Can chewing gum prevent cavities? Yes! It can if the gum is sweetened with xylitol.

What is xylitol?
Xylitol is a type of “sugar alcohol,” similar to sorbitol and mannitol, sugar replacements that are used in many low calorie foods. Xylitol occurs naturally in many fruits and vegetables and is obtained from the bark of birch trees, coconut shells and cottonseed hulls. It looks and tastes like sugar and is a diabetic-safe, low-calorie carbohydrate.

How does xylitol stop cavity formation?
Decay starts when certain bacteria break down sucrose (regular table sugar) and produce acids that dissolve the minerals in the enamel, the outer protective layer of your teeth. When the decay-causing bacteria try to consume xylitol, they are unable to break it down, and instead they begin to starve.

A normal mouth contains a large population of bacteria, and it is better for your teeth to have more “good” bacteria of the kind that do not cause cavities. Xylitol also stops your saliva from becoming acidic, so your mouth becomes a better environment for the “good” bacteria.

Chewing xylitol gum also increases your flow of saliva. Saliva contains calcium and fluoride and helps give these minerals back to your teeth (re-mineralization), undoing some of the effects of the cavity-causing bacteria. This makes chewing xylitol gum a particularly good solution for people who suffer from dry mouth.

How much xylitol do you need to prevent cavities?
We recommend that you chew or suck on two pieces of xylitol gum or two pieces of xylitol candy for five minutes following meals or snacks, four times daily — if you are at moderate to extreme risk for cavities. The target dose of xylitol is 6 to 10 grams (one or two teaspoons) spread throughout the day. Prolonged gum chewing is not advised, so most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

I don't like chewing gum. Is there another way to get xylitol?
People who don't like to chew gum have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (one teaspoon) three times per day.

So now you can add xylitol to the list of ways to fight cavities: daily brushing and flossing, and regular professional cleanings — and chewing xylitol gum.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”

A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”

While some people associate the need for root canal treatment with an injury or trauma to a tooth (which is a valid cause), it can also most commonly be caused by tooth decay that is left untreated. This is the reason why we have put together this brief guide to explain the three common stages of tooth decay that lead up to the need for a root canal.

Stage 1: During this stage, decay begins to form in the tiny grooves on the biting surface of a tooth or where the teeth contact each other. The result is loss of the surface enamel of the tooth.

Stage 2: Left untreated, the disease progresses through the enamel and into the dentin, which forms the body of the tooth. Once in the dentin, it progresses more rapidly until it reaches the pulp — the living tissue within the root canals of the tooth. The decay infects the pulp tissues, which contain the nerves of the teeth, causing pain. The end result of inflammation and infection of the pulp is that it dies.

Stage 3: As the nerve dies an infection results, which causes pain and swelling. For some people who do not regularly visit our office, this may be the first physical sign that they have a problem. But all is not lost, a successful root canal treatment, whereby the infected pulpal tissue is removed and the root canals are cleaned and sealed will not only relieve the pain, but save your tooth. So the good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, the tooth can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our office as soon as you feel you have a problem with a tooth.

If you are having pain or symptoms from a tooth or teeth, check it out with us — you may or may not need a root canal treatment. Contact our office to schedule an appointment and find out. Don't wait until it's too late. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “I'd Rather Have A Root Canal....”

People always wonder when it is appropriate to contact their dentist. To answer this, we have put together the following list to provide some guidelines for you and your family. However, your calls are always welcome! Our goal is simply to give you some clear scenarios that illustrate when you should give us a call or come in to our office.

For Bite Related Problems

1. Early or late loss of baby teeth.
2. Difficulty in chewing or biting.
3. Mouth breathing.
4. Finger sucking or other oral habits.
5. Crowding, misplaced, crooked or even missing teeth.
6. Jaws that shift, jaw joints that “pop” or “click” or are uncomfortable.
7. Any change causing speech difficulty.
8. Cheek or tongue biting.
9. Protruding teeth — large overbite.
10. Teeth that meet in an abnormal way or don't meet at all.
11. Facial imbalance or asymmetry.
12. Grinding or clenching of teeth.

For Injuries And Immediate Care

1. Knocked out permanent tooth: Call us immediately. You need to take action within 5 minutes of the injury for best results.
2. Injuries to lips, cheeks, tongue or gums that appear to require stitches: Call us for instructions as soon as possible.
3. Tooth injury — if a tooth has shifted from its original position: Call us to tell us you are on your way to our office and see us within 6 hours of the injury.
4. Chipped or broken tooth that is still in its original position: See us within 12 hours of the injury.
5. A knocked out baby tooth: Call us as soon as possible.
6. Bleeding without any significant tears in tissue that could require stitches: Call us for instructions.

What To Do Now

If any of the above describe you or another member of your family, then contact us today to discuss your questions or to schedule a consultation. You can also learn more about treating dental injuries by reading the Dear Doctor article, “The Field-Side Guide To Dental Injuries.”