May 25, 2018
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Prevent ear infections in children with chewing gum

By Georgia Clark-Albert, Special to the BDN

Despite the fact that there has been nearly a 30 percent drop in young children’s doctor visits for ear infections over the past 15 years, it is still a problem that affects about six of every 10 kids in their first year of life. About 83 percent of children have at least one ear infection by age 3. Acute otitis media is the most common bacterial infection among young children in the United States, accounting for almost 16 million office visits in 2000 and costs almost 3.8 billion annually in direct and indirect health care costs.

Antibiotic treatment of AOM is costly and raises concerns regarding the development of antibiotic-resistant strains of bacteria.

An alternative treatment for ear infections is xylitol, or birch sugar. Xylitol, a sugar-alcohol, has been used for decades as a natural nonsugar sweetener in chewing gums, candy, baked products, toothpaste and medicines. Many middle ear infections occur when bacteria accumulate in the Eustachian tubes that connect the nose and ears, so the thinking is that xylitol may also prevent ear infections by preventing bacteria from growing there. Since it has been shown to curb the growth of some bacteria, some dentists recommend chewing xylitol-sweetened gum to prevent the risk of tooth decay.

Based on the review of three studies of healthy children from Finland, researchers found that there is “fair evidence” to support the conclusion that kids who chew gum containing xylitol may have a lower risk of ear infections. The review looked at three studies that included 1,826 healthy children and a single study that involved 1,277 children with respiratory infections who were at high risk for developing ear infections.

Use of xylitol-containing gum, lozenges or syrup did not appear to reduce middle ear infection in the children who already had respiratory illnesses, but regular consumption of xylitol was associated with a 25 percent reduced risk for developing middle ear infections.

It appears that xylitol works in healthy children by inhibiting bacteria.

Xylitol-containing gum was superior to xylitol syrup for preventing middle ear infections in healthy children. Gum itself appears to be beneficial as a way to prevent ear infections, possibly because chewing gum opens and closes the Eustachian tubes, which link the throat to the middle ear. Too much gum can be an issue, however, and young patients can develop jaw problems.

Xylitol is alkaline — the opposite of acid — so it makes your mouth a difficult place for bacteria to thrive or grow in.

Some brands of chewing gum that contain xylitol include:

• B-Fresh costs about $10 for a bottle of 100 pieces, and there are about .85 grams of xylitol in every piece.

• Spry costs about $6.20 for a pack of 100 and there are .72 grams of xylitol in every piece.

• Xponent costs about $14 for a bottle of 100 and there are .72 grams of xylitol in each piece.

• Xylichew packages of 100 pieces cost about $9 and each piece contains .72 grams of xylitol.

• Trident containing xylitol costs about $1.29 for a package of 18 and there are .17 grams in each piece.

Sugar alcohols do not contain any alcohol. They are called sugar alcohol because their chemical structure is similar both to sugar and alcohol. Other sugar alcohols include erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol and hydrogenated starch hydrolysates. Consumption of too much sugar alcohol may have a laxative effect.

Georgia Clark-Albert is a registered dietitian and adjunct nutrition instructor at Eastern Maine Community College who lives in Athens. Read more of her columns and post questions at or email her at


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