Should Xylitol be apart of your child’s daily oral health care?

Xylitol and Teeth – What The Experts Say

What is Xylitol:

Xylitol is a naturally occurring sugar alcohol found in small amounts of fruits and vegetables.  It has been used as a sweetener aimed to improve oral health1. Xylitol as well as other sugar alcohols are not readily metabolized by oral bacteria, and thus are considered non-cariogenic sugar substitutes 2

How do I get Xylitol

Xylitol is available in many forms (eg, gums, mints, chewable tablets, lozenges, toothpastes, mouthwashes, cough mixtures, and oral wipes). The chewing process enhances the caries inhibitory effect.

xylitol and teeth, whats the truth

Do Xylitol Benefits Out Weigh The Side Effects?

The main concern with xylitol is in order to see the dental benefits, one must consume 3-8 gram each day and spread out that amount 5 times throughout the day.  At this constant level abdominal distress and diarrhea have been reported 3.

What do the studies prove:

Overall the results are inconclusive for caries reduction in short term use as well as long-term use. To consume 3-8 grams of Xylitol is unrealistic in a clinical practice 4,5.

Pediatric Dentist in Yardley

Our recommendation:

At Growing Smiles in Floral Vale, we agree with the American Academy of Pediatric Dentistry that Xylitol is a non-cariogenic replacement for sugar. But the lack of consistent evidence that Xylitol reduces the cavity causing bacteria in children in addition to the abdominal side effects is why we do not recommend the use of Xylitol as part of a daily oral health regimen.

Xylitol and Dogs:

Xylitol is considered safe for human consumption, it is extremely toxic to dogs. Only 0.10 g/kg of xylitol can cause issues. Thus a dog weighing about 7 pounds (3kg) can get sick from eating less than 1 piece of xylitol chewing gum.





1. Mäkinen KK. Biochemical principles of the use of xylitol in medicine and nutrition with special consideration of dental aspects. Experientia Suppl 1978;30:1-160.

2. Scheinin A, Mäkinen KK, Ylitalo K. Turku sugar studies. V. Final report on the effect of sucrose, fructose and xylitol diets on caries incidence in man. Acta Odontol Scand 1976;34(4):179-216

3.Ly KA, Milgrom P, Rothen M. Xylitol, sweeteners, and dental caries. Pediatr Dent 2006;28(2):154-63. Discussion 192-8.

4. Oscarson P, Lif Holgerson P, Sjöström I, Twetman S, Stecksén-Blicks C. Influence of a low xylitol-dose on mutans streptococci colonisation and caries development in preschool children. Eur Arch Paediatr Dent 2006; 7(3):142-7.

Stecksén-Blicks C, Holgerson PL, Twetman S. Effect of xylitol and xylitol-fluoride lozenges on approximal caries development in high caries-risk children. Int J Paediatr Dent 2008;18(3):170-7.

Kovari H, Pienihäkkinen K, Alanen P. Use of xylitol chewing gum in daycare centers: A follow-up study in Savonlinna, Finland. Acta Odontol Scand 2003;61(6):367-70.

5: Hujoel PP, Mäkinen KK, Bennett CA, et al. The optimum time to initiate habitual xylitol gum-chewing for obtaining long-term caries prevention. J Dent Res 1999; 78(3):797-803.

Why are My Child’s Teeth Coming in Yellow

This is one of the most common questions I get from parents of 6 and 7 year-olds. Even though there are multiple reasons why your child’s permanent teeth are yellow, the most common reason is the intrinsic color difference between the permanent teeth and baby teeth.

What Causes Yellow Teeth in Kids

This yellow appearance is also enhanced by the fact that they sit right next to baby teeth.   This contrast between they very white baby teeth makes the grown up teeth look even more yellow.

Primary teeth have a milky white appearance when compared to the sometimes yellowish appearance of the permanent teeth. Primary teeth have thinner enamel, less amount of dentin and dentin in primary teeth is less yellow in color.

Permanent teeth have a greater amount of dentin, which is yellow in color. Since enamel is translucent the color of the dentin shows through. When all the permanent teeth have erupted the color will blend and appear uniform.

What can be done?

Young permanent teeth have very large nerve canals when they erupt and these teeth are more transparent, leading to a yellower appearance. As we age, the canals slowly calcify and the tooth will naturally lighten. 

Bleaching Kids Teeth

As for bleaching, we advise parents to wait until all of their permanent teeth to erupt (usually 12/13). Otherwise when the new adult erupt, they will not match his bleached primary teeth.

How Thumbsucking and Pacifiers Affect Babies Teeth

The effects of thumb sucking and pacifier use.

Most parents get concerned when they see their infant or toddler sucking their thumb or using a pacifier. According to the Academy of Pediatrics almost 100% of babies will engage in nonnutritive sucking and typically begins around  the 29th week of gestation.

Nonnutritive sucking has many benefits as it helps infants in their ability to manage emotions, helps them relax and provides comfort and security. Sucking tends to occur more often when the child is tired, anxious, or upset.

It has also been cited that the use of a pacifier has been shown to decrease the incidence of Sudden Infant Death Syndrome.

When to worry

The dental effects of nonnutritive suckling correlate to the magnitude, frequency, and duration of the habit.  The most common effect is the movement of the central incisors resulting in an anterior open-bite as seen below. Nonnutritive sucking habits can also result in maxillary constriction, resulting in a posterior cross-bite. Dental effects are generally reversible before the age of 3

Stop Thumb Sucking Before Age 3

Ideally the habit should stop by the age of 3.  If it persists, parents may notice that the habit is interfering with their child’s speech.

Baby Pacifiers vs Thumb Sucking

Several articles showed that the use of a pacifier beyond the age of 3 has an increasingly harmful effect on the developing dentition when compared to a digit (finger). The most notable changes are an increase in the prevalence of an anterior open bite, posterior cross bite, narrow intercuspid width of the maxillary arch, and a high narrow palate. According to the most recent publication of the Journal American Dental Association, “Pacifiers were associated with a higher risk
of developing most malocclusion features when compared with digit (finger) sucking.”

For more information on thumb sucking or pacifier use, or to schedule an appointment, please contact Growing Smiles in Floral Vale at 215-860-9808 or


White Spot Lesions on Primary (baby) Teeth

White Spots on Baby Teeth Should Not Be Ignored

As you can see on the picture below, the black arrow indicates  “white spots,” which first appear as dull white bands on the smooth surface of the tooth.  While the red arrow indicates a cavity where the lesion has a progressed. White spots are often one of the firsts signs of tooth decay in children. This occurs as the result of enamel demineralization when acids from the plaque harm the tooth enamel.   Some white spot lesions are signs of active tooth decay, while other white spots have a “chalky” appearance as the tooth is not as glossy as other teeth.

White Spots on Baby Teeth

Early Signs of Tooth Decay

Children with white spot lesions are considered to be at a high risk for cavities. Don’t worry just yet, there are various ways to prevent these white spots from progressing. It is important to realize that the color will not change and it will continue to have a “chalky” appearance as long as it does not progress.

Treatment focuses on helping the affected teeth to re-calcify. The best and most effective way to re-calcify these areas is by the application of topical fluoride. Topical fluoride helps strengthen tooth enamel.  This can be accomplished by cleaning your child’s teeth as soon as they erupt with a “smear” of fluoride toothpaste. This should be done twice a day, after breakfast and then right before bedtime. Additionally at each dental visit a professional application of fluoride can be applied as the use of fluoride varnish has shown to consistently reduce caries.

Typically we monitor these white spot lesions  and ensure the surface remains hard and intact. With improved brushing and flossing, as well as reducing sugar consumption and maintaining a well balanced diet, these white spots will not progress to soft brown or black spots which indicates an active cavity as id.

For more information on prevention of dental decay, or to schedule an appointment, please contact Growing Smiles in Floral Vale

Weatherell J, Deutsch D, Robinson C, Hallsworth AS.Assimilation of fluoride by enamel throughout the life of the tooth. Caries Res 1977;11(2):85-115.

Beltrán-Aguilar ED, Goldstein JW, Lockwood SA. Fluoride varnishes: A review of their clinical use, cariostatic mechanism, efficacy and safety. J Am Dent Assoc 2000; 31(5):589-96.

Preventing Cavities Starts During Pregnancy

Dental caries is considered an infectious transmissible disease within our saliva. Mutans Streptococci (MS) is considered to be the principal group of bacteria responsible for the invitation of dental decay. MS adhere to teeth, metabolize sugars and produces acids that demineralize tooth structure.  Babies are not born with MS, but colonization may occur at the time of birth and over 70% of the time it is transmitted by their mother or primary caregiver (1,3).

The higher the levels of maternal/primary caregiver salivary MS, the greater the risk of the infant being colonized at a younger age. In order to suppress the reservoirs of MS, it is important for the mother or primary caregiver to maintain a healthy well rounded diet, reduce the frequency of simple carbohydrate intake, applying topical fluoride at routine dental visits, restoring active caries, and chewing xylitol gum.

Xyltiol Gum Reduces Plaque Production

Xyltiol is a 5 carbon sugar alcohol that looks, tastes and has similar sweetness to sucrose, but with 40% fewer calories. It is plant derived and is found in small quantities in fruits and vegetables. It has been shown to reduce the production of plaque and number of MS in the mouth. Evidence has shown that parents that chewed xylitol gum (4 pieces a day for 20 minutes) as early as 3 months after birth can significantly decrease the child’s caries rate(2).

Preventing Tooth Decay in Children

Transmission of caries can also occur between siblings of similar age or children in daycare(1).

A healthy smile for your child starts before they are born. By the age of 1 or 6 months after their first teeth erupt,  it important that they see a pediatric dentist for an initial exam, cleaning, and fluoride treatment. Follow these helpful hints to prevent the spread of Mutans Streptococci (MS).

  • Don’t cut your child’s food into smaller pieces by biting it in half.
  • Don’t clean off a dropped pacifier or bottle by putting it your mouth first.
  • Don’t blow on your child’s hot food to cool it off.
  • Don’t share eating utensils.

1. Genotypic diversity of mutans streptococci in Brazilian nursery children suggests horizontal transmission.

Mattos-Graner RO, Li Y, Caufield PW, Duncan M, Smith DJ. J Clin Microbiol. 2001 Jun;39(6):2313-6.

2. Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants.Söderling E, Isokangas P, Pienihäkkinen K, Tenovuo J. J Dent Res. 2000 Mar;79(3):882-7.

3. Streptococcus mutans and Streptococcus sanguinis colonization correlated with caries experience in children.Ge Y, Caufield PW, Fisch GS, Li YCaries Res. 2008; 42(6):444-8.

Why Are Dental Sealants Important?

Are Dental Sealants necessary? Simple answer is yes. I am very fortunate having two parents as dentists and received sealants at the age of 6 on my first molars and at the  age of 12 on my second molars. My sealants were placed by both of our wonderful staff members and Expanded Functions for the Dental Auxiliary (EFDA) Jolene and Marlene, and are still on molars more than 20 years later.

The reason we recommend sealants are that Pit and fissure caries (cavities) account for approximately 80 to 90% of all caries in permanent posterior teeth and 44% in primary teeth (1). Only on certain occasions do we recommend sealants on primary molars and premolars, but we recommend sealants on every 1st and 2nd molar. Pit and fissure sealants have been found to be 99% effective in prevention of occlusal caries when the material is completely retained and have been shown to be more effective on newly erupted teeth.

Dental Sealants For Kids Reduces Decay by 80%

Placing dental sealants reduce the decay rate more than 80% and lower the number of viable bacteria. Studies have shown that sealants lower Streptococcus mutans and lactobacilli by at least 100-fold and reduced the number of lesions with any viable bacteria by about 50 percent.

At Growing Smiles in Floral Vale we use a resin (white filling) based sealant material with a bonding agent which has been proven to have the highest retention rates.  The process of placing sealants is very simple. Your child will not have to get numb and it takes about 30 minutes to complete.





1. Beauchamp J, Caufield PW, Crall JJ, et al. Evidence-based clinical recommendations for the use of pit-and-fissure sealants: A report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2008;139 (3):257-68.

2. Griffin SO, Gray SK, Malvitz DM, Gooch BF. Caries risk in formerly sealed teeth. J Am Dent Assoc 2009;140(4): 415-23.