoided cavities.
... Another benefit of xylitol is that it can
loosen plaque and improve daily tooth cleaning.
Useful as this is, you still need
well-formulated mouth rinses, good toothpaste
and effective brushing habits.
Additionally, xylitol must reach a
minimum daily dosage,
and Dr Milgrom’s studies at the
University of Washington in 2002
indicated a dosage between
6.5 and 10 grams xylitol is required,
and frequency is important.
This is why you find so much information
about how to use xylitol,
how to clean your teeth, and
which mouth rinses work with xylitol, etc
on our websites."
6.18:
American Academy of Pediatric Dentistry 2015:
Overall results of [xylitol] trials are inconclusive,
and there appear to be study design issues
and/or bias in many of the studies
(eg, insufficient sample size, control group issues,
issues with randomization, blinding,
and conflict of interest).6-35
Most studies used a very large dose ...
18,20,23,24,27,32,33,35
which may be unrealistic in clinical practice.

Data is inconclusive for caries reduction
for short-term use.9,12-14
12
Influence of a low xylitol-dose on
mutans streptococci colonisation
and caries development in preschool children.
Eur Arch Paediatr Dent 2006; 7(3):142-7.
13.
Effect of xylitol and xylitol-fluoride lozenges
on approximal caries development in high caries-risk children.
Int J Paediatr Dent 2008;18(3):170-7.
14.
Use of xylitol chewing gum in daycare centers:
A follow-up study in Savonlinna, Finland.
Acta Odontol Scand 2003;61(6):367-70.

Data also is inconclusive for long-term effectiveness
for caries reduction.11,15-18
11.
The optimum time to initiate habitual xylitol gum-chewing
for obtaining long-term caries prevention.
J Dent Res 1999; 78(3):797-803
15.
Enhanced anticaries efficacy of a 0.243% sodium fluoride/
10% xylitol/silica dentifrice: 3-year clinical results.
Am J Dent 1995; 8(5):231-5.
16.
Anticaries efficacy of a sodium monofluorophosphate dentifrice
containing xylitol in a dicalcium phosphate dihydrate base.
A 30-month caries clinical study in Costa Rica.
Am J Dent 2002;15(4):215-9.
17.
Sealants and xylitol chewing gum are equal in caries prevention.
Acta Odontol Scand 2000;58(6):279-84.
18.
Xylitol chewing gums and caries rates: A 40-month cohort study.
J Dent Res 1995;74(12):1904-13.