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While  using xylitol chewing gums for their caries-preventative effect meanwhile can be considered an established tradition in countries such as Finland (see Xylitol, a dental miracle sugar?), it is due to Dr. Bruhn's initiative that using xylitol for its dental health benefits has now become affordable to next to everyone.
This is how it started: it will soon be a decade that Dr. Bruhn had the ingenious idea that instead of using expensive (in fact, overpriced in my eyes) xylitol chewing gums or similar products, it should be possible to use xylitol sugar in its pure form (which is much less expensive) to obtain the same beneficial effects  on dental health. He immediately set to the task of testing this hypothesis on his own teeth which proved very successful. Following this first self-experiment, he proceeded to work with volunteer patients and has since been able to consistently demonstrate that using pure xylitol powder works  (see Amazing dental healing success stories).

In the course of this experimentation, he also discovered what initially came as a great surprise: xylitol used in its pure form not only showed the effects on caries bacteria and benefits for dental hygiene already validated in scientific studies  - but it also provided outstanding effects in the area of periodontal health and disease  (see Amazing dental healing success stories). The latter could only be explained by the assumption that to obtain such benefits regarding gum disease,  larger amounts of xylitol were required than those sufficient to prevent tooth decay.

In other words, the fact that these gum-healing effects of xylitol so far have not been observed or documented in official studies (the vast majority of which were conducted using xylitol chewing  gums), is likely to be due to periodontal disease only yielding to higher doses of xylitol than those found in chewing gums.

Numerous attempts of this caring dentist to spread his novel experiences (which by now covered observations of many hundreds of patients over a number of years) to his collegues, professional circles as well as to universities , so far have mostly been falling on deaf ears or been met with doubt and skepticism. As Dr. Bruhn commented, "skepticism has always had priority before experience and observation". In other words, the world will have to wait for the numerous scientific studies (similar to the ones  already performed with xylitol chewing gum) which could substantiate these new findings (and which due to reasons of cost, can't be shouldered by an individual).

That's why a grassroots movement may be required (thankfully facilitated by the internet) to help those important insights for the benefit of humanity to the light of day and into the public eye, long before we can hope to see them actually being promoted to "state of the art" in the mainstream of society.

Xylitol's three outstanding benefits

(The following presents both a concise summary as well as an extension of Healing Teeth Naturally's first page devoted to xylitol, the dental miracle sugar and is based upon the novel insights and experiences of dentist Dr. Ulrich Bruhn regarding the so far not scientifically validated intensive use of pure xylitol sugar [i.e. straight xylitol rather than the typically used xylitol chewing gum] as a tooth rinse and for dental hygiene purposes.)

1. Xylitol selectively inhibits & eventually destroys cariogenic Streptococcus mutans (caries bacteria which form dental plaque and produce acid) in the entire oral cavity, i.e. xylitol fights tooth decay at its root.

Mechanism of action: S. mutans lives on carbohydrates and will try to metabolise xylitol as well, unsuccessfully so, however, since xylitol inhibits an enzyme required for  S. mutans' sugar metabolism. In this manner, S. mutans bacteria will be unable to make use of  sugars for energy generation even when there are accessible sugars (such as sucrose) simultaneously present in the mouth3. This means that S. mutans will eventually die due to lack of energy reserves. In other words, as long as the oral concentration of xylitol is high enough to "occupy" all the S. mutans bacteria colonizing the mouth, all of these will be killed off (at least eventually).

Obviously, S. mutans bacteria thus hindered in their metabolic activity will be unable to produce dental plaque and acids, which puts paid to one of the major causative factors of both tooth decay and gingivitis.5

With its saliva-soluble consistency, xylitol also bathes the crevices between adjacent teeth  (which constitute 40% of the total tooth surface area according to the German Stiftung Warentest magazine) and thus also reaches the bacteria nestled in those hard-to-reach places.

2. Xylitol sugar possesses a cleaning action which hasn't been studied so far.

Dentist Dr. Bruhn experienced xylitol powder as having a more powerful cleaning effect than any toothpaste (unless a person requires heavy abrasives to get their teeth clean, xylitol due to its solubility in saliva doesn't have any abrasive effect by itself). For this reason, xylitol sugar can occasionally be used in lieu of other oral hygiene measures or be taken instead of toothpaste1.

3. Xylitol simplifies successful dental care.

Since xylitol effectively destroys the bacteria responsible for the formation of dangerous plaque and acids, cleaning and brushing teeth becomes less of the essence. In other words, it is no longer required for the conscientious "tooth owner" to clean each tooth after each meal to free it from films using toothbrush, floss etc. In its stead, a short xylitol application will suffice, as described in the following.

Xylitol sugar for cleaning and healing teeth, gums and mouth (recommended application according to dentist Dr. Bruhn)

Xylitol for sucking, mouth rinsing and tooth brushing
(At least) 3 times a day, take half a teaspoon of xylitol powder (or more) and rinse your mouth with the xylitol-saliva mixture which will form for 3 to 5 minutes a time, then spit. Alternatively, use the xylitol-saliva mix as if it were toothpaste and brush your teeth with it  for 3 to 6 minutes. Do not rinse your mouth afterwards, washing out with water markedly reduces xylitol's positive effect.

By exposing the dangerous oral bacteria for hours and/or nights to the action of xylitol in this manner (with xylitol also reaching the dental pockets and interstices as mentioned), these bacteria are very successfully removed from the oral cavity. Compare Frequently Asked Questions regarding the applications of pure xylitol sugar according to dentist Dr. Bruhn's  recommendations.

Note: Dr. Bruhn's recommended use of xylitol to rinse the mouth or brush the teeth with, rather than chewing xylitol gum, of course has the additional advantage that one doesn't have to swallow the xylitol (in contrast to gum chewing) when simply rinsing or brushing one's teeth. This will allow all of those who may have doubts about the safety of ingesting xylitol or whose digestive system may not handle it well (compare Xylitol safety issues) to use xylitol as well, since any absorption via the oral mucosa (if occurring at all) is likely to be minimal.

Amazing dental healing success stories, even in "hopeless" situations

As mentioned in the foregoing, the vast majority of the scientific studies validating the effect of xylitol on caries and dental hygiene were conducted using small amounts of xylitol applied to the teeth via chewing  gums. This may explain why the additional effects obtained under more intense xylitol use as experienced and reported by Dr. Bruhn and his patients which are listed below, to date have not been discovered (or described) by other researchers.

1. Periodontal disease/periodontitis/gingivitis: excellent healing successes even with dental hygiene program unchanged, periodontal disease halted in its tracks, gingivitis improved enormously.

As shown in  years of Dr. Bruhn's practical dental experience, xylitol exerts a pronounced healing effect upon the gums (a university in Asia is currently conducting a scientific study into this effect). All subjects without exception experienced success, the only prerequisite was that they used xylitol 3 to 4 times a day for 3 to 5 minutes each,  for 1 to 2 months (and if the standard dose of half a teaspoon wasn't sufficient to reach the desired effect, doubling the xylitol amount did the trick).

Loose teeth became solid again (an unexplainable and unexpected occurrence).

2. Existing caries / new tooth decay

can be healed / prevented with xylitol. Tooth decay already present next to completely disappears or is halted in its tracks (carious processes are stabilized). To make these statements, one year of observation or longer is required however. Tooth decay at the edge of crowns can be prevented or stopped with xylitol as well (but probably not if the carious lesion is under the crown).

3. Dental plaque

If there still is some plaque formation, the plaque is very easily removed.

4. Tooth neck sensitivity

Sensitive tooth necks quickly lost their sensitivity (compare advice re the use of xylitol under "My sensitive tooth necks hurt when I do a xylitol rinse").

5. Tongue

Another positive side effect is that coated tongues recover their healthy pink colour while losing their coating  (bacteria will also colonize the tongue which thanks to its many tiny crevices provides an ideal home). Once the tongue is "self-cleaning" in that manner, using a tongue scraper or the daily scrubbing off of coatings are a thing of the past.

6. Breath (morning breath and bad breath in general)

Distinct improvement or complete disappearance (it is particularly effective to follow the above recommendation and go to bed without rinsing the residual xylitol from your mouth [i.e. don't rinse after the nightly toothbrushing or rinsing with xylitol]).

Interestingly and encouragingly, this breath-freshening effect even seems to apply when there are several "rotting" teeth in the mouth.

7. Formation of calculus (tartar)

was much reduced.

8. Cleaning of positioners

Positioners which  were made to soak in a solution of 10 to 20 percent xylitol for several hours became clean and free of odour. Compare Further helpful xylitol applications.

9. Inflammation following dental implant surgery

Unpleasant (and dangerous) infections surrounding a newly implanted tooth, where all other attempted measures such as Chlorhexidine had failed, successfully responded to xylitol application within just over a week.2

10. Toothbrushing

was no longer of paramount importance for keeping teeth clean.4

On the potential consequences of widespread xylitol use for purposes of dental hygiene

While these would be most welcome and pleasant for Jane and Joe Bloggs (no more plaque, i.e. considerably less tooth decay and periodontal disease, hence no or hardly any visits to the dentist), those trades and professions who currently make a living off the tooth decay epidemic either directly or indirectly would naturally be hit at their core.

In the first instance, these are the dentists of course, but also the entire supply industry (dental practice, equipment and instruments purveyors, dental laboratories, pharmaceuticals traders etc.) would see a massive drop in revenues. Put in different terms, xylitol if applied consistently will create a revolution in dentistry. As mentioned aboved, thanks to Dr. Bruhn's pioneering work it now has become affordable to next to everyone - so it is up to each person whether they wish to take the chance offered to them.... (compare Even xylitol sugar is still too expensive for me).

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Footnotes

* Dr. Ulrich Bruhn himself does not seem to have a website. He actively participates in various forums, however, and it is based on one such German-language forum thread (www.ht-mb.de/forum/showthread.php?1070229-Mit-Xylit-gegen-Karies-und-Parodontose-Dreimal-t%E4glich-ein-halber-Teel%F6ffel) that Healing Teeth Naturally has compiled its extensive while concise xylitol FAQ and other information summarizing the essentials of Dr Bruhn's approach to dental treatment with xylitol. As is typical for forum and social media discussions, most of the text appearing in the above thread is highly repetitive or irrelevant, and it took several days to read the thread alone (which meanwhile spans over 500 pages) and many more to compile and translate what is essential so it could be presented here in a user-friendly and time-saving manner for the reader.

Please also note that Healing Teeth Naturally is not associated with Dr. Bruhn in any way, shape or form. In all likelihood, Dr. Bruhn would not endorse some, much or most other material published on this humanitarian site.

1 Healing Teeth Naturally doesn't recommend using conventional toothpaste, see Toothpaste: hazardous to dental and bodily health?.

2 Healing Teeth Naturally is against tooth implants (for reasons see Potential risks of dental implant surgery: from implant failure to irreparable nerve damage).

3 Personally, I have found this to be a particularly welcome feature. When I eat sugar-containing foods and brush my teeth afterwards with "healthy" toothpaste, shortly thereafter I can still taste the sweet taste in my mouth (similar with other foodstuffs). This may be due to the fact that (as I  have read) sugar tends to hide in various "nooks and crannies" in the mouth. Thanks to xylitol, even those stubborn sugar residues can be neutralized and prevented from creating acids.

4 More under Xylitol sugar rinses and brushing testimonials.

5 The other major ones are listed under Dentinal fluid transport - revolutionary theory of natural caries resistance and cariogenesis.

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