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Xylitol is a natural sugar found in plums, strawberries, and raspberries. It is often used as a sweetener to replace sugar. Xylitol has been used to kill harmful bacteria in the mouth and prevent ear infections. It can be chewed as a gum or taken as a syrup. Xylitol can also be taken as a powder or added to toothpaste. It can also be injected into the bloodstream by a healthcare provider.


4 to 10 grams daily

What Research Shows

Likely Effective

  • Cavities —likely to prevent cavities when used with standard treatment A1-A3

Not Enough Data to Assess

  • Ear infection B1

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Safety Notes

It is likely safe to use xylitol and to take xylitol products orally in small doses for a short time. Not enough studies have been done to say whether it is safe to use for a long period. It may also not be safe to take by women who are pregnant or breastfeeding.


Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse.



A. Cavities

A1. Riley P, Moore D, et al. Xylitol-containing products for preventing dental caries in children and adults. Cochrane Database Syst Rev. 2015;(3):CD010743.

A2. Marghalani AA, Guinto E, et al. Effectiveness of Xylitol in Reducing Dental Caries in Children. Pediatr Dent. 2017;39(2):103-110.

A3. Wang Y, Li J, et al. Effect of non-fluoride agents on the prevention of dental caries in primary dentition: A systematic review. PLoS One. 2017 Aug 7;12(8):e0182221.

B. Ear infection

B1. Azarpazhooh A, Lawrence HP, et al. Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database Syst Rev. 2016;(8):CD007095.

Last reviewed July 2019 by EBSCO NAT Review Board Eric Hurwitz, DC  Last Updated: 3/26/2020