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Are you trying to cut down on sugar? As dentists and health professionals, we definitely support that choice! But be aware: though many drinks and foods claim that they are “diet” and sugar-free, not all artificial sweeteners are created equal. But how do artificial sweeteners and sugar substitutes affect the health of our mouth and teeth?
Scientists are still learning about the health effects that various sugar substitutes have on the human body, but we do know that artificial sweeteners are non-cariogenic, meaning that they don’t promote tooth decay. According to a study by the International Journal of Basic & Clinical Pharmacology (IJBCP), artificial sweeteners may even have an anti-cariogenic affect, meaning they may actually work against tooth decay.
Here is a quick breakdown: properly balanced saliva should be around 6.2 to 7.6, and tooth enamel begins dissolving below pH 5.5. When we consume foods or drink with sugar, the pH in our mouths drops due to an increase in acidity. Conversely, artificial sweeteners seem to do the opposite, which may help balance the pH of our saliva and decrease the amount of cavity-causing bacteria in our mouths. Artificial sweeteners do seem to provide some benefits for our oral health and teeth, but does that mean they are a healthy choice? The short answer is: Not really.
The detailed answer: Though cutting down on sugar is a great choice for your oral and overall health, artificial sweeteners lack nutritional value, and some may even cause unwanted negative effects on your health. If you trade a sugary soda for a diet soda sweetened with aspartame or sucralose, you are simply trading one non-nutritious drink for another. And like regular sodas, diet sodas are very acidic (pH between 3 and 5), which can wear down tooth enamel and contribute to tooth decay. That said, for those trying to make healthier eating decisions, swapping sugars for artificial sweeteners in moderation and limited use is still something we can absolutely support! Let’s take a look at some of the most common sugar substitutes and their various properties.
Popular Artificial Sweeteners:
Saccharin (Sweet’n Low)
The body does not metabolize saccharin.
300 times sweeter than sugar.
Has a notable aftertaste.
May cause allergic reactions and skin allergies, particularly to individuals sensitive to sulfa drugs.
Aspartame (Equal)
Provides insignificant calories.
180 times sweeter than sugar.
Cannot be used in baking since it breaks down under heat.
Independent studies showed that aspartame caused weight gain and cancer in rats and mice, and “a chemical that has been shown to cause cancer in animals should be assumed to pose a cancer risk to humans.”
Sucralose (Splenda)
Body does not metabolize sucralose.
600 times sweeter than sugar.
Some studies indicate that it may be damaging to DNA.
Sugar Alcohols (Xylitol, Erythritol, Malititol, Mannitol, Sorbitol)
All types of sugar alcohols stimulate the flow of saliva, especially when used in chewing gum or lozenges.
About as sweet as sugar, with about half the calories.
Sugar alcohols do NOT contain ethanol, and are named because their chemical structure resembles both sugar and alcohol, but are different from both.
Consuming high amounts of sugar alcohols may cause digestive issues such as bloating, cramps and diarrhea. Nausea and headaches are other noted side effects.
Specific for Xylitol:
No drop-in plaque pH + No adaptation of plaque of fermenting Xylitol in long-term use. Xylitol raises the pH of saliva and is indigestible by bacteria
In clinical studies, the mineralization-promoting effects of Xylitol may reflect effects on oral flora - it may actually reduce the amount of bacteria in the mouth.
So there you have it! Of the popular sugar substitutes, Xylitol may be the best choice for oral health. It helps stimulate saliva flow, raises the pH of saliva and is indigestible by bacteria. This means that when we consume candies sweetened by Xylitol, bacteria cannot stick to the teeth well, the bacterial growth is greatly reduced, and far less enamel-attacking acid is produced in the mouth.
Whether you decide to add regular sugar, sucralose, or nothing at all to your morning coffee -- Remember to always brush morning and night, and floss once a day to help keep your mouth clean and healthy, and reduce your risk of tooth decay!