You’ve seen this ingredient plastered all over many oral health products: xylitol. Most people know about the potential dental benefits of this sugar alcohol. This natural sugar substitute has been added to toothpastes, mouthwashes, chewing gums, lollipops, other candies, and even baked goods as a healthier alternative sweetener.
However: Did you know that if a product contains xylitol in addition to other sugar substitutes that also have the “-tol” suffix, such as sorbitol, mannitol, and others, it may be rendered less effective? At least three separate articles have casually mentioned that in order to be effective, xylitol needs to be not only the first ingredient listed for a product, but also not have additional sugar alcohols competing or working against it, in addition to any acids:
From xylitol.org:
The best items are 100% xylitol. Next best are items where xylitol is the principal sweetener. Always make sure there are no acids in the products.
From an article by Lisa E. Stillman, RDH BS:
Xylitol products vary, so reading labels is important. For example, if the label on the product lists other natural sugarless sweeteners such as sorbitol, mannitol, or maltitol — which all consist of a 6-carbon chain — the xylitol will be competing with those other sweeteners and, therefore, be less effective. When reading product labels, make sure that xylitol is the first ingredient and that no other sweeteners are listed.
The rest of the articles and more information can be found at these links:
A sweet, effective alternative to prevent dental decay
Xylitol for a Healthier Smile, and a Healthier Life
Keep in mind, it's not just about the number of exposures per day to xylitol, there are recommended minimum gram amounts. When taking into account that 5-6 grams of xylitol is the daily recommended dose needed for a clinical effect (Source: Research Findings on Xylitol and the Development of Xylitol Vehicles to Address Public Health Needs), it seems imperative that if a product contains xylitol, it needs to be the focus of that product. As the articles cited mentioned, be sure to read labels, research ingredients and amounts, and from this information, choose products that would deliver the most punch against cavities and the most benefit for overall oral health.
