Childhood dental caries (cavities) continues to plaque the profession of pediatric dentistry and remains the most common contagious disease in the civilized world. Those of you with young children know the challenge that dental caries presents to many aspects of daily life. Fluoride applications have dominated preventive dental research and practice for the past half century. In combination with good oral hygiene and dietary restrictions of refined sugars, fluoride applications can offer significant reduction in dental caries.

Now, there is a growing body of evidence that a sugar, natural in many fruits and fibrous foods, can help us control dental caries by reducing dental plaque and acid production in the mouth. What we find in mouths that are exposed to Xylitol is a reduction of dental plaque by about half within 24 hours. A child's dental brushing habits rarely match that kind of plaque reduction. Acid production is also reduced and since acid is the cause of surface demineralization, caries incidence is reduced.

Xylitol is available in many sources. It has the same sweetness quality as table sugar, so it can be purchased in 8 ounce (227 grams) containers and used in home food preparation. It is available in tooth pastes, oral wipes for infants, mouth rinses, nasal and oral sprays, chewing gums, breath mints, and candies.

Although xylitol comes from nature in the form of a vegetable sugar, remember to use it in moderation. A maximum daily dose for young children is about 6 grams. The frequency of use is important. Using xylitol just once or twice daily may be ineffective. It is best if used four or five times a day and in a medium that holds it in the mouth for extended periods. Chewing gums, lollipops, and mints provide maximum benefits. Brushing or using wipes for infants before bed or nap time is ideal as the xylitol will remain in the mouth for a longer period during sleeping hours when saliva production is at its lowest.

Be sure to look at the ingredients of the products you purchase. Some products will claim to be a xylitol product, but in reality xylitol is near the bottom of the list of ingredients and other less expensive sweeteners. Never use a xylitol product that also contains sucrose, fructose, corn syrup, or citric acid. Chewing gums and mints should list xylitol first. Toothpastes will probably list it third or fourth. Below is a list of manufacturers of the products we recommend. An excellent web site for more information is www.Xylitol.org.

XLear: this company probably has the largest product line and uses effective levels of xylitol in their tooth pastes, oral rinses, oral sprays, mints, and chewing gums. Visit their website at www.xlear.com.

Bling tooth pastes—the tooth paste we sell in the office. You can also purchase these directly on-line at www.tannertastypaste.com.

Spiffy wipes—these wipes are perfect for infants and can be used for oral cleansing any time during the day, but best right before sleep time. You can purchase these at www.spiffies.com.

Dr.John's—the maker of the lollipops we distribute in the office and available at www.drjohns.com.