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Understanding Xylitol


The first speaker at the seminar was Doctor Kauko Makinen, widely considered the godfather of xylitol research. Currently in semi-retirement, Dr. Makinen began his research career in the ’60s at the University of Turku in Finland.

He started his presentation with the basic explanation of the importance of xylitol molecule’s unique biochemical characteristics, highlighting its ability to chelate calcium. This is key to the understanding of how xylitol facilitates systemic absorption of calcium and also explains its potential for dental re-mineralization.

He also spoke about xylitol as an important constituent of the biochemical pathway known as the gluconate xylitol cycle, essential for our carbohydrate metabolism. This cycle helps explain why xylitol is superior to glucose as parenteral therapy in post-operative patients.

Dr. Makinen discussed some of the most important clinical trials and studies, starting with the famous Turku Sugar Studies carried out between 1972 and 1975. The Ylivieska school program showed that there was a long term clinical benefit well after the discontinuation of xylitol use. In the Estonia school program it was discovered that the use of xylitol candies was as effective as the use of xylitol gum. The Belize Trials between 1989 and 1996 were essentially a pentatol hexatol comparison. And xylitol was shown to be superior to sorbitol in terms of non and anti-cariogenic effects.

Dr. Makinen briefly mentioned the mother-child transmission studies knowing Dr. Eva Soderling would expand on them. He then went on to present evidence produced by various studies to support the following: that there is a special relationship between xylitol and Streptococcus Mutans in plaque production; that in the presence of xylitol there is less plaque which is less adhesive and slightly more alkaline; xylitol makes calcium and phosphates more available for re-mineralization, both dentally and systemically.

There is some fairly recent and ongoing studies that Dr. Makinen brought to our attention. Dr. Peter Milgram from the University of Washington in Seattle has done much work on dosages and frequency of xylitol use. The China study has demonstrated that xylitol gums reduced levels of both Strep Mutans and
lactobacillus more than 15 months after intervention was terminated. He also alluded to latest studies being done in Finland with regard to the topical application of xylitol in infants.

Before closing with a rather humorous look at a reference to xylitol as a panacea in Chinese traditional medicine, Dr. Makinen quoted one of his contemporaries, Brian Burt, professor of public health at the University of Michigan. “The evidence is strong enough to support the regular use of xylitol-sweetened gum as a way to prevent caries, and it can be promoted as a public-health preventative measure.”