Xylitol Toothpaste Benefits and Side Effects

Xylitol toothpaste is a type of toothpaste that contains xylitol, a sugar alcohol sourced from birch trees and other types of hardwood trees and plants. Xylitol is believed to improve dental health; it tastes sweet, but unlike sugar, it isn't converted in the mouth into acids that can promote tooth decay.

Said to slow the growth of Streptococcus mutans (the bacteria most closely associated with tooth decay), xylitol toothpaste is often touted as a natural approach to cavity prevention.

Xylitol is also used as an ingredient in dental care products like chewing gum, lozenges, tablets, and breath mints.

Three toothbrushes in a white cup
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The Research on Xylitol Toothpaste: Does It Work?

Although research on xylitol toothpaste has yielded mixed results, there's some evidence that brushing with xylitol toothpaste may provide certain dental health benefits:

Benefits of Xylitol Toothpaste

In a 2015 report from the Cochrane Database of Systematic Reviews, for instance, scientists sized up 10 previously published studies (with a total of 5,903 participants) on the use of xylitol to prevent cavities. In their review, the report's authors found that over two-and-a-half to three years of use, a fluoride toothpaste containing 10% xylitol reduced cavities by 13% when compared to a fluoride-only toothpaste. The study authors noted, however, that the evidence was considered low quality and recommended large, well-designed clinical trials.

A 2014 study from the Journal of Dentistry for Children assessed the effectiveness of xylitol toothpaste in preventing early childhood cavities and reducing streptococci mutans. For the study, 196 four to five-year-old children brushed their teeth with either a fluoride toothpaste with 31% xylitol or standard fluoride toothpaste. After six months, the xylitol toothpaste wasn't found to be more effective than the standard fluoride toothpaste.

Other research hasn't found xylitol toothpaste to be effective at reducing the growth of oral bacteria. For instance, a laboratory study published in the European Archives of Paediatric Dentistry in 2015 compared the effects of different types of toothpaste on the growth of Streptococcus mutans and Lactobacillus acidophilus. The researchers found that xylitol toothpaste did not significantly inhibit the growth of Streptococcus mutans or Lactobacillus acidophilus.

Xylitol Toothpaste Side Effects

Xylitol has been approved for safety by the U.S. Food and Drug Administration as a non-nutritive sweetener.

Adverse effects that have been reported in studies include mouth sores, bloating, cramps, constipation, gas, loose stools, and diarrhea. Xylitol toothpaste shouldn't be ingested or left in the mouth without rinsing.

It's important to note that xylitol toothpaste shouldn't be used as a substitute for standard care in the treatment of a dental condition (such as periodontitis). If you are considering trying a xylitol toothpaste, it's a good idea to consult your dentist first.

Xylitol is extremely toxic to dogs. If your dog eats xylitol toothpaste, it is important to take the dog to a veterinarian immediately.

A Word From Verywell

Although it's too soon to tell whether xylitol toothpaste can significantly cut your risk of cavities, it's possible that xylitol products may be of some benefit when used in conjunction with standard measures to prevent cavities.

For optimal dental health, the National Institutes of Health suggest brushing your teeth every day with a fluoride toothpaste, cleaning between your teeth every day with dental floss or another type of between-the-teeth cleaner, limiting your consumption of sugary foods, avoiding tobacco use and smoking, and seeing your dentist or oral health professional on a regular basis.

There's also preliminary evidence that several foods may help protect against cavities. For instance, some research indicates that black tea and oolong tea can each help prevent tooth decay. And in a research review, scientists note that cranberry may help fight tooth decay by preventing bacteria from sticking to teeth.

Frequently Asked Questions

  • How do I know if my toothpaste has xylitol?

    Many toothpaste brands are starting to clearly list xylitol on their product labels, especially those that claim to be fluoride-free. Other products aren't so obvious. Xylitol may go by other names, such as wood sugar, birch sugar, and birch bark extract. Some products simply list "sugar alcohol" under inactive ingredients.

  • Can xylitol cause cavities?

    Unlike other sugars, xylitol does not promote tooth decay and should not cause cavities. That said, it is unclear whether xylitol toothpaste is any more effective than standard fluoride toothpaste for preventing cavities.

  • What are some popular xylitol toothpaste brands?

    Popular toothpaste brands that contain xylitol include Epic Fluoride-Free Toothpaste, Spry All Natural Kids Fluoride-Free Tooth Gel with Xylitol, Now Solutions Xyliwhite Toothpaste Gel, and Tom's of Maine Fluoride-free Antiplaque & Whitening Natural Toothpaste.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV. Xylitol-containing products for preventing dental caries in children and adultsCochrane Database Syst Rev. 2015;(3):CD010743. doi:10.1002/14651858.CD010743.pub2

  2. Chi DL, Tut O, Milgrom P. Cluster-randomized xylitol toothpaste trial for early childhood caries preventionJ Dent Child (Chic). 2014;Jan-Apr;81(1):27-32.

  3. Evans A, Leishman SJ, Walsh LJ, Seow WK. Inhibitory effects of children's toothpastes on Streptococcus mutans, Streptococcus sanguinis and Lactobacillus acidophilusEur Arch Paediatr Dent. 2015;16(2):219-26.

  4. FDA. CFR- Code of federal regulations Title 21.

  5. FDA. Xylitol and dogs, a deadly combination.

  6. NIH. Fluoride and dental health.

  7. Goenka P, Sarawgi A, Karun V, Nigam AG, Dutta S, Marwah N. Camellia sinensis (Tea): Implications and role in preventing dental decayPharmacogn Rev. 2013;7(14):152–156. doi:10.4103/0973-7847.120515

  8. Philip N, Walsh LJ. Cranberry Polyphenols: Natural weapons against dental cariesDent J (Basel). 2019;7(1):20. doi:10.3390/dj7010020

  9. FDA. Paws off! Xylitol is toxic to dogs.

By Cathy Wong
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health.