Xylitol Products From Spry® Part of Dentist’s Strategy for Caries Prevention
As a young registered nurse who emigrated to the United States from Russia in 1996, Irina P. Chandler, DDS, RN, NP, noticed an interesting commonality among her patients. "My special interests while studying nursing included the oral-systemic health connection," she says. "As a nurse, I frequently observed that patients with poor oral health often had other underlying medical issues-with their mouth being ‘a canary in the mine,' pointing to health problems before they manifested as chronic illness. That interest influenced my decision to then study dentistry."
This desire to help patients recognize the oral-systemic connection and be proactive in managing oral care to improve overall health led her to graduating from Virginia Commonwealth University, School of Dentistry, in 2005, and she now is in private practice in rural Virginia.
"My patients are mostly an older demographic with multiple medical issues and a high rate of dental decay and xerostomia," Chandler says. "Most are primarily concerned with ‘function' rather than ‘esthetics.' Interestingly enough, patients frequently realize that getting their mouth healthier leads to their teeth looking better. Beauty is a byproduct of health, and healthy teeth look good by default."
In her practice, Chandler employs the CAMBRA model (caries management by risk assessment) and encourages her patients to use xylitol products as a means of creating a healthy microbiome. She likes to recommend Spry® products from Xlear that incorporate xylitol and carries them in her office to make it easy for patients to obtain them. These include Spry toothpaste, Spry chewing gum, Spry mints, and Spry mouthwash. "The combination of xylitol's pH of 7 and its ability to draw moisture toward itself increases salivary production and buffers the pH of the mouth, making calcium, phosphate, and fluoride ions more bioavailable and able to enter deeper layers of enamel during the remineralization process," she explains.
Along with xylitol and L-arginine, which increases oral pH, new Spry EnamelMax toothpaste features sodium trimetaphosphate (STMP) to help strengthen enamel. The anti-cavity toothpaste, according to the manufacturer, is designed to remineralize, strengthen tooth enamel by up to 33% more than regular fluoridated toothpastes, and reduce sensitivity.
Many patients, Chandler notes, have been through the vicious cycle of dental work failing due to recurrent decay. "We use xylitol products to help protect patients' investment in their dental care. Patients are also more willing to spend their valuable resources on their mouths if they feel that the dental work is going to last."
"The focus of our patient management protocol," Chandler summarizes, "is on promoting a healthy intraoral microbiome, which plays a significant role in preventing, arresting, and repairing the damage of acid on the tooth structure." Spry xylitol-based products, she acknowledges, give her patients a fighting chance in the battle against dental decay.
Irina P. Chandler, DDS, RN, NP
Private Practice, Warsaw, Virginia