Pseudo-Sugar and You

Author: Kimberly N. Powell, DDS, MS, FAGD

High intake of sugars is associated with obesity, diabetes mellitus (DM), metabolic syndrome, cardiovascular disease (CVD) and dental caries (Fitch, C, Keim, KS).  Sugar substitutes are used as a cost-efficient method of obtaining sweetness, to help reduce caloric intake, improve glycemic control, and control dental caries (Fitch, C, Keim, KS, Wee, M, Tan, V, Forde, C).  In the United States, artificial sweeteners (aspartame, sucralose, stevia, saccharin) are regulated by the Food and Drug Administration (FDA) as approved food additives or generally recognized as safe (Collins, F).  Compared to sugar, artificial sweeteners are much sweeter.  For example, aspartame is 160 – 200x sweeter and saccharin is 200 – 700x, so a little goes a long way (COHN).  When considering caries prevalence and artificial sweeteners, it is noted that they cannot be metabolized by cariogenic bacteria and are therefore noncariogenic, do not cause caries/cavities.  There are conflicting studies regarding the consumption of artificial sweeteners and artificial sweetened beverages.  According to an article published in Colgate Oral Health Network (COHN), several organizations have reported short-term consumption of artificial sweetened beverages and other low-calorie beverages may help to reduce energy intake and weight in some adults.  As noted in one study, artificial sweetened beverage consumption should not be encouraged and long-term intake should be avoided in children as there is little long-term data for its intake (COHN).  Although there is value for artificial sweeteners and beverages in management of metabolic diseases and its noncariogenic property which is beneficial in dentistry, consultation with your primary care provider and dentist as well as further research is needed as the public has various thoughts concerning risk and benefits.