Youtube videos about xylitol remineralizing teeth have been popping up on my news feed, which has compelled me to tell you, that is incorrect.
Xylitol may assist with the remineralization process but it does NOT directly remineralize teeth, unlike fluoride and hydroxyapatite which can do it.
This misconception stems from the misunderstanding of what teeth are made of and what the remineralization process entails.
How xylitol assists with remineralization
While xylitol does not directly remineralize demineralized teeth, it can assist with the remineralization process.
How it helps: Xylitol creates a conducive environment for remineralization.
Raises pH. Chewing xylitol gum or pulling with it, will cleanse the mouth and also induce salivation. Both of these activities help bring the pH of the mouth back up to neutral which slows down bacterial activity and demineralization.
Starves bacteria. This sugar alcohol is a non-nutritive sweetener and when bacteria process it, they lose energy instead of gaining. This can eventually starve them over time.
Both of these activities are good for your mouth and they shift the equilibrium towards remineralization rather than demineralization. Therefore, this ingredient will indirectly help the process.
As a rule of thumb, the mouth is typically in a demineralization phase when the oral pH is acidic but can switch to remineralization when the pH is neutral/basic. Therefore, using xylitol will make it more likely for your teeth to be in repair mode rather than destruction mode.
How xylitol differs from fluoride and hydroxyapatite
Unlike xylitol, fluoride and hydroxyapatite are considered direct remineralization agents because they can initiate remineralization.
How fluoride results in remineralization
Studies have shown that fluoride is more readily absorbed by decayed/demineralized tooth structure. That means your tooth will actively pull fluoride from the oral environment into itself if it is under an acidic attack.
That is beneficial because fluoride in turn will actively pull in calcium and phosphates which are required to remineralize the teeth. In other words, it draws in the building blocks used to repair the enamel.
How hydroxyapatite results in remineralization
Since hydroxyapatite (HAP) is literally made of the same mineral as teeth, it can directly insert itself into demineralized areas. In other words, it uses itself as the building block to repair damaged tooth structure.
The diagram above shows how it can literally just insert itself into damaged parts of the teeth. This is why it is considered a direct remineralization agent!
This ingredient can be widely found in toothpastes such as in the example below, so it's not as if you need a prescription for it.
The remineralization process
Demineralized teeth can remineralize, meaning that it can repair itself. To understand what this means, we need to review the demineralization and remineralization process.
Demineralization: The process when teeth lose minerals, aka the enamel dissolving.
Process begins when the pH drops below the critical level of 5.5
Enamel loses calcium and phosphate.
Remineralization: The process when teeth regain lost minerals, aka enamel repair.
Process begins when the pH rises above the critical level of 5.5
Enamel regains calcium and phosphate.
In summary, both of these two processes exist on the same spectrum but on opposite sides of it. Depending on the pH in the mouth, it will shift either way.
Takeaway
Xylitol is helpful for remineralization of teeth but if you really want to make an impact, you should use a fluoride or hydroxyapatite toothpaste instead. Both of the latter two, are ingredients that are directly involved in the repair process. In other words, they're much more effective!
Last but not least, don't forget that teeth can remineralize but only up to a certain extent. There will come a point in time where you need to see a dentist to have it repaired with a filling or even a crown if it gets too severe.
If you're nearby in Long Island City, NY our dentists are available for in person consultations!
