Exploring the Benefits and Risks of Xylitol Gum

A registered dietitian nutritionist explains the safety and benefits.

Medically reviewed by Allison Herries, RDN

Xylitol is a sugar alcohol used to sweeten food products. It exists naturally in plants, microorganisms, and animal tissues. Berries and fruit are common natural sources of xylitol. Xylitol can also be made artificially from xylan, a component (part) of beechwood and birch wood.

Historically, in World War II, xylitol was a substitute for sugar during a shortage in some Scandinavian countries (Finland, Norway, and Sweden). Xylitol’s prevalence increased when dentists began using it to prevent cavities and improve oral health.

Continued interest in sugar alcohols has led to research on the health benefits of xylitol beyond oral health.

The following article covers xylitol gum’s benefits, uses, and safety facts.

What Is Xylitol Gum?

Xylitol is a single-molecule (monosaccharide) sugar alcohol. In addition to natural and commercial sources, the body produces small amounts of xylitol through carbohydrate metabolism.

Xylitol gum is a sugar-free chewing gum sweetened with xylitol.

Nutrition

One gram of xylitol contains about 2.4 calories. Xylitol is a lower-calorie sweetener commonly used to sweeten low-calorie foods.

The body absorbs about 50% to 95% of xylitol consumed. This wide range is due to the variability of individual responses to xylitol. Additionally, differences in research methods make deciphering xylitol absorption difficult.

Xylitol is a suitable sugar alternative for people following specific diets because of its lower caloric content and low glycemic index. People with diabetes or who follow a low-calorie eating pattern may benefit from its nutrition profile.

Safety

Xylitol is relatively safe. Any adverse side effects are gastrointestinal, including diarrhea, gas, and bloating.

Contrary to some beliefs, xylitol does not cause cancer. Preliminary animal studies suggest xylitol may prevent the spread of cancer.

Studies suggest that xylitol in dosages of up to 0.3 grams per kilogram of body weight (g/kg BW) is well tolerated without signs of diarrhea. For a person weighing 135 pounds, 0.3 g/kg BW equals 18 grams of xylitol daily.

Other research shows that some adults tolerate xylitol in dosages up to 200 grams daily, provided it is slowly increased.

Moreover, one study observed minimal side effects with 430 grams of xylitol daily for two months.

However, the maximum tolerable dosage of xylitol depends on the person, their health, and how the sugar is administered (bolus or multiple small doses throughout the day).

It is possible to develop a tolerance to xylitol. Still, regular bouts of diarrhea may negatively affect health, impacting electrolyte levels and nutrient absorption.

Benefits of Xylitol Gum

Xylitol's dental benefits have been known for some time. Emerging research indicates that xylitol's health effects may extend beyond the mouth.

Dental Health

The World Health Organization estimates that 3.5 billion people worldwide are affected by oral diseases, many of which are preventable. Dental caries (tooth decay or cavities) impact nearly 2.3 billion people worldwide.

Chewing sugar-free gum like xylitol gum is an effective method for preventing cavities.

Cavities occur when dental plaque (dental biofilm) accumulates. Saliva, eating carbohydrates, and oral hygiene contribute to plaque buildup.

Regularly consuming xylitol reduces cavities. And chewing gum is a standard vehicle for xylitol. Studies vary on the exact timing, but chewing xylitol gum for 20 minutes following a meal cleanses and remineralizes teeth and decreases the presence of plaque.

According to some research, xylitol gum is more effective at reducing dental caries than mouth rinses, toothpaste, tablets, or candies containing xylitol.

Still, xylitol-containing foods and mouth rinses provide oral benefits by reducing germs and biofilms contributing to tooth decay.

Weight Management

Xylitol’s effect on weight management is based on several factors.

Some research indicates that xylitol reduces food intake by slowing food movement through your digestive system (gastric emptying).

Other studies suggest that xylitol contributes to weight management by increasing the production of two hormones related to fullness (satiety): cholecystokinin (CCK) and glucagon-like peptide 1 (GLP-1).

CCK affects satiety and weight in two ways: it influences gastric emptying and promotes the release of leptin, a hormone that signals fullness.

GLP-1 receptors in the gut activate areas of the brain that promote satiety.

Still, other research implies that xylitol’s diarrhea-inducing effects cause reduced food consumption that supports weight management.

Xylitol contains fewer calories than table sugar (sucrose). So, selecting xylitol-containing products instead of foods sweetened with sucrose may help manage weight.

Prioritizing fruits, vegetables, whole grains, and lean proteins contributes to a sustainable, healthy weight. Sleep, a robust support system, mindfulness, stress management, and regular physical activity are also important.

A registered dietitian can help you develop sustainable, personally tailored habits to maintain a healthy weight.

Diabetic-Friendly

Some consider xylitol to be a diabetes-friendly sweetener.

Xylitol has a low glycemic index, meaning it does not raise blood sugar levels significantly. The average glycemic index of sucrose is 65 compared to 12 for xylitol.

Opting for xylitol instead of table sugar produces a reduced increase in blood glucose levels. For people taking insulin, xylitol requires a smaller dosage to manage blood sugar.

Because xylitol has a limited effect on blood glucose, it triggers only a small amount of insulin to be released from the pancreas. Moreover, unlike glucose, xylitol does not need insulin to enter cells for removal from the bloodstream.

Some studies indicate that xylitol stimulates the release of GLP-1, which increases insulin levels and promotes greater insulin sensitivity.

More research is necessary to understand xylitol’s benefits in other areas of diabetes besides eliciting a reduced glycemic response.

Antimicrobial Properties

Bacteria are rampant in the mouth. Oral bacteria ferment sugars from food to produce acid. This acid partially erodes tooth enamel, allowing bacteria to enter the tooth and create a cavity.

Oral bacteria cannot ferment xylitol. Streptococcus mutans (S. mutans) is a bacteria in the mouth associated with cavities.

Unlike other sugars, xylitol and S. mutans have a unique relationship. S. mutans cannot ferment xylitol, and xylitol prevents S. mutans from attaching to the tooth surface.

Moreover, chewing xylitol gum reduces the amount of S. mutans in the mouth, effectively helping to prevent tooth decay.

However, S. mutans may become resistant to xylitol with long-term habitual usage. Some evidence suggests that the xylitol-resistant S. mutans bacteria are still less likely to produce cavities than their non-resistant counterparts.

According to some studies, xylitol is an effective antimicrobial agent against the oral yeast infection Candida albicans. However, further research is necessary.

Bowel Function After Surgery

Multiple studies have shown that chewing xylitol gum following surgery restores bowel function. Bowel function encompasses passing gas, bowel sounds, and bowel movements.

Some research shows that people who chew xylitol gum three times daily following laparoscopic surgery or a cesarean section (C-section) pass gas and make bowel sounds sooner than those who do not use xylitol gum.

Other research shows no difference in initial bowel sounds between women who chew xylitol gum after a C-section and those who do not. However, xylitol gum shortened how much time passed before the first post-surgery bowel movement.

The beneficial effects of xylitol may be due to its impact on intestinal bacteria. However, additional research is necessary to understand its role in bowel function.

Risks and Considerations

Avoid xylitol if you're allergic to it or its components. Seek immediate medical attention if you have a severe allergic reaction (itching, hives, shortness of breath).

Although generally well tolerated, there are some situations where xylitol gum may do more harm than good.

Digestive Effects

The intestines absorb xylitol slowly. As they do, xylitol draws water into the gut, causing diarrhea.

People with irritable bowel syndrome (IBS) or those on a low-FODMAP diet should be cautious of xylitol due to its gastrointestinal effects.

The digestive effects of xylitol are highly individualized. Moreover, diarrhea and other digestive effects can be affected by the following factors:

• Weight

• Meal history
  

• Dosage

• Whether xylitol is consumed with food or on its own

• Quantity of food eaten before or after using xylitol

Despite these influential factors, the gut can adapt to higher quantities of xylitol. Individuals can build up a tolerance to prevent diarrhea and other side effects. Furthermore, fine-tuning how and when you take xylitol helps reduce the chances of diarrhea.

Toxicity in Pets

Xylitol impacts dogs differently than it does humans. Dogs release a significant amount of insulin when they consume xylitol. This causes a drop in blood sugar levels (hypoglycemia), which can be life-threatening if untreated.

Xylitol does not have as pronounced an effect on other animals. Similarly, other animals like cats may be less likely than dogs to consume foods containing xylitol.

Comparing Xylitol With Other Sweeteners

Xylitol is as sweet as sucrose. It has the sweetest taste of all sugar alcohols, including sorbitol, mannitol, and erythritol. Sorbitol and mannitol are about half as sweet as xylitol, whereas erythritol is roughly two-thirds as sweet.

Xylitol contains fewer calories than sucrose. One gram of sucrose has four calories compared to the 2.4 calories per gram of xylitol. Xylitol and sorbitol contain similar numbers of calories. However, xylitol is higher in calories than mannitol (1.5 calories per gram) and erythritol (zero calories).

Erythritol is easily digested and does not impact blood glucose or insulin.

Despite their similar calorie content, sorbitol and xylitol have different glycemic indices. On the glycemic index of 0 to 100 with pure glucose at 100, xylitol and sorbitol are 12 and 9, respectively.

Erythritol and mannitol have a glycemic index of zero.

The different calorie content, glycemic index, and chemical structures of xylitol and other sweeteners influence its usage, suitability, and risks.

Using Xylitol Gum

Chewing gum that contains 5 grams or more of xylitol for 10 minutes three to five times daily improves dental health. Specifically, periodically chewing xylitol gum throughout the day prevents plaque accumulation.

Most xylitol in sugar-free chewing gum dissolves within three minutes of chewing. Therefore, chew the gum for at least three minutes to reap the benefits of xylitol. However, chewing the gum for extended periods may diminish the xylitol’s oral health benefits.

Though 5 grams of xylitol is the recommended amount for supporting dental health, dosages ranging from 10 to 30 grams are well tolerated in healthy individuals.

Significant individual variability influences xylitol tolerance. Some adults may be able to tolerate more than 200 grams of xylitol daily, provided the dosage is slowly increased and spaced out across the day.

Practical Tips

Simply chewing xylitol gum provides health benefits. However, there are ways to optimize them.

Choosing Quality Products

Look for gum products that contain at least 5 grams of xylitol because this is the amount associated with oral health.

Xylitol is a low-calorie alternative sweetener. If you’re looking for a low-calorie food or chewing gum, double-check that the label does not contain other sweeteners. Other sweeteners do not offer the benefits xylitol does.

Combining With Dental Care

Xylitol gum with proper dental hygiene promotes good oral health.

Regularly brushing teeth prevents the buildup of biofilms like dental plaque, which contribute to cavities and periodontal disease.

The Centers for Disease Control and Prevention recommends brushing your teeth twice and flossing once daily for optimal oral health. Visit your dentist once yearly. Smoking and alcohol also affect dental health —quit smoking and limit alcoholic beverages.

Chew xylitol gum between meals and tooth brushing as another layer of protection against dental plaque.

Summary

Xylitol is a low-calorie sweetener that can provide oral health, diabetes, and weight benefits.

Incorporating xylitol gum into your dental routine reduces plaque accumulation and cavity formation.

Xylitol is well tolerated for most individuals. Despite xylitol's digestive side effects, people with irritable bowel syndrome may be able to tolerate it. Introduce xylitol gum into your diet slowly to limit any digestive effects.

If you have any concerns about xylitol gum, consult your healthcare provider. 

Read the original article on Verywell Health.