What is Xylitol?


Andra Mahoney, BS RDH

What is Xylitol?

What if I told you there was a sugar that actually prevents cavities?  Would you believe me?  Well, you should!  And it called Xylitol (pronounced zai-li-tall).

What is Xylitol?

Xylitol is a naturally occurring sweetener found in plants, fruits, and vegetables.  It looks and tastes just like sugar (sucrose).  Xylitol has about a third the calories as table sugar, and is a healthy alternative for diabetics. Not only does it make an excellent sugar substitute, but it aids in the prevention of dental caries, and reduces plaque formation.

How does it help prevent cavities?

Everyone has bacteria in their mouth all the time.  Bacteria is highly attracted to the sugars found in the foods and beverages that we eat and drink.  Most people think this means sweets, candies, etc.  While that is true, it also can mean carbohydrates (which are complex sugars) or fruit (which has fructose, a sugar) or any number of things.  The bacteria in our mouths eat all those sugars and excrete acid.  That acid is what causes cavities.

Now bacteria is way more attracted to xylitol than regular sugar.  The Bacteria head right for xylitol!  But bacteria cannot break down xylitol.  Meaning if they can’t “eat” it, they can’t excrete it.  The bacteria dies not able to make acid to cause cavities.  That is how xylitol can help prevent cavities!

How does it help dry mouth?

Many things, including prescription medications, can cause dry mouth.  But why is dry mouth such a big deal?  Dry mouth can effect you quality of life!  It decreases your ability to taste.  It can cause bad breathe.  It can make eating difficult.  It can make talking difficult.  It can even significantly increase your susceptibility to getting cavities!

Xylitol has a cooling effect, quenching the burning of dry mouth.  Xylitol also stimulates saliva flow, which fixes all of the problems previously mentioned.  Xylitol is also an humectant, which means it attracts moisture.  And Xylitol neutralized saliva’s pH.  An acid pH leads to dry mouth, a basic pH can lead to an overgrowth of plaque bacteria.  Nice neutral pH is where your mouth is the happiest!

Who can have Xylitol?

Xylitol is safe for all ages!  Great for the whole family!

Even diabetics can use xylitol.  “The body does not require insulin to metabolize xylitol. For this reason polyols like xylitol produce a lower glycemic response than sucrose or glucose. This has made xylitol a widely used sweetener for the diabetic diet in some countries. If you do have diabetes, however, it’s important to consult your doctor or diet professional before incorporating xylitol into your daily diet. (1)”

And, like chocolate, onions, raisins, or avocados, xylitol is not safe for our 4-legged furry family members.  Please do not share it with them.

Where can you find Xylitol?

Xylitol can be found in a wide array of products.  Most commonly, chewing gum, candies, and mints.  It is also found in tooth pastes, mouth sprays, and even as granulated crystals to replace table sugar.

Hope this has been informative and you have found a new way to incorporate the many benefits of Xylitol in your life!

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Oral Health: A Window to your Overall Health



Andra Mahoney, BS RDH

Oral Health: A Window to your Overall Health

Many people are realizing that there is a direct connection between oral health and total body health.  It is finally being generally accepted that oral health and general health are to be interpreted as one entity, not separate as has been the view in the past.  Dentists has been saying this for years, and finally science is proving them right! You cannot be healthy without good oral health.

“The mouth can act as a portal of entry for infection, ” says Salomon Amar, DMD, PhD, Professor and Director at the Center for Anti-Inflammatory Therapeutics at Boston University School of Dental Medicine.  “Ongoing inflammation in your mouth can allow bacteria to enter the bloodstream, which may lead to more inflammation in other parts of your body, such as the heart.”

What conditions may be linked to oral health?



Cardiovascular disease. Some research suggests that heart disease, clogged arteries, and stroke might be linked to the inflammation and infections that oral bacteria can cause.

In 2005, the NIH funded a study on this topic. They randomly selected 1,056 participants with no prior heart attacks or strokes.  All were evaluated for levels of periodontal bacteria.  After removing the effects of the other risk factors of age, gender, and smoking, Moise Desvarieux, MD, PhD, Associate Professor of Epidemiology at the Mailman School and lead author of the study stated, “It was found that there was an independent relationship between gum disease and heart disease.” One theory about why this may occur is that small amounts of bacteria enter your bloodstream while you’re chewing. “Bad” bacteria from an infected mouth may lodge itself inside blood vessels, ultimately causing dangerous blockages. Strengthening his theory is the fact that when scientists have looked at atherosclerotic blood vessels, they have sometimes found fragments of periodontal bacteria. Meanwhile, a study published in the New England Journal of Medicine in 2007, established that aggressive treatment of gum disease reduces the incidence of atherosclerosis within six months.

It has been found that up to 91% of patients with heart disease have periodontitis. “The theory is that inflammation in the mouth causes inflammation in the blood vessels,” says Sally Cram, DDS, PC, Consumer Adviser for the American Dental Association. “This can increase the risk for heart attack in a number of ways. Inflamed blood vessels allow less blood to travel between the heart and the rest of the body, raising blood pressure. There’s also a greater risk that fatty plaque will break off the wall of a blood vessel and travel to the heart or the brain, causing a heart attack or stroke.”


Scientists believe that gum disease or inflammation in the mouth possibly triggers an increase in a chemical compound called prostaglandin, which induces early labor. While this theory has not yet been confirmed, a 2001 study found that pregnant women who develop gum disease between weeks 21 and 24 of their pregnancy are four to seven times more likely to give birth before week 37. There is evidence that poor gum health in the extreme can lead to low birth weight as well.

Babies born too early or at a low birth weight often have significant health problems, including lung conditions, heart conditions, and learning disorders. While many factors can contribute to premature or low birth weight deliveries, infection and inflammation in general seem to interfere with a fetus’ development in the womb.

Though men have periodontitis more often than women do, hormonal changes during pregnancy can increase a woman’s risk. For the best chance of a healthy pregnancy, Pamela McClain, DDS, President of the American Academy of Periodontology, recommends a comprehensive periodontal exam, “If you’re pregnant or before you become pregnant, identify whether or not you’re at risk.”

Diabetes. Diabetes reduces the body’s resistance to infection which puts the gums at risk.

Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels.  Researchers at Columbia University’s Mailman School of Public Health followed 9,296 non-diabetic participants, measuring their level of periodontic bacteria over the course of 20 years. “We found that people who had higher levels of periodontal disease had a two-fold risk of developing type 2 diabetes over that time period compared to people with low levels or no gum disease,” explains Ryan Demmer, PhD, Associate Researcher at the Department of Epidemiology at the Mailman School and the lead author. There are a few theories about why this might be the case.  One proposes that when infections in your mouth get bad enough, it can lead to low-grade inflammation throughout your body, which in turn wreaks havoc on your sugar-processing abilities. “There are all kinds of inflammatory molecules,” says Dr. Demmer, “and it’s believed that maybe some attach to insulin receptors and prevent the body’s cells from using the insulin to get glucose into the cell.”

It has also been noted that inflammation that starts in the mouth seems to weaken the body’s ability to control blood sugar. People with diabetes have trouble processing sugar because of a lack of insulin, the hormone that converts sugar into energy.  “Periodontal disease further complicates diabetes because the inflammation impairs the body’s ability to utilize insulin,” says Dr McClain. Diabetes and periodontitis have a two-way relationship. High blood sugar provides ideal conditions for infection to grow, including gum infections. Diabetes can also slow the healing process and lower resistance to infections, including oral infections.  Fortunately you can use the gum disease-diabetes relationship to your favor: managing one can help bring the other under control.

HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.  Studies suggest that oral bacteria and the inflammation associated with periodontitis, a severe form of gum disease, might play a role in some diseases. Certain diseases, such HIV/AIDS, can lower the body’s resistance to infection, making oral health problems more severe.

Osteoporosis. Osteoporosis, which causes bones to become weak and brittle, might be linked with periodontal bone loss and tooth loss.  Osteoporosis and periodontitis have an important thing in common, bone loss. Researchers are testing the theory that inflammation triggered by periodontitis could weaken bone in other parts of the body.

Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease.
Dementia: The bacteria from gingivitis may enter the brain through either nerve channels in the head or through the bloodstream, that might even lead to the development of Alzheimer’s disease.

Pneumonia. A 2008 study of elderly participants found that the number who developed pneumonia was 3.9 times higher in patients with periodontal infection than in those free from it. “The lungs are very close to the mouth,” says Marsha Rubin, DDS, practicing Diplomat of Special-care Dentistry at New York-Presbyterian/Weill Cornell. “Even in a healthy mouth there is lot of bacteria, but bacteria in a not-healthy mouth can get aspirated into the lungs, causing pneumonia or aggravating COPD, chronic obstructive pulmonary disorder.” Several intervention studies cited by the CDC show that an improvement in oral health can lead to a reduction in respiratory infection.  Periodontal disease may make pneumonia and chronic obstructive pulmonary disorder worse, possibly by increasing the amount of bacteria in the lungs.

Pancreatic Cancer. A study published in 2007 in the Journal of the National Cancer Institute surveyed 51,529 American men about their health every two years between 1986 and 2002. Of the 216 participants who developed pancreatic cancer, 67 of them also had periodontal disease. Independent of the participants’ smoking status, the study found that having a history of periodontal disease was associated with an increased risk of pancreatic cancer. This, according to the study, could be because of systemic inflammation or increased levels of carcinogenic compounds produced in the infected mouth. Interestingly, another viable theory about why gum disease may cause type 2 diabetes points to damage to the pancreas as well. “With the pancreatic cancer study, we thought it was very interesting that you have this localized infection that has an impact on a systemic organ that is very intimately tied to the pathophysiology of diabetes,” says Dr. Desvarieux.

Cancer.  Your dentist and hygienist should screen for oral cancer and other cancers of the head and neck, including skin cancer, cancer of the jaw bone, and thyroid cancer, during routine checkups. He or she feels for lumps or irregular tissue changes in your neck, head, cheeks and oral cavity, and thoroughly examines the soft tissues in your mouth, specifically looking for any sores or discolored tissues. Survival rates greatly increase the earlier oral cancer is discovered and treated. During your next dental visit, ask your dentist to do an oral cancer screening. See your dentist immediately if you observe:

Any sore that persists longer than two weeks

A swelling, growth, or lump anywhere in around the mouth or neck

White or red patches in the mouth or on the lips

Repeated bleeding from the mouth or throat

Difficulty swallowing or persistent hoarseness

Scientists aren’t sure of the exact cause of oral cancer. However, the carcinogens in tobacco products, alcohol and certain foods, HPV infections, as well as excessive exposure to the sun, have been found to increase the risk of developing oral cancer. Risk factors for oral cancer may also be genetically inherited. You can help prevent oral cancer by:

Not smoking or using spit tobacco

Limiting your alcohol intake

Eating plenty of fruits and vegetables

Also, periodic self-examinations can increase your chances of detecting oral cancer, so be sure to examine your face, cheeks, jaw and neck regularly for any changes or lumps.

Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome, an immune system disorder that causes dry mouth, and eating disorders.

Because of these potential links, be sure to tell your dentist if you’re taking any medications or have had any changes in your overall health, especially if you’ve had any recent illnesses or you have a chronic condition, such as diabetes.

How can I protect my oral health?


Brush your teeth at least twice a day.

Floss daily.

Eat a healthy diet and limit between-meal snacks.


Schedule regular dental checkups.

Also, contact your dentist as soon as an oral health problem arises. It is important to let your dentist know your full family medical history. If you have periodontal disease, make sure you see your dentist frequently and get it treated promptly, before it progresses to the point where you begin losing teeth or it starts to affect your overall health.  Remember, taking care of your oral health is an investment in your overall health.

One thing is clear: the body and mouth are not separate. Your body can affect your mouth and likewise, your mouth can affect your body.  Taking good care of your teeth and gums can really help you live well longer.

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Click to access connection-oral-health.pdf





Diabetes and Dental Care

Sharma RDH

Sharma Mulqueen RDH

Diabetes and Dental Care

What do brushing and flossing have to do with diabetes? Plenty. If you have diabetes, here’s why dental care matters — and how to take care of your teeth and gums. 

When you have diabetes, high blood sugar can take a toll on your entire body — including your teeth and gums. The good news? Prevention is in your hands. Learn what you’re up against, and then take charge of your dental health.

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Cavities and gum disease


  • Early gum disease (gingivitis). Diabetes reduces your ability to fight bacteria. If you don’t remove plaque with regular brushing and flossing, it’ll harden under your gumline into a substance called tartar (calculus). The longer plaque and tartar remain on your teeth, the more they irritate the gingiva — the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily. This is gingivitis

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Proper dental care


  • Make a commitment to managing your diabetes. Monitor your blood sugar level, and follow your doctor’s instructions for keeping your blood sugar level within your target range. The better you control your blood sugar level, the less likely you are to develop gingivitis and other dental problems.

Floss your teeth at least once a day. Flossing helps remove plaque between your teeth and under your gumline. If you have trouble getting floss through your teeth, use the waxed variety. If it’s hard to manipulate the floss, use a floss holder.

  • Schedule regular dental cleanings. Visit your dentist at least three times a year for professional cleanings.


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 Periodontal Disease and Diabetes 


Peggy Stoor, RDH

 Periodontal Disease and Diabetes

Recently much has come to light regarding oral health and its impact on systemic health and disease. While I’ve always been borderline fanatic about oral health and have been aware of some of these relationships, the recent research connecting oral health to systemic health has helped to make my daily work much more relevant and interesting.

Presently there are 18 million diabetic patients in the U.S. and 171 million diabetic patients worldwide. Diabetes is characterized by increased susceptibility to infection, poor wound healing, and a number of complications that can affect quality of life and length of life.  Diabetes is also a risk factor for severe periodontal disease (the destruction of tissues and bone that support the teeth). It’s critically important to realize that diabetics who have periodontal or gum disease have two chronic conditions, each of which affect the other.


While we have long known that diabetes can predispose one to periodontal disease, research now suggests that treatment of periodontal disease can have a positive impact on the diabetic condition.  Patients with periodontal disease have more difficulty controlling their blood sugar. Patients who have treatment and gain control of their gum disease have been shown to require less insulin and have a decreased hemoglobin A1c level. (A1c denotes a patients average blood sugar level over the past 3 months). In other words, periodontal disease and diabetes is a two-way street with each disease having a potential impact on the other, either positively or negatively.

Management of gum disease in patients with diabetes involves removal of plaque and calculus both at home and professionally, and maintenance of glycemic control. Nearly all diabetics respond to treatment and maintenance, therefore treatment of periodontal disease should be done as soon as possible. Both conditions require frequent professional evaluations, patient-self monitoring, daily brushing and flossing, approved antibacterial mouth rinses, and good blood glucose control.

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Southerland, J.H. (2005.) Diabetes and periodontal infection: Making the connection. Retrieved from http://clincial.diabetesjournals.org/content/23/4/171

Diabetes and Periodontal Disease: Retrieved from http://www.perio.org,  American Academy of Periodontology, Diabetes and periodontal Disease

Diabetes and Oral Health: Retrieved from http://www.nidcr.nih.gov/OralHealth/Topics/Diabetes.National Institute of Dental and Craniofacial Research by National Institutes of Health-(2007)

Mealey, B.L. ,(2006).Periodontal disease and diabetes: A two-way street. Journal of American Dental Association. Oct.137 suppl:26S-31S. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed

Mirza,B.A., Syed A., Izhar F., Ali Khan. (2001). Bidirectional relationship between diabetes and periodontal disease: Review of evidence. J  Pak Med Assoc. Retrieved from http: http://www.ncbi.nlm.nih.gov/pubmed/21381588

Dental Care and Diabetes. http://www.webmed.com/diabetes/dental-health-dental-care-diabetes

Image Credit: http://www.intelligentdental.com/2012/03/31/effect-of-systemic-factors-on-the-periodontium-part1

The Link Between Mouth and Body-Exploring Possible Links


Lindsay Whitlock RDH



The oral cavity is recognized as a portal of entry for many infections that affect overall health; including both physical health and emotional health. Among these infections are two leading widespread dental diseases: caries (decay) and periodontal disease (gum disease). The consequences of decay in the oral cavity and periodontal diseases are profound and often times underestimated in context of their negative impact on one’s physical health. More studies are needed but some researchers suspect that bacteria and inflammation linked to periodontal disease play a role in some systemic diseases and or conditions. Research suggests that although periodontal disease starts as a local infection in the mouth, it is generally accepted that associated bacteria and toxins gain access to the body’s blood supply and travel throughout the body. This creates a systemic inflammatory response, which may increase the risk for: heart disease, pneumonia, and complications of diabetes and pregnancy. Although periodontal disease may contribute to these health conditions, it is critical to understand that just because two conditions occur at the same time does not necessarily mean one condition is the cause for another. Researchers are continuing to work hard to examine the affects of when periodontal disease is treated within individuals suffering with these various health problems.


Periodontal Disease – What You Should Know

Periodontal disease is a chronic infection within the oral cavity caused by bacteria. It begins when specific bacteria in dental plaque produce harmful toxins and enzymes that irritate the gums. An inflammatory response occurs if dental plaque is not removed on a daily basis. Plaque that remains on teeth over a short period of time can irritate the gums making them red and likely to become tender and bleed. This condition is called gingivitis, which can lead to more serious types of periodontal diseases. Gingivitis can be reversed and gums kept healthy by removing dental plaque daily with oral hygiene routine as well as having your teeth professionally cleaned.

If gingivitis is allowed to persist, it can progress to periodontitis (periodontal disease), a chronic disease in the pockets around the teeth. Inflammation that results may be painless however, it can damage the attachment method of gum tissue and bone to the teeth. Consequently advanced periodontitis is linked with other health problems such as cardiovascular disease, stoke and bacterial pneumonia. Left untreated, teeth may eventually become mobile, fall out, or require removal by a dentist.

Given the link between periodontal disease and the systemic health problems, prevention is a critical step in maintaining overall health.

1. Brush your teeth twice a day for two minutes.

2. Clean between teeth with floss or another type of interdental cleaner once a day.

3. Eat a balanced diet and limit snacks.

4. Schedule regular dental checkups as recommended by your dental hygienist or dentist.

5. Tell your dentist about changes in your overall health.

Click this link that is presented by Listerine and Reach to watch a video further explaining the link between periodontal disease and our bodies.







Health and Nutrition



Julie West BS RDH 

Statistics from the World Health Organization show that up to 93% of diabetes, 81% of heart disease, 50% of strokes, and 36% of all cancers could be prevented by a healthy diet and lifestyle.  We have all heard of fad diets and medications that claim to slim you down in weeks, but have you looked at the asterisk on the bottom of your television screen during their commercials?  You will see that the testimonials you are seeing are from “results not typical” and have occurred in less and 5% of the people who took that particular diet plan or pill.  The best weight loss experts will tell you that there is no shortcut to being healthy.  Diet and exercise are essential in establishing and maintaining health.

Obesity is increasing in prevalence and is a major contributor to worldwide morbidity.  As obesity in this country rises, are we surprised that the prevalence of heart disease, diabetes, cancer, and other diseases rises too?  One of the dangers in obesity is due to a prolonged state of inflammation in the body.  Inflammation is the first response of the body to injury, cell damage, infection, or irritants.  Inflammation that is chronic and unresolved can lead to:

  • Rheumatoid Arthritis
  • Periodontal Disease
  • Diabetes
  • Cardiovascular Disease
  • Asthma
  • Cancer

Fat cells produce hormones and proteins that cause inflammation and insulin resistance, which promote cell growth.  Overweight people have high levels of substances circulating in their blood that stimulate cell division. The more often cells divide, the more opportunity there is for cancer to develop.  To help lower your risk for cancer, it is important to know how much inflammation is present inside your body.

At your next visit to your doctor, ask for a blood workup with a screening of your C-reactive protein, a protein made by the liver when there is inflammation in the body.

Inflammation also often manifests in the mouth.  If you have one or more of the above diseases, inflammation may be the underlying factor.  At your next dental visit, ask your dental hygienist if there is inflammation in your mouth.  Your dental hygienist can provide great information about the inflammation process and its effects on the body.



Brand-Miller J, et al. Cur Opin Lipidol 2012, 23(1): 62-7

Low Dog, MD. (February 2014). Cancer and Nutrition in the 21st Century. Western Regional Dental                    

Convention.  GC America, Phoenix, Arizona.