Risk-benefit assessment is always a very personal matter, that requires consideration of concomitant health habits (dietary and exercise), disease and family history.

Given the perfect-storm paradigm, my take is to reduce the chances of it happening. So, I stay away from xylitol and generally, from all artificial sweeteners. If you have your sugar cravings under control there is no need for substitution. And I have no beef with xylitol in dental care products. The exposure is probably too limited to have any effect.