Apparently your ear pain is referred from an oral infection which xylitol helps with. You can consider xylitol mouthwash instead that is spit out. Pure table salt (without additives) also makes a decent antimicrobial mouthwash.

That sounds horrible. How much salt are we talking taking and for how long? If I only had iodized salt, is that going to make a difference?

Chemically, it makes sense, but I doubt my mouth loves being exposed to a salt bath either.

If it sounds horrible, it's because your interpretation of it is horrible, also horribly wrong. Iodine doesn't matter, but such salt is almost always coupled with numerous other additives that can be quite harmful to the teeth, e.g. starches, sugars, etc. It is best to get pure salt.

If not having an active infection, it needs to be done only at night before bed. It is not a big deal if you don't eat or drink anything after it. Do not swallow it while you rinse it. The moment you drink something after it, that's when it becomes horrible.

If having an infection, it is better to do it at least three times a day while you're waiting for professional treatment, e.g. antibiotics and/or a root canal.

I forgot to tell you yesterday that if antibiotics don't fix any recurring or underlying dental infection that you may have, you may then very much need x-rays and perhaps a root canal.

Besides the ear, it can also cause a headache, plus sharp pain in the back of the head, so it's good that you are keeping it in control.

My doctor checked for that with a CT scan and X-ray. I have a spot where my sinus narrows that is prone to infection but no abscesses or anything like that, but thank you I know this advice could be very important.

Millions upon millions of people chew xylitol gum every day. If you're actually observing direct benefits yourself, I'm sure those greatly outweigh any potential downsides.

This is one study, if you are seeing a benefit I would continue to use it but remain alert to new research.