A new oral health fad has been trending on the internet, which uses xylitol pulling for teeth in lieu of the more popular alternative of oil pulling. Yes, this is the same ingredient that you often see in sugarless gum and even in some toothpastes.
While xylitol have proven benefits for your mouth, the alleged claims of "pulling" with it falls a little short. The concept is a lot more optimistic than what your actual results may be because our dentists believe that it is no more effective than other types of mouth rinses.
What is xylitol pulling for teeth?
Xylitol pulling is a form of extended mouthwashing using a liquid xylitol crystals.
Extending rinsing. Most OTC mouthwashes only have you rinse for about a minute but all forms of "pulling" with a rinse mandates 15-20 minutes of swishing in the mouth. That is a significantly longer rinsing time.
Xylitol crystals. Xylitol is most commonly found as a non-nutritive sugar sweetener in gum and other candies. However, for pulling in the mouth the crystal form of it gets dissolved in the mouth and the saliva acts as a dissolving medium.
![xylitol crystals by now foods](https://static.wixstatic.com/media/8960a6_b390f5a06fce40dc85e80a460a490d74~mv2.png/v1/fill/w_356,h_500,al_c,q_85,enc_auto/8960a6_b390f5a06fce40dc85e80a460a490d74~mv2.png)
The idea or concept for pulling with it was derived from oil pulling. This is merely using a different rinsing medium to hopefully achieve better oral health.
How to do it:
Place one teaspoon of xylitol crystals in the mouth.
Wait for the saliva to start pooling, which should happen almost immediately.
Swish it around your mouth for 15-20 minutes.
Spit out and don't rinse.
If you can make do without rinsing, you'll derive more benefits from it. Rinsing immediately afterwards will dilute the residual xylitol and wash it away thus reducing its benefits.
Alleged benefits of pulling with xylitol
Allegedly, if you pull with xylitol, it will starve the oral bacteria to death since it is a non-nutritive sweetener. Therefore pulling with it can improve your oral health by reducing the bacteria load or count in your mouth.
Xylitol as a non-nutritive sweetener: Studies have shown that xylitol disrupts the energy production process for mutans streptococci, bacteria that are present in plaque and saliva.
The mechanism the bacteria processes xylitol results in a net energy loss.
Reduces the adhesion of the bacteria to tooth surfaces.
Reduces their acid production potential.
Basically, for the bacteria to process the xylitol, it ends up starving itself to death since it loses energy from trying to do so. The final product is also not acid producing, so the byproducts are not harmful to the tooth enamel either.
It is due to these benefits that it is commonly found in toothpaste.
![xylitol toothpaste](https://static.wixstatic.com/media/8960a6_39b0ad9981b641cba9a0c546a5e55f0e~mv2.jpg/v1/fill/w_980,h_254,al_c,q_80,usm_0.66_1.00_0.01,enc_auto/8960a6_39b0ad9981b641cba9a0c546a5e55f0e~mv2.jpg)
A new novel use of it could potentially be for stopping bleeding after wisdom teeth removal.
What results to actually expect
It's amazing that xylitol can reduce bacteria by starving to death but don't go around expecting your mouth to be bacteria free from pulling with xylitol.
The reason is that while it results in a net energy loss for bacteria, starvation is a slow process that happens over a long period of time. Bacteria won't perish from being starved from one meal.
If you're xylitol pulling once a day such as in the morning, your lunch and dinner should provide plenty of sustenance for the bacteria to survive and maybe even thrive! Although we suppose you could pull with it all day long but do you really have the time to be doing that?
Ultimately, starvation is a game of attrition and based on all of our own experiences... living organisms will not die that quickly from missing one meal. Would you die from missing breakfast once? Probably not and neither would bacteria in your mouth.
Therefore, the actual results that you may expect will differ from greatly from alleged claims.
Results to expect:
Slow down bacterial activity. Pulling with xylitol will raise the pH of the mouth from acidic back to neutral. This de-acidifying effect can slow down bacteria activity which is good slowing down cavity progression as well as gum disease. Bacteria are most active at acidic pHs.
Freshen breath. Similar to chewing sugar free gum, pulling with this should help you freshen your breath!
We believe that the most important effect from pulling with this sugar alcohol is that it raises the pH in the mouth back to neutral. This simple effect will help suppress oral bacterial activity.
However, the same could be said about other mouthwashes as well.
![chart of mouth pH from various mouthwashes](https://static.wixstatic.com/media/8960a6_968a1dc59cb54cc6adb7a890e6ac79cf~mv2.jpg/v1/fill/w_500,h_345,al_c,q_80,enc_auto/8960a6_968a1dc59cb54cc6adb7a890e6ac79cf~mv2.jpg)
The chart above shows various mouthwashes and the effect it has on the oral pH. As you can see just about almost any rinse will de-acidify the oral environment.
Takeaway
Pulling with xylitol can starve oral bacteria to death since it is a non-nutritive sweetener but it is more effective to outright kill them instead. Listerine can kill bacteria on contact and it does so in less than 30 seconds. You don't have to "starve" the bacteria and wait for them to slowly die which they may not!
Last but not least, while mouth rinsing is important, it is still not a replacement for a regular dental checkup and cleaning. Come schedule yours with one of our dentists in Long Island City if you're NY!
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