Supplement analysis backed by scientific evidence · PT

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Moderate evidenceGeneral health

Xylitol

A sugar alcohol that oral bacteria cannot ferment. Used as a sugar replacement it reduces cavities, and chewing gum containing it modestly reduces ear infections in children.

Evidence last reviewed: August 2026

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What the science says

  • Fewer cavities when it replaces sugar Moderate evidence

    A systematic review and meta-analysis of sugar substitutes for caries prevention in permanent teeth of children and adolescents found lower caries increments with xylitol and other non-fermentable sweeteners. Much of the benefit appears to come from displacing sugar rather than from a unique property of xylitol, and trial quality is mixed.

  • Fewer episodes of acute otitis media Moderate evidence

    A Cochrane review found that xylitol chewing gum, lozenges or syrup reduced the occurrence of acute otitis media in healthy children by roughly a quarter compared with control. The evidence was rated moderate quality and the benefit was not seen in children who were already unwell.

  • Cardiovascular signal worth noting Limited evidence

    Observational and mechanistic work has linked higher circulating xylitol with platelet reactivity and cardiovascular events. This is preliminary and not from randomised trials, but it is a reason not to consume large quantities habitually.

Dosage & safety

Studied doseCaries and otitis media trials used roughly 5–10 g/day divided across at least three occasions, usually as gum or lozenges after meals. Occasional use does not appear to work; the frequency matters more than the total.
SafetyAbove about 30–50 g/day it commonly causes gas, bloating and osmotic diarrhoea, and tolerance varies widely. Xylitol is severely toxic to dogs even in small amounts, causing hypoglycaemia and liver failure, so keep products away from pets. The emerging cardiovascular association is unresolved.

Scientific references

Where to buy

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