To Breathe, or Not to Breathe: That is the Question – Xlear is the Answer

Xlear nasal sprays are gaining notoriety for effectiveness on viral, bacterial, and fungal pathogens.

by Lisa Stillman, RDH, BS; Julie Seager, RDH, BSDH; and Rhoda Kublickis, RDH, BASDH, MHS

 Xylitol – you may know it as a natural sweetener, but did you also know it has wellness properties which enable it to be used for prevention and treatment of certain systemic conditions and biofilm-related illnesses? Every airway-aware clinician has an opportunity to improve not only nasal breathing but have a serious impact on their health using xylitol.

Xylitol’s Mechanism of Action (MOA) in the upper airways is as follows:

  • Blocks adhesion of pathogens to mucosal tissues (bacterial, fungal, viral)
  • Hypertonic: Opens airway by reducing swollen tissues
  • Facilitates cilia movement which enhances the natural mucociliary cleaning cycle and produces nasal nitric oxide (NO)
  • Hydration/moisturizing

Research has found that xylitol blocks adhesion of bacteria to epithelial cells thus allowing the body to wash them away.1 Irrigating the sinuses with a saline-xylitol solution has also been shown to improve chronic rhinosinusitis symptoms associated with the nose, ears, facial pain, quality of sleep, and daytime productivity versus a saline-only irrigation.2 In a 2015 presentation, Dr. Nsouli shared his findings of a study which showed that a nasal spray with xylitol increased peak airflow 35% more than saline alone and measurably increased participants’ quality of life.3 In a similar study, Drs. Olmos and Baba’s findings showed that three minutes after spraying participants’ noses with Xlear Sinus Spray, participants experienced a 20% improvement in airflow volume. “The health benefits of nasal volume and flow improve sleep breathing disorders and respiratory disease. Increases in nasal breathing results in uprighting head posture resulting in a reduction of chronic facial pain, headaches and jaw locking.”4

Prior to the pandemic, it was well established that saline spray with xylitol was highly effective on bacterial and fungal pathogens in the nose. Effectiveness on viral pathogens has, naturally, claimed the attention of medicine. Xlear has been proactively working with researchers conducting in vitro and in vivo studies. Researchers found the nose has the highest viral load of SARS-CoV-2 in the body when infected with the virus.5 By adding anti-viral or virucidal agents, like xylitol and grapefruit seed extract, to a saline nasal wash, the scientists found lower viral loads – making the combination beneficial against SARS-CoV-2.6 A case series of three patients with active Covid infections showed that use of Xlear Nasal Spray resulted in a reduction of symptoms related to the viral infection and received a negative test twice as fast as participants who did not use the nasal spray.7 Researcher Antony Cheudjeu found that xylitol blocks receptor sites of the SARS-CoV-2 virus which inhibits it from attaching to the cell wall of its host.8 Researchers also performed laboratory studies at Utah State University (2020) and University of Geneva (2020) which showed Xlear Nasal Spray destroyed 99.99% of the SARS-CoV-2 virus.9

In a different study, researchers used electron microscopy to photograph the interaction between xylitol, grapefruit seed extract (GSE), and the SARS-CoV-2 virus. They concluded, “Combination therapy with GSE and xylitol may prevent spread of viral respiratory infections not just for SAR-CoV-2 but also for future H1N1 or other viral epidemics. GSE significantly reduces the viral load while xylitol prevents the virus attachment to the core protein on the cell wall.”10

Dental offices assisting patients to improve their airway health have long suggested nasal rinses to increase nose breathing. Suggesting a combination of saline, xylitol and grapefruit seed extract such as Xlear adds antiviral effects. Patients seeking natural products to address health concerns can be assured the lack of artificial chemicals and medications will provide them relief from nasal stuffiness, decreased exposure to the virus, and the convenience of a simple spray. Reducing barriers to effective therapy benefits every outcome clinicians hope for.

About Xlear

Xlear Inc. is the leading manufacturer of natural nasal care products containing xylitol. The company started in the year 2000 and is based in American Fork, Utah. Xlear, Inc. is committed to providing natural, health-enhancing products based on the safety, effectiveness, and science of xylitol. They offer drug-free sinus and oral care products, and a line of natural xylitol sweeteners.

Xlear Nasal Spray and Kid’s Xlear

Ingredients: Water, Xylitol, Sodium Chloride, Grapefruit Seed Extract (GSE)*

MOA: Hydrates nasal tissues, hypertonic properties which reduce tissue swelling to open the airway, reduces the ability for pathogens to stick together, cell divide and invade the tissues. Blocks adhesion of pathogens to mucosal membranes. Washes away allergens and pathogens.

Protocol: Use prophylactically morning and night. Use every four hours when symptomatic of allergies or infection. Safe for all ages. Safe for use during pregnancy. No drug interactions. 

Xlear Rescue

Ingredients: Water, Xylitol, Glycerin, Sodium Chloride, Sodium Bicarbonate, Oregano, Tea Tree, Eucalyptus, Parsley, Pau D’ Arco, Grapefruit Seed Extract (GSE)*

MOA: Essential oils alleviate congestion, open airway.

Protocol: Use as needed when exposed to pathogens.

Xlear Max

Ingredients: Water, Xylitol, Capsicum, Aloe Vera, Sodium Chloride, Grapefruit Seed Extract (GSE)*

MOA: Xlear Max quickly alleviates sinus pressure, capsicum acts as a natural vasoconstrictor.

Protocol: Use for severe sinus pressure, sinus headache, allergies and congestion as needed.

Xlear 12-Hour Decongestant (medicated)

Ingredients: Oxymetazoline HCL (hydrochloride), Benzalkonium Chloride, Purified Water, Xylitol

MOA: Oxymetazoline HCL (hydrochloride) is a medicated vasoconstrictor which shrinks swollen tissues immediately. Xylitol alleviates dryness and mitigates rebound effect.

Protocol: For temporary use only. Provides instant relief from severe congestion due to colds, hay fever, or sinusitis. Use as needed every 12-24hrs. Follow instructions on packaging.

* Is grapefruit seed extract (GSE) safe to use with medications? Furanocoumarins interact with a variety of medications. From grapefruit juice and pulp, 45,000 – 139,000 ppb of the chemical is common; from GSE, 62 -345 ppb. There isn’t data available for medication interactions at this level, so customers should consult their physician prior to use of any products containing GSE. – Jason Neal, Quality Manager, Xlear

The ZZZ Pack podcast hosted Nathan Jones, founder of Xlear. Hear how this product can improve airway and overall health.

Lisa Stillman, RDH, BS, knows from personal experience how this natural sweetener, xylitol, can help those in need. She is a clinical dental hygienist, national speaker, published author, and was awarded the RDH Magazine/Sunstar Award for her work with the mental health population. Lisa is a Regional Education Manager for Xlear/Spry, who is the leading manufacturer of the xylitol dental defense system. She can be contacted at 

Julie Seager, RDH, BSDH, is an informed and engaging speaker and published author with more than 25 years in the dental industry. She blends real-world experience and evidence-based clinical information so her audiences can put to good use what they learn in her courses. Julie is sponsored and employed by Xlear, Inc. as the Western Regional Education Manager, representing both Spry and Xlear Xylitol products. She lives in Sacramento, California where she also uses her “passion for prevention” to help encourage her dental hygiene patients toward achieving improved oral and systemic health. Julie can be contacted at 

Rhoda Kublickis, RDH, BASDH, MHS, was born in the Philippines. Twenty-nine years after receiving her Associates in hygiene school, she received her Masters of Health Science at Nova Southeastern University. Prevention is her passion. She has educated thousands across the country on the oral systemic link as the Regional Education Manager for Xlear/Spry. Rhoda can be contacted at

  1. Kontiokari, T., Uhari, M., & Koskela, M. (1998). Antiadhesive effects of xylitol on otopathogenic bacteria. The Journal of Antimicrobial Chemotherapy, 41(5), 563–565.
  2. Weissman, J. D., et al. (2011). Xylitol nasal irrigation in the management of chronic rhinosinusitis: a pilot study. The Laryngoscope, 121(11), 2468–2472.
  3. Nsouli, T. M.; et al., (2015) ORAL ABSTRACT #46.
  4. Olmos, S., Baba, J., (2019.). Improved Nasal Volume Utilizing Hyperosmotic Saline Xylitol Mixture (Effective Alternative or Adjunct to Decongestants and Antihistamines). EC Pulmonology and Respiratory Medicine 8.5, 444-452.
  5. Zou, L., et al., (2020). SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. The New England Journal of Medicine, 382(12), 1177–1179.
  6. Farrell NF, et al. (2020). Benefits and Safety of Nasal Saline Irrigations in a Pandemic—Washing COVID-19 Away. JAMA Otolaryngol Head Neck Surg., 146(9):787–788.
  7. Go, C. C., et al., (2020). Potential Role of Xylitol Plus Grapefruit Seed Extract Nasal Spray Solution in COVID-19: Case Series. Cureus, 12(11), e11315
  8. Cheudjeu, A. (2020). Correlation of D-xylose with severity and morbidity-related factors of COVID-19 and possible therapeutic use of D-xylose and antibiotics for COVID-19. Life Sciences, 260, 118335.
  9. Ferrer, G., et al., (2020). A Nasal Spray Solution of Grapefruit Seed Extract plus Xylitol Displays Virucidal Activity Against SARS-Cov-2 In Vitro. BioRxiv.
  10. Cannon, M. L., et alk., (2020). In Vitro Analysis of the Anti-viral Potential of nasal spray constituents against SARS-CoV-2. BioRxiv.

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