May 12th, 2010
Role of Sweeteners in Dental Health
By Christos Zacharis
Technical Manager for Functional Sweetener Danisco (UK) Ltd.
Healthy foods and especially healthy food choices are becoming increasingly important as we depend upon these choices in order to be an efficient organism and lead lives without disease.
Under our everyday health maintenance regime comes also oral hygiene, whereby the mouth and teeth are kept clean to prevent dental problems and bad breath.
Tooth brushing, inter-dental brushing, flossing, and tongue cleaning are a few necessary (yet voluntary) towards maintaining dental health. As with many forms of disease, nutrition can play a preventative role, and this is no exception when it comes to dental health.
One of the food categories that we refer to as "detrimental" when it comes to oral hygiene is
non-milk extrinsic sugars, otherwise known as
"free sugars". Evidence for this accumulated over the years from all parts of the world and from many studies.
One way of controlling sugars in the diet has been to substitute non-milk extrinsic sugars with alternative sweeteners, particularly in foods, beverage and even medicines that are likely to be consumed between meals, such as snack foods, confectionery and weight management drinks.
Two groups of alternative sweeteners have been identified to serve this purpose. In the first group we can include the so-called
"high intensity sweeteners" that lack calorie content but provide a potent sweetness and are used in very small amounts.
The second group include the so-called
"bulk sweeteners" which do have some calorie value. Despite exhibiting a calorific value, bulk sweeteners have typically around 40% less calories than standard sugar(s). The major bulk sweeteners used in foods today are
xylitol, sorbitol, maltitol,
lactitol, mannitol, and erythritol. The use of these bulk sweeteners is regulated under national legislation with regards to them being used in foodstuffs.
The above sweeteners, often termed
"polyols", are friendly to teeth and can help towards general maintenance of dental health. None of the polyols are fermented in the oral cavity and therefore do not promote carries-forming conditions (low pH, etc.). however, not all bulk sweeteners share some properties and very few of the resemble the sweet taste of sugar, which is a key benefit when replacing sugar.
Important preventive role
Nevertheless,
xylitol has been used to promote dental health in oral care products for over 40 years, and it has been described by many leading experts in the world of dental science as the bulk sweetener that can play an important preventive role within all stages of carries formation.
"Caries", otherwise known as "tooth decay", is a dynamic equilibrium of remineralisation (the deposition of essential minerals on tooth surfaces) and demineralisation (the dissolution of these essential minerals), caused by acid attack. Such acid is formed by the fermentation of fermentable carbohydrates by the microflora found in the oral cavity (including a high proportion of Streptococcus mutans). The acid formation leads to a drop in the oral pH, which favours demineralisation, eventually leading to the formation of carries. This condition can be reversible when it is tackled in its early stages. However, in its advanced stages, mechanical repair will normally be required in order to restore the tooth surface.
The key to xylitol's unique benefits over other sugar free sweeteners is that it alone has been demonstrated to dramatically reduce dental carries incidence, and even to reverse the disease itself by stimulation remineralisation (the process of increasing salivary ions along with hydroxyl ions).
Recent scientific evidence suggests that the mechanism of xylitol's action lies with its inhibition of certain metabolic pathways found in S. mutans, and in particular the metabolic pathways responsible for sugar utilization (including the transport mechanisms for various sugars implicated in the carries process).
In addition, xylitol has been awarded a positive opinion by the European Food Safety Authority (EFSA) with regards to the reduction of dental carries ability in 100% xylitol sweetened gum, as part of the approval process of a health claim under the new EC Regulation 1924/2006 regarding nutritional and health claims.
Health & Nutrition Technology March 2010
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