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Profile in Oral Health Trisha E. O'Hehir, RDH, BS, Editorial Director, Hygienetown Magazine

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by Trisha E. O'Hehir, RDH, BS
Editorial Director, Hygienetown Magazine

Xylitol is our newest weapon to fight the bacteria that causes dental caries, and ear and sinus infections. It is also a safe sugar for diabetics. Xlear, Inc., makers of Xlear Nasal Wash and Spry Dental Defense System products, is a leader in the drive to educate professionals and consumers about the many benefits of xylitol-rich products. Xlear provides a wide range of natural products to the oral health market, which isn't usually focused on "natural" products. Educating health care professionals about xylitol presents a challenge that Xlear, Inc., is taking on with oral and respiratory health as their ultimate goal.
I recently had the opportunity to interview Xlear President and Marketing Executive Nathan Jones. Jones wasn't even 30 years old when he started Xlear, Inc. After just a few years and with lots of hard work, Nathan's company is helping hygienists succeed in preventing dental disease and upper respiratory infections with xylitol-rich products.

Nathan Jones		 Nathan, I know you must get this question a lot, but please tell me how you decided on the name "Xlear" for your company?
Jones: The name Xlear – pronounced "clear" – has been confusing to many, especially with regard to the correct pronunciation. The "X" actually comes from the "x" of xylitol and since our first product, the nasal wash, was intended to keep the upper respiratory, sinuses and Eustachian passages clear; the name Xlear seemed to fit.
How do the Spry products fit into the Xlear company?
Jones: Xlear is the name of the company and the name of the nasal wash. For the dental line, we have tried to keep all the oral care products under the Spry Dental Defense System umbrella. Spry, of course, is intended to give a "youthful" and "active" feeling to the products. The chewing gum, mints, toothpaste, mouth rinse, tooth gel and dry mouth spray are all sweetened with 100 percent xylitol.

Nathan, I understand you were a diver, doing underwater welding on oil rigs. How did you go from diving to starting Xlear, Inc.?
Jones: It happened when I was home on a break visiting my dad, Dr. Alonzo "Lon" Jones, in his medical office in Texas. I overheard the nurse tell dad a patient was asking for more "jungle juice." So, I asked my dad, "What is this juice and what does it do?" That's when he told me the story of discovering, through the dental research, the benefits of xylitol for preventing ear infections.

He was seeing an increase in the incidence of upper respiratory infections due to environmental factors and problems with antibiotic therapy. He was searching online scientific literature for a better way to treat ear infections when he ran across the dental research showing a reduction in ear infections when kids were given xylitol syrup or chewed xylitol gum. This was a "side effect," if you will, of the research looking at the caries rates. Since ear infections are a problem in babies who can't chew gum, dad was mixing up saline and xylitol to make a nasal wash.
When I noticed people were driving more than 100 miles to his office to get his "jungle juice" I knew there was a market for this product. The need was there and the xylitol nasal wash reduced ear infections in my dad's patients by 90 percent! He was also seeing incredible results with sinus infections, allergies and asthma – all without antibiotic use. That amazed me. If it helped these kids and adults, why not share it with everyone. That's how the company started in June 2000.
My dad applied for a patent and I started the company with a friend of mine, (Xlear CEO) Blaine Yates. Blaine put up the money; I quit my diving job and worked diligently for the next few years to get the company off the ground. Shortly after Blaine and I started the company, another friend of ours, Mike Hassey joined the team. Mike is now an orthodontist.

It's quite a challenge to start a company with just one employee. I'm sure you did everything when you started the company. Was there a turning point along the way for your company?
Jones: You're right, I did work hard in the beginning, covering all the jobs and exhibiting at more than 30 dental and health meetings each year. The turning point came when Dr. David Williams, who had an alternative medical practice in central Texas, started using Xlear nasal wash. He is the author of an alternative medicine newsletter called Alternatives. When he wrote about Xlear and the benefits of xylitol, our business jumped from $5,000/month to $5,000/day! It was definitely a turning point for us. Getting the word out is the most difficult job for a new business and when Dr. Williams told his 300,000 subscribers about Xlear, the business took off.

You started with just one product, the nasal wash. When did you expand your product line?
Jones: Expansion came from our customers. They asked us for more xylitol products so we looked at what was available. We added chewing gum and toothpaste from manufacturers in Finland. After a year, the volume was so high we started manufacturing our own brand of oral care products with xylitol, and called it Spry. "Spry," meaning lively, active and brisk fits our products and our customers.

How many products containing xylitol do you now offer?
Jones: We now have a full spectrum of xylitol products including chewing gum in many flavors, toothpaste, oral rinse, tooth gel (both with and without a dispensing pacifier), mints, candies, oral spray, nasal spray and even pure xylitol that can be used to replace regular sugar in cooking, baking and other sweetening applications.

I know we can get xylitol from various fruits, mushrooms, lettuce and berries, but obviously we don't get enough xylitol to prevent caries. Where do you get the xylitol for your products?
Jones: You're right, the xylitol in blueberries and cranberries isn't enough to prevent tooth decay. A cup of raspberries only contains one gram of xylitol. To get the recommended daily dose of six to 12 grams, it would take a lot of raspberries.

The Finnish researchers who began looking at the oral health benefits of xylitol found that the five-carbon xylitol sugar could be extracted from the bark of birch trees, which were plentiful in Finland. Xylitol comes from products rich in hemicellulose like rice, oat, wheat and cotton seed hulls, various nut shells, straw, corn cobs and corn stalks.

Xylitol was produced in many countries like the former Soviet Union, China, Japan, Germany, and Italy for local use. The primary source today is corn cobs and stalks from China. That's where we get our xylitol. Whether xylitol comes from berries, fruits, tree bark or corn, it's all the same five-carbon sugar.
Where are the Xlear and Spry products made?
Jones: Most of our products are actually manufactured here at our own facility in Orem, Utah. We recently built a state-of-the-art facility to manufacture Xlear nasal wash, Spry tooth gel, Rain oral mist and Spry oral rinse. The Spry toothpaste is manufactured in the U.S. by a company that specializes in toothpaste production and they make the toothpaste to our specifications.
You can oversee and control the quality of the products you make here in the U.S., but how do you monitor the xylitol production in China?
Jones: We conduct inspections of our Chinese suppliers, which are GMP-certified and FDA-licensed to ensure the quality of products that they send to us. We also conduct testing on each and every batch of material we import to further certify that we have the best possible quality products.

I see that Spry mouthrinse contains alcohol. Why did you decide to make it with alcohol?
Jones: We're committed to products with a neutral pH, so we worked with researchers and chemists to develop products that deliver xylitol and also maintain a pH that helps remineralize the teeth and wouldn't dry the tissue. We have a very low amount of alcohol (six percent) in our mouthrinse, as a preservative. The pH level is more important than the alcohol content. An alternative preservative is ascorbic acid, which produces a very low pH, but allows claims of being alcohol-free. Low levels of alcohol will preserve the ingredients, protect the xylitol and allow a neutral pH to be maintained.

How do your products impact the practice of dental hygiene and consumers' oral health?
Jones: Hygienists are the prevention experts in dentistry and Xlear provides hygienists with a variety products that allow them and their patients to incorporate sufficient exposures of xylitol into their daily lives as easily as possible. People like the pleasant taste of Xlear and Spry products and they are available in stores nationwide, making compliance for patients much easier. Patients will be able to quickly see results from using the products.

In the past, xylitol was reserved for those who were at the greatest risk of developing caries. Your message suggests that everyone should be using xylitol. Why is that?
Jones: Let's take you for example, Trisha. I don't suppose you've had a cavity since you've been a dental hygienist, so you're not at risk of tooth decay, but I'd still suggest you strive for five xylitol exposures daily. Just using xylitol will reduce plaque accumulation by half, which means you wake up with a cleaner mouth. Using xylitol throughout the day will make the oral bacteria slippery, so they slide right down the digestive tract rather than forming plaque biofilm on the teeth. Xylitol is better than sugar if you are concerned about diabetes and it stimulates saliva, which remineralizes enamel that is demineralized several times each day when you eat foods with high acid content and beverages like fruit juice and wine.

I would also suggest that you wash your nose several times each day with xylitol to keep it clean. You wash your hands everyday because they come in contact with lots of dirt and pollutants. Your nose breathes in dirt, allergens and pollutants so washing your nose several times every day is a good way to keep it clean.

So you see, xylitol is the good sugar that has benefits for everyone.

There are more and more products available containing xylitol; are they all equally effective in preventing caries?
Jones: Some products contain only a "token" amount of xylitol, but not enough to effectively prevent acid production by the Mutans streptococci bacteria. Research studies have compared various combinations of xylitol and sorbitol and compared xylitol to sorbitol. Sorbitol still allows acid production by the bacteria. The chewing gums that are most effective in preventing dental caries contain only xylitol. Check the ingredients and pick products that are sweetened only with xylitol. The daily goal is four to eight exposures of xylitol spread out over the day.

I'm convinced! I want less plaque biofilm so I'm going to strive for five xylitol exposures each day. With a history of diabetes in my family, it's a good time to switch from sugar to xylitol for cooking as well. If you want to learn more about Xlear, Inc., please visit www.xlear.com, or call 877-599-5327. Thank you, Nathan.
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