Xylitol mouth rinses.
Rinsing can make a good choice.
Using a mouth rinse can be an effective way to create an oral exposure of xylitol. Lif Holgerson (2006) found that rinsing raised xylitol levels in saliva and dental plaque on the same order as chewing gum and candy products.
In similar fashion as with other types of products we review, we performed a web search so to identify some of the various brands of oral rinses that are available.
For each product, we were interested in: 1) It's xylitol concentration [percent]. 2) The product's list of ingredients.
We didn't find much.
Our web search fared quite poorly. In fact, the table below shows the only two we found.
|Epic Xylitol Mouthwash||25%|
|CariFree CTx3 Rinse||25%|
You can either buy xylitol rinse or make your own (see below).
Most products didn't provide sufficient documentation.
Actually, our search did identify a number of rinses but most simply did not provide the concentration documentation that we were looking for. (If you know of any, please leave a comment below.)
We commend the two above on making this information readily available. It reflects positively on them as manufacturers. After all, how can a consumer gauge their daily xylitol exposure unless they know how much is in the products they consume?
How much rinse do you need to use?
In the case of Epic's mouthwash, let's examine how much you would need to use in order to create a one-gram exposure of xylitol.
It's simple enough to calculate that you would need to use four grams of a 25% rinse to create a one-gram dosing. But how much liquid is four grams?
Well, assuming Epic's rinse has a density similar to water (see below), then a person would need to use on the order of one teaspoonful to create a one-gram oral exposure. That's a very small amount.
Choosing a xylitol mouthwash by way of reading its ingredient list.
Take a look at the list below and notice that water is the main ingredient (that's why we made the assumption above that Epic's product has a density somewhat similar to water). Xylitol is a solid at room temperature and therefore needs to be dissolved into a liquid in order to make a usable rinse.
If the main ingredients in most rinses are just water and xylitol, why not make your own?
How to identify high quality products.
The best rinses (those with the highest concentration) will be those where only water is listed before xylitol.
Also, lookout for the presence of the sugar sorbitol. If a product contains this sweetener, it suggests that the manufacturer has chosen to skimp on xylitol in favor of a cheaper compound.
How to make homemade xylitol rinse.
Once you've seen the typical ingredient list, a question that often comes to mind is why not just make your own? Well, you certainly can.
First off, you'll need to know how much xylitol exposure you'll get from your homemade rinse. As a point of reference, one teaspoon of granulated xylitol weighs about four grams.
To create a 1 gram exposure, start with a smallish quantity of water (however much liquid you want to rinse with) and mix in 1/4 teaspoon of granulated xylitol (that's not very much at all). Rinse with this solution for about 30 seconds or so.
If the granulated xylitol hasn't fully dissolved in the small amount of water you have dispensed, you can just add more (or use warmer water). Or, just go ahead and start rinsing and let it finish dissolving while you swish.
Spit or swallow?
Since xylitol is a food item (a type of sugar), when you're finished you can either spit it out or just swallow (homemade rinses only, for commercial products, read their directions). Remember though, it's only the xylitol that's in your mouth that has any effect on the bacteria that cause cavities. Swallowing provides no additional benefit (however, it will add a few calories to your diet).
From the standpoint of developing consistency in technique, with kids the best plan might be to spit out. That's because most other types of oral products (fluoride rinse, mouthwash) absolutely should not be swallowed (see below). Spitting out would also be the best plan for those who have experienced difficulties with xylitol side effects.
Advantages of commercial products.
Manufacturers sometimes include additional compounds in the formulation of their rinses. For example, some contain oral moisturizers that can be a benefit to those people who have a chronically dry mouth.
As discussed elsewhere on our pages, the use of both fluoride and xylitol to prevent tooth decay are complimentary. Both work by different mechanisms and can be used together.
Toward this goal, commercially prepared xylitol rinses are often formulated with fluoride. Parents need to be aware of this and consult with their child's dentist for directions. The inappropriate use of fluoride (such as swallowing it) can result in a dental condition termed fluorosis.