Q&A with Dr. Ellie: Not all xylitol products are the same

Every month Dr. Ellie Phillips will answer your oral health questions as part of the Ultimate Oral Health Guide.
 

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Q: Are the gums on the market – such as Trident – effective at delivering xylitol? Also, I make lemonade with xylitol in the summer and my kids don’t know the difference. Is that not as effective as xylitol and water because of the acidity of the lemon?  -P

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A: Dear P,

Any gum (like Trident) that mixes xylitol and sorbitol together – basically inactivates the benefits of the xylitol – plus sorbitol can give you bad stomach problems. Sorbitol is used by plaque bacteria – to produce thickened plaque – and many who eat a lot of sorbitol (sugarless) gum have gingivitis and bleeding gums.

Also, sorbitol appears to give people symptoms of acid reflux – quite possibly because it fuels the bacteria responsible for indigestion symptoms (C. Pylori).

So – my suggestion: don’t consume gum with sorbitol – it is really not safe for you or for your teeth!

Also you would be better to use a natural sugar in the lemonade and then have some xylitol after drinking it. I do not recommend putting xylitol in acidic or harmful drinks – it gets too diluted in the acidity. Use xylitol immediately after to take the acidity away.

Best wishes,
Dr. Ellie

 

For more information, please visit all of Dr. Ellie’s web-sites:

Dr. E Oral Health Coaching – articles, resources and videos to help you learn more
Zellies.com – learn more & order your Zellies Xylitol & the Complete Mouth Care System
Dr. Ellie.com – a great resource for learning more about oral health & Dr. Ellie

Join the conversation online on the Zellies Facebook page!

38 thoughts on “Q&A with Dr. Ellie: Not all xylitol products are the same

    1. Hi Michele,
      I honestly don’t know the scientific answer to your question. At my next opportunity – I will ask a microbiologist for their opinion.
      You could consider to spritz the brushes – or maybe just alternate days. Make sure that after rinsing the Listerine off with water, you let your toothbrushes dry out completely. Bacteria die when they dry!!
      We have started selling Mouth Watchers antibacterial toothbrushes. Does anyone have comments or testimonials about these new brushes we added to our website?

      Like

  1. 1.-How it will be the ultimate oral health for people with a few teeth and dentadures?

    2.- and which material for dentadures you believe is the less harmfull for health ?

    Regards
    Thank you very much for this amazing complete program you put together and share it for free
    God bless you and the world
    Mony

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    1. Materials for bite plates and dentures contain various metals and plastics. Concerns about these metals or plastics should be addressed with your dentist – particularly to find out if the plastic leaches Bisphemol A.
      When you have dentures, you still need to clean your mouth – and plaque grows on your tongue and is present in saliva. If you lost your teeth to periodontal disease, you can still transmit this to others. I suggest Closys as an excellent mouth rinse for mouth health – especially for anyone who has implants to hold in their dentures. Brush your denture with a little toothpaste, and rinse under running water.
      Zellies mints are wonderful for anyone with dry mouth or dentures – and they will help protect from fungal infections and keep the mouth balanced and healthy. Our ZellieBears are another good option – or you may want to make a drink with a teaspoon of xylitol in water – and sip this during the morning or during the night for mouth protection.
      If you ever see a white coating on your tongue or the skin of your mouth – consider diet and nutrition – and maybe add some probiotics to your daily nutrition.Zellies will help prevent this from happening also.

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  2. I just read your article about 10 steps to prevent gum recession and the brief one about “black triangles.” I recently found a black triangle between my front 2 lower teeth, which appeared only after 4 months on your program. On the one hand, I am delighted to always feel the “after the dental cleaning” cleanliness in that spot, you know, where your tongue can actually feel the separations between each tooth, but on the other hand, I’m worried that my gums are receding. The dentist checked for recession a month ago and noted just a “2” there and didn’t say a word about recession except around my back teeth, where there were a couple of “4’s.” I only brush 2x/day and floss every 2-3 days. I eat healthfully and am in my mid 40s. Will quitting flossing altogether (I have cut down from daily to every 2-3 days) make the triangle ever disappear/the gum tissue grow in again?

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    1. I always want to know what “on my program” means! I need to ensure that you eat Zellies after everything you eat or drink, and whenever your mouth is dry. I also need to ensure you have at least 5 grams of xylitol each day?
      Are you using other forms of xylitol rather than Zellies?……perhaps they are not working well….
      I also need to assume you have the correct “system” products ( Closys, Crest Cavity Protection paste, Original Listerine, ACT anti-cavity rinse) and have read our booklets and instructions to use it correctly.

      Gum health is directly related to gut health, the quality of your diet and the health of your digestion.
      You may want to think about taking a good multi-vitamin, possibly a probiotic, and definitely ensure you have enough fresh veggies and fruits (for their anti-oxidant qualities). I like to recommend fresh pineapple too – the bromalain in pineapple can help digestive absorption – which could be important for saliva quality.

      I’d also like to know what kind of toothbrush you use and if you brush your gums and massage them.
      Some brushes are way too soft and some are too hard.
      The idea is to massage the circulation in your gums – and bring a healthy blood supply to help the gums get healthy and possibly grow back. The nutrients that you consume help the healing process, but only if you stimulate circulation in the gum tissues with your toothbrush. Let me know if you need more help with brushing – this is very important for gum health!

      I have no idea how flossing could possibly help re-grow gums, and certainly there is no science to show it can. If you can email a picture to me at ellie@zellies.com I can take a look and maybe help you with some other suggestions.

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  3. My dentist would like to apply a white sealant to my pre-molar because it has a very deep fissure which she said is causing staining/food to get caught. I do see a fine dark line in that tooth frequently and she demonstrated with her explorer how deep the tip is able to reach in. I am 46 and in good health. I am using your complete system — should I allow her to do the sealant? (Perhaps this situation would be an exception to your usual advice to avoid sealants since eventually they leak, harbor bacteria, and do need to be replaced every few years?)

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    1. I cannot diagnose nor give information about a specific tooth here, but we can discuss why I believe it is better to avoid sealants whenever possible. In this case, a sealant would probably be extremely small, and it may look nicer– so your decision could be made for esthetic reasons.

      On the other hand, most US dentists have never seen a cavity reverse, and only a few believe in remineralization. Slowly this is changing, but xylitol is new to the United States and without its help, “miraculous” tooth repairs are not possible. Personally I suggest you use Zellies Mints and my system for at least 12 months and “watch” the outcome for this tooth before making any decision (by the way, we would all love to hear the rest of this story if you decide to wait…..).

      Every time you eat a Zellies Mint and it dissolves in your mouth, xylitol liquid washes over teeth –into every pit and fissure. In these hidden places, xylitol eliminates harmful bacteria that may be lodged there. Without cavity-forming bacteria, danger is averted – and a sealant becomes unnecessary.

      The biggest problem with sealants is they contain BPA (BisPhenol A) a chemical that is disruptive since it mimics estrogen and can get into brain tissue. There are additional problems with sealants for kid’s teeth, since healthy bacteria in tooth grooves are a positive source to balance mouth bacteria and fight infection and cavities. This idea of promoting healthy bacteria in tooth grooves is a little-known concept – and we will discuss this in future newsletters.

      When you use xylitol at the end of every meal and snack, your risk for decay will be reduced so much that the need for a preventive sealant is eliminated.

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  4. I have a 20 month old daughter. She has a minor upper lip tie (which I read can lead to a greater chance of cavities) and she is still nursing at night. It seems to me that her upper 4 baby teeth have been rough and discolored almost since they came in. I’m brushing her teeth 2-3 times a day now with a natural child-safe toothpaste because I fear they are decaying. It is a traumatic event, where we have to hold her down to get to all her teeth, so we used to brush them once before bed (without paste when she was younger) and allow her to ”brush” her teeth any other time she wanted to try.

    I’m concerned about some the artificial colors and ingredients in the products you recommend, but I’m willing to use them to protect her teeth and prevent further damage. She drinks only water from a sippy cup. I’m working on making less starchy meals. She doesn’t have enough molars yet to master leafy greens, but she does try.

    What would you recommend for a toddler in this situation?

    I have read good things about breast milk actually being protective for teeth, and we won’t be night weaning soon. I’d like to know what to do during the day and if you recommend rubbing xylitol on her teeth several times a day. I also worry about giving her too much flouride in toothpaste form. We have a Reverse Osmosis water filtration system that may be taking the flouride out of our water already, though.

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  5. Hi, I’m wondering how long I need to rinse with Listerine. I can only make it about 12 seconds before it starts stinging really badly.

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    1. The ingredients in Listerine do their work in less that 60 seconds – according to research. I know that this can seem forever – so I empathize. Ensure you are using the correct toothpaste – Crest Cavity Protection -immediately before the Listerine step. Cover your gums and teeth in the toothpaste before rinsing with Listerine. Spit out any big “glob” of paste, but don’t rinse the paste off your teeth or gums with water. Go straight to the Listerine step and squish the Listerine vigorously between your teeth – like liquid floss – for as long as you can tolerate. Spit out and immediately rinse with ACT. Use only Original or Cool Mint Listerine – never the purple or other varieties! If this continues to be intolerable for you – try diluting the Listerine with warm water – or in the worst case scenario – just use it for as long as you can! Even a short rinse will be a benefit for your oral health. Thanks so much for your question.

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    1. The reason I talk about sorbitol is to warn people that there are many “sugarless” products ( often made with sorbitol) that are NOT safe for teeth. Sorbitol can feed plaque bacteria and grow plaque when eaten regularly. Most importantly, when mixed with xylitol, in gum – for example, the sorbitol appears to inactivate remineralization.

      On the other hand, in toothpaste and mouth rinses ( although I wish we did not have sorbitol) it does not create any problems – so don’t worry!

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  6. Hi Dr. Ellie, I have a question. How long does the bacteria in your mouth live without food?
    What if you took xylitol but did not eat so as not to nourish the bacteria? Maybe one could
    fast only on water and xyitol thus weaking and elimiating the bacteria until elimination.-Dennis

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    1. Wow – that is not exactly something I have ever considered suggesting to patients! I do know that limiting snacking/eating/drinking to four or less times per day appears to make a huge difference and make oral health much easier to control. On the other hand, oral health is virtually impossible to control if someone is constantly eating/snacking/drinking.

      I have never seen a study where the bacteria count was performed on fasting individuals – this would be very interesting. I have never seen any animal studies using this approach either.

      In the 1950s they did studies with no-biotic animals ( animals bred without any bacteria in their mouths) which were fed a continuous diet of sugar, yet they did not develop any decay. Once bacteria were introduced into their mouths, these same animals ( and their offspring) quickly developed cavities.

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  7. Hi,
    I’m intrigued by what I’ve been reading and as I’ve had a lot of dental issues the last few years I’m willing to give your system a try.
    What I really wanted to ask was if people ever complain about xylitol GIVING them dry mouth? I’m not using zellies right now, but I was very careful to get mints that are 100% birch with nothing else but a little flavoring (I’m not a gum person). My mouth is Sooooo dry. (Again I haven’t started the whole system yet. I find it hard to believe that not having added the complete system explains the dry mouth from xylitol.)

    I also admit that I like many others have a tendency to not drink enough during the day. I was very disappointed to hear that using it in place of sugar to make lemonade or other drinks doesn’t work, because I have a hard time with plain water and if I don’t have something available to sip during the day I’m that much more likely to be on the dehydrated sided. So I’m still trying to figure out how to balance hydration and eating xylitol. Any ideas what’s going on here? Ann

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    1. Two of your comments make me believe you are dealing with bacterial imbalance in your mouth.

      When water does not taste good, it usually indicates the presence of pocketing and periodontal disease in your mouth. It’s possible that a periodontal germ mixes in the water you drink to make it taste bad. Getting your gums healthy ( with the system of care I recommend) will change this for you – and you may begin to love drinking water. Right now, drinking acidic drinks will perpetuates the cycle of disease ( since all bad bacteria grow in acidic conditions).

      My suggestion is to drink acidic drinks that you enjoy (juices, fruits etc) at meal times and end with Zellies mints.( I’m not going to endorse other xylitol products since many of them contain ingredients that can be problematic). In between meals, I suggest you put a half teaspoon of xylitol granules in water – and sip this when you are thirsty. Xylitol dissolves in room temperature water, so you need to mix it in, prior to chilling.

      Finally I am suspicious of the toothpaste or rinses you may be using. If you are using any of the Sensodyne products, this may explain why your mouth feels dry. Colgate Total, Crest Pro-health, and all the whitening and bleaching pastes are so chemically imbalanced – they can easily contribute to dry mouth problems.

      My suggestion is to ditch all the things you are currently using and begin the exact protocol I recommend. I think your teeth will quickly feel great and your dry mouth sensation will become a thing of the past. In addition – I am certain your gum health will improve within a year and Zellie-water may become your favorite new drink! We’d love to hear back if you decide to take this Zellies Challenge for oral health!

      Best wishes, Ellie

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  8. Dear Dr. Ellie,
    I went to buy the products in your book. You say not to eat sorbitol because its bad for teeth, but in the original crest and regular act mouthwash their is sorbitol. Its frustrating because the act is the last step to be on your teeth all night. What should I do?—–Becky.

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    1. Thanks for this question. Sorbitol is able to feed plaque bacteria – which is why “sugar-free” candies are not safe for teeth. On the other hand, by the time you have gone through all the parts of my Complete Mouth Care System, there are no plaque bacteria to feed! Don’t worry about sorbitol as an ingredient in these oral care products – you will spit it out at the conclusion of your rinse. The problem with chewing gum sweetened with sorbitol is that you swallow the sorbitol-liquid while you chew – and this can give symptoms of acid reflux and also feed plaque bacteria. I hope this explains the difference.

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  9. Dear Dr. Ellie,
    After I wrote the previous post I read the one by Frank. Please explain why sorbitol is bad in food and drinks,
    but not in toothpaste and rinses. How does your mouth know the difference? Why doesn’t it inactivate remineralization when in toothpaste and rinses as im eating xylitol all day?——-Becky.

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    1. I think the important thing is to know xylitol is altogether unique! It is a five-carbon (pentose molecule) known as a polyol. Regular sugar molecules have six carbon atoms, as do sorbitol and all the other “sugar alcohols”. Xylitol is unique – with a completely different structure – with five carbon atoms, resembling RNA molecules of perfect nature. I believe it is most important to know the difference between sorbitol and xylitol.
      Sorbitol in tiny amounts (from time to time) do have the potential to feed plaque – you are correct, but it is frequent and regular consumption of sorbitol (in drinks, candies, and foods etc) that appears to grow plaque in the mouth, and also give symptoms of acid reflux. I am not concerned about a tiny amount of sorbitol flavor in a pea-size drop of toothpaste or a rinse that you spit out – but I worry about sorbitol in chewing gum and products that are frequently swallowed, or consumed. Of course, I wish the paste and rinses that I recommended were flavored with xylitol, but at present, all the xylitol pastes and rinses contain glycerin – which I think is far more troublesome and therefore not recommended. Maybe one day Zellies will make toothpaste! Stay tuned….

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  10. Dear Dr. Ellie,
    If you do the system and have no plaque bacteria to feed then it should be o.k. to eat sorbitol in food then right? You said act is o.k.with sorbitol because you spit it all out, but yet your supposed to use it so the fluoride
    stays on your teeth all night to remineralize.so at the same time the sorbitol will be on your teeth all night too. You said sorbitol makes teeth softer. Its just not adding up. How does your mouth know the difference and how much money are you making off of promoting this system? just curiouse

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    1. Many people have problems with the myriad of toothpastes out there. I recommend Crest Cavity Protection paste – which is the original formulation – and although it is usually the least expensive – I believe it to be one of the very best! The difference is that most pastes use a cheap fluoride ingredient called stannous fluoride (made from tin). The Crest Cavity Protection paste uses sodium fluoride which is one of the best types of fluoride.
      I’d suggest you switch immediately – then your mouth should heal quickly. Zellies mints and gum are made with xylitol which may help repair the damaged biofilm in your mouth. You should also consider avoiding baking soda, peroxide or whitening products and stay away from acidic drinks if possible.

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  11. Dear Dr. Ellie,

    Will it be possible to reverse receding gums by following your system strictly or will it JUST stop a further recession?

    Thanks in advance

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    1. There are many reasons for gums to recede. If you know the reason responsible for your ( such as damage from bleaching, baking soda, too much acidity, or over-flossing) you can stop causing damage and stop the problem. Zellies and my suggested mouth care system will prevent things from getting worse, but without more information, it’s impossible to say if your gums will repair. I’ve had cases where black triangles have gone away completely ( complete reversal) in 1-2 years and this involved stopping flossing and of course using Zellies and my Complete System of Care.

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      1. Thanks so much for your quick reply Dr Ellie. What may have caused the recession of my gums (at least this is what my new dentist is supposing..) is the fact I had an orthodontia a few years ago that could have moved my teeth too fast. I also believe my saliva was too acid till a few months ago (before starting a much more healthy food habits) but definitely no bleaching, baking soda or over flossing involved. I’m currently 44 and the gums of some teeth have receded around 3-4 mm so…any hope?
        Thanks again

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  12. Hi Doctor Ellie,

    Will your system help remineralize the portion of tooth that is normally below the gumline, but has become exposed due to receding gums? I have a dark spot showing in that lower portion of my tooth and am wondering if I should have it repaired or wait to see whether your system will recitfy it in time (I have been using your system for 6 months now).
    I know your system has been reminerlazing a small cavity I have (above the gumline) in another tooth, so I am curious as to whether it should also do the same below the gumline.

    Thanks for your help.

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    1. The great thing about rinsing is that the liquids will flow everywhere in your mouth – even under crowns, along crevices, and below the gum line! Be certain you are using the exact and correct products – especially toothpaste – since the Cavity Protection variety of Crest is the only one with ingredients that rebuild enamel. Zellies will help a lot of course – so enjoy Zellie’s mints or gum after every meal, snack and drink during the day!
      The problem with gum-line fillings is that they usually do not last very long and need constant repair – so they quickly become very annoying – and may also lead to tooth sensitivity.

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  13. Dear Dr. Ellie
    I have been an avid reader of your website but unfortunately I can not find any of the products here besides Listerine, and I can not afford them shipped either.
    However, I am glad there are doctors/dentist promoting successful preventative tactics – unlike my experience so far. I am 36 and I have already had extensive work done in my mouth. It was a rollercoaster since I was 12. I never got new cavities in the last 15 years but I kept getting my old stuff redone.

    I always used a whitening toothpaste, ranging from Aquafresh, Colgate, Sensodyne, etc..I was just told to brush for 2 minutes and never ever thought about the way I brush….I want to stop the damage and I would love to follow your recommended treatment – but it’s not possible for me – I am in Ireland.

    I’ve been looking at the tooth on which a replacement filling is needed and it is white from all sides – the old filling is white and can’t be distinguished so there’s nothing I can see with my untrained eye. My new dentist hasn’t done an x ray and I am worried he is just finding stuff to do. I am on a medical card and have two free fillings per year and an exam – which is exactly what this dentist is aiming to do. I don’t know whether to trust him but I may be paranoid at this stage.

    I started using xylitol upon your recommendation and I stopped drinking coca cola. I used to eat lots of oranges/freshly squeezed orange juice, and lemons dipped in sugar! :)….only now I realise they are acidic.

    I am in two minds whether to go ahead with a filling replacement or whether to ask the dentist to just maybe take an x-ray. I know you can’t recommend since I can’t follow your regimen but I just had to let it all out of my chest! I will keep searching for your products or maybe one day I can purchase them from your website. I hope I can manage with substitute remedies until then.

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    1. We needed to edit your letter to fit on our page – I hope you don’t mind!

      It seems you’ve already figures out how to protect your teeth. Acidity causes damage – and now you are keeping acidic drinks and foods to meal times. I’d suggest you end every meal with some xylitol – swished around or, better yet, a few granules of xylitol eaten from a spoon. Allow the granules to dissolve in your mouth. This small change will help alkalize your mouth and protect your teeth from the acidity generated at meal times and from acidic drinks.

      It’s good you found a similar toothpaste to the one I recommend – and I like your idea of adding water after brushing to swish around your teeth (making your own “mouth rinse”). Rinsing is helpful, and since xylitol makes plaque slippery, rinsing washes plaque off teeth – so it’s a great combination for oral health!

      Yes, you have every right to want to hold off the replacement filling. Twinges of sensitivity – for about a minute- indicate a filling may need help. Replacing a white filling can often expose nerves and make teeth sensitive, which can lead to a root canal and crown – which is good reason not to have a replacement unless it’s necessary!
      Good luck with everything and thanks for sharing all your experiences.

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      1. Dear Dr. Ellie,

        It’s been 8 months since I posted. I don’t know if you keep the original non truncated post where I explained what I’ve been doing as a substitute to your recommended system due to the lack of availability here.
        I just wanted to say that it works and my mouth has improved tremendously. My gums are strong and don’t bleed even if I am rough with the brush over them(wasn’t like this before). My teeth are several shades whiter(imagine what the colour was, 20 years smoker’s teeth but now you can’t tell). I followed all the tips bar the mouth washes(basic non-glycerine tooth paste, brushing the gums and teeth, xylitol after meals and drinks). I just use diluted toothpaste as a final step and coconut oil as a first step before brushing instead of the other mouth washes.
        I am a mature student and this is my final year so hopefully afterwards I’ll be able to afford to order the mouthwashes online. I can’t wait. If I can see such improvements by using half your system, I could imagine what would happen if I follow it exactly.

        I just want to say that I wish I had access to this sort of information about oral health years ago.
        I can send you a couple of pictures before and after if you wish via e-mail but I don’t know how to do this here.

        All the best.

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  14. Thanks Dr. Ellie for your comprehensive reply.
    And no, I don’t mind about editing my “letter” 🙂 I think I wrote way too much…
    I let my dentist do the filling which was the last molar top left. The odd thing is when he told me the filling needed a replacement it was after he probed the tooth with the dental explorer on the side next to the other tooth which is the 2nd last molar. However, a few weeks later when I went he drilled the corner of the tooth on the total opposite side and didn’t even replace the entire filling. It was fairly quick. I don’t know what to think to be honest as I honestly couldn’t see or feel the issue myself and he doesn’t seem to talk much, or explain anything at all.

    Apart from that odd experience with the dentist, I feel my mouth better than ever with my regime as decribed above. I still wish I could source your mouth washes recommended to try your protocol fully but they aren’t sold here.
    I do use the xylitol sugar after each meal or drink as you recommended, alongside the oil pulling morning and evening which is my other “mouth wash”, and brushing twice a day and I’ve stopped having issues like bad breath, gum bleeding and my teeth are visibly way whiter, My colleague at work sitting next to me started doing it herself after she saw the visual improvement. But I have some discoloration on my bottom molars on the sides which I think maybe previous demineralization issues, or is it old bacterial deposits?…I don’t know… (not holes like cavities, the tooth feels smooth on the touch but there is black/brown on the sides) which I yet have to see improving.

    All I can say is, a huge thank you for all the information you’ve given us ” teeth mortals” 🙂 Although I am not using the exact “formula” your recommended because of limitations beyond my control, your logic of how things work in one’s mouth and how they can be altered to a good effect, surely leads to a significant improvement if adhered to.

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  15. How do you deal with a severe dry mouth problem while sleeping if you cannot tolerate sorbitol and xylitol because it causes severe gas and bloating?

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    1. You must avoid sorbitol – it is a horrible product for gas and bloating. Also be aware to protect your teeth from acidity – and may oral care products are acidic – like Biotene.
      You could dissolve xylitol in water – just a teaspoon in 16 ounces of water and sip that.
      I also recommend you consider taking a digestive probiotic supplement – maybe one for colon health would help you most.

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