This week on A Tale of Two Hygienists TIPisode we are joined by Steve Pardue from Elevate Oral Care to talk about xylitol, a tool to fight against acid producing bacteria!
- Demineralization and Remineralization
- Quantity of Xylitol
“Everyday when we eat and drink our exposed teeth demineralize for a period of time.”
“Fluoride hardens the tooth surfaces but does little to effect the bacterial presence in the mouth.”
“Xylitol has no effect on the tooth but can starve out specific bacteria that are very acid producing.”
“You don’t need to consume a bunch of xylitol, just rather just have small amounts throughout the day.”
“Here at Elevate we try to add xylitol to everything we can.”
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This TIPisode has been transcribed for your viewing pleasure:
Michelle Strange: A Tale of Two Hygienists presents this week’s TIPisode: quick and easy tips to keep you up to date and presented by the experts in the profession. Now, get ready for your unofficial TIPisode, this week brought to you by Elevate Oral Care.
Steve Pardue: Welcome back, everyone. Steve Pardue here from Elevate Oral Care again with this month’s installment of TIPisodes on prevention. When patients sit down in your chair and present with gingivitis, mild periodontitis, perhaps even some recession and attachment loss from poor oral hygiene over the course of their life, you’ll find exposed root surfaces. These can be formidable surfaces to try to maintain health, especially if the patients are a bit older and have lower than ideal oral hygiene standards.
A part of every good periodontal maintenance plan should include root caries management on these surfaces that are more susceptible to decay. Not only are these dentin surfaces more prone to decay than enamel surfaces just because they’re also less likely to have the protection of fluorapatite in those surfaces [sic].
The longer the tooth is exposed in the oral environment, like the crowns of the teeth, the more fluoride exposure they’ve had through their life. This makes surfaces, whether they’re dentin or enamel, more resistant to acid challenges and decay. Every day when we eat and drink, our exposed teeth demineralize for a period of time. This is buffered by our saliva and potentially brushing after eating — although, most people don’t do this — and then again, our teeth begin to remineralize.
This is all on a minute scale day in and day out. If fluoride is present during this remineralization, fluorapatite gets created, and this mineral is much more resistant to decay than our natural enamel or dentin.
Roots that become exposed due to aggressive brushing, periodontal issues, poor oral hygiene, and any other reason doesn’t have the benefit of this slow, gradual bath of fluoride over time. With little or no fluorapatite, the acids that wouldn’t affect the rest of the tooth surfaces in the mouth can begin to demineralize these roots. This makes it important to reduce the acids in the mouth, specifically the acids created by bacteria, which are the acids that linger and cause teeth decay and gingivitis.
One great way to do this is to use products like xylitol whenever possible. Fluoride hardens the tooth surfaces but does little to affect the bacterial presence in the mouth. Xylitol does the opposite. It has no effect on the tooth but can starve out specific bacteria that are very acid producing. The strep mutan family of bacteria is specifically what xylitol effects. These bacteria consume xylitol but can’t metabolize this into acids as they do other sugars and sugar substitutes. Xylitol essentially starves out these bacteria and allow other bacteria to opportunistically grow in their niche in the oral microbiome. This results in a healthier oral microbiome with less acids and root surfaces less likely to demineralize.
Also, there’s no need to have patients chew significant amounts of xylitol gum or use lozenges anymore. Nowadays, you’ll find xylitol in many products, and each of these can provide some therapy. Remember, you don’t need to consume a bunch of xylitol but rather just have small amounts regularly throughout the day. If you brush with xylitol-containing toothpaste, that’s one application; then chew a xylitol-containing gum later, that’s two applications; then perhaps brushing with a xylitol toothpaste later in the day provides the third application; and perhaps a breath or dry mouth spray that contains xylitol as a fourth, fifth, or sixth application. Just make sure the products you recommend have a high enough quantity of xylitol.
Over the counter gums and foods will always be listed in the order of descending quantity, so look for xylitol first or second on the ingredient list. Drug products and medical devices are listed in alphabetical order, so on those products, look for a statement somewhere on the package that xylitol is in the product at a certain percent. Five or ten percent or higher is best.
Here at Elevate, we try to add xylitol to everything we can because it’s just one more application of xylitol that a patient might get. There are also a few studies showing that xylitol combined with fluoride will work synergistically to increase the benefit of both, so why wouldn’t we add xylitol?
Allday Dry Mouth Spray contains 44 percent xylitol, our prescription toothpastes FluoriMax 5000 and Just Right 5000 both have 10 percent xylitol added, and our stannous fluoride contains 10 percent xylitol as well. Using these products, patient-centered communication, and motivational interviewing to understand what your patients need will both help you gain the compliance and help them improve their oral hygiene.
To find out more about xylitol and how Elevate Oral Care can help you treatment plan and gain high case acceptance with your patients, schedule an in-office or virtual AGD-PACE accredited continuing education staff meeting by calling 877-866-9113 or email us at [email protected]
Michelle Strange: Thanks for listening to another TIPisode, and thank you to Elevate Oral Care for sponsoring this week’s episode. You can find out more about their great products at elevateoralcare.com.
And don’t forget to hit the “subscribe” button in your podcast app, follow us on Facebook or Instagram, and head over to our website, ataleoftwohygienists.com, to sign up for our newsletter. We always appreciate ratings and reviews. Thanks for listening to your unofficial dental hygiene podcast.