Noncariogenic sweeteners. Sugar substitutes for caries control.

The evidence is clear that the incidence of dental caries is related to the frequency of eating sugar. The use of sugar substitutes is a suggested way of reducing sugar intake. A variety of noncariogenic sweeteners exists, but most have no practical value for caries control because of their technical or safety problems, taste, or cost. Urinary bladder tumorigenic effects have been reported in experimental animals treated with saccharin and cyclamates. Because of concerns for human safety, cyclamates were banned in the U.S., and saccharin use was permitted only by special legislation. The polyalcohols sorbitol and xylitol are important sugar substitutes since they are not efficient substrates for plaque bacteria and therefore produce only minimal plaque pH drop. Aspartame, with its sugar-like taste, is an excellent low-calorie sweetener now used in over 100 products under the name NutraSweet. Consumption of aspartame by normal humans is safe and does not promote tooth decay. Individuals with a need to control their phenylalanine intake should handle aspartame like any other source of phenylalanine.