Xylitol is the alcohol form of xylose, which is used as a sweetener in chewing gums and other dietetic products. Xylitol has less effect on blood sugar or insulin levels compared with sucrose,1 so it may be a useful sugar substitute for diabetics.2 In addition, xylitol inhibits the growth of several types of bacteria, including those that cause tooth decay and ear infections.3 , 4 , 5 , 6

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

This supplement has been used in connection with the following health conditions:

Used for Why
3 Stars
Ear Infections
8.4 grams daily divided into several doses of chewing gum
Xylitol, a natural sugar found in fruit, helps control mouth bacteria that cause ear infections.

Xylitol, a natural sugar found in some fruits, interferes with the growth of some bacteria that may cause ear infections. In double-blind research, children who regularly chewed gum sweetened with xylitol had a reduced risk of ear infections. However, when they only chewed the gum while experiencing respiratory infections, no effect on preventing ear infections was found.

3 Stars
Tooth Decay
Chew gum containing xylitol regularly
Chewing gum with xylitol, a sugar substitute, may reduce the activity of cavity-causing bacteria.

Certain sugar substitutes appear to have anti-caries benefits beyond that of reducing sugar intake. Children chewing gum containing either xylitol or sorbitol for five minutes five times daily for two years had large reductions in caries risk compared with those not chewing gum. Sorbitol is only slowly used by oral bacteria, and it produces less caries than sucrose.

Xylitol gum was associated with a slightly greater risk reduction than sorbitol gum. Bacteria in the mouth do not ferment xylitol, so they cannot produce the acids that cause tooth decay from xylitol. A double-blind study found 100% xylitol-sweetened gum was superior to gum containing lesser amounts or no xylitol. Another study found xylitol-containing gums gave long-term protection against caries while sorbitol-only gum did not.

Other research has confirmed the anti-caries benefits of xylitol in various forms, including gum, chewable lozenges, toothpastes, mouthwashes, and syrups. Mothers typically transmit one of the decay-causing bacteria to their infant children, but a double-blind trial found that the children of mothers who regularly chewed xylitol-containing gum for 21 months, starting 3 months after delivery, had a greatly reduced risk of acquiring these bacteria, and also had 70% less tooth decay.

How It Works

How to Use It

For prevention of dental caries (cavities), 7 to 20 grams per day are given, divided into several doses in candies or chewing gum. For prevention of ear infections, 1.7 to 2.0 grams are given fives times per day in gum, lozenges, or syrup.

Where to Find It

Xylitol occurs naturally in straw, corncobs, fruit, vegetables, cereals, mushrooms, and some seaweeds. For use in food manufacturing, xylitol is extracted from birch wood chips. Xylitol may be found in many foods labeled as "sugar-free," including hard candies, cookies, chewing gums, soft drinks, and throat lozenges.

Possible Deficiencies

Xylitol is not an essential nutrient; therefore, no deficiencies are possible.


Interactions with Supplements, Foods, & Other Compounds

At the time of writing, there were no well-known supplement or food interactions with this supplement.

Interactions with Medicines

As of the last update, we found no reported interactions between this supplement and medicines. It is possible that unknown interactions exist. If you take medication, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

Xylitol is recognized as a safe food additive by the U.S. government.7 Large amounts (30 to 40 grams) taken all at once can produce diarrhea and intestinal gas.


1. Hassinger W, Sauer G, Cordes U, et al. The effects of equal caloric amounts of xylitol, sucrose and starch on insulin requirements and blood glucose levels in insulin-dependent diabetics. Diabetologia 1981;21:37-40.

2. Bakr AA. Application potential for some sugar substitutes in some low energy and diabetic foods. Nahrung 1997;41:170-5.

3. Trahan L. Xylitol: a review of its action on mutans streptococci and dental plaque—its clinical significance. Int Dent J 1995;45(1 Suppl 1):77-92 [review].

4. Tapiainen T, Kontiokari T, Sammalkivi L, et al. Effect of xylitol on growth of Streptococcus pneumoniae in the presence of fructose and sorbitol. Antimicrob Agents Chemother 2001;45:166-9.

5. Kontiokari T, Uhari M, Koskela M. Antiadhesive effects of xylitol on otopathogenic bacteria. J Antimicrob Chemother 1998;41:563-5.

6. Kontiokari T, Uhari M, Koskela M. Effect of xylitol on growth of nasopharyngeal bacteria in vitro. Antimicrob Agents Chemother 1995;39:1820-3.

7. Xylitol. Code of Federal Regulations, Title 21, Volume 3. U.S. Government Printing Office, 2003: 21CFR172.395.