DEFINITION

Sugar substitute is based on the

concept of replacing sucrose in
food stuff which are proved to
be highly cariogenic
 TYPES
These are of two types:

(A) Non nutritive sweeteners

(B) Nutritive sweeteners

 NON NUTRITIVE
SWEETNERS
These are intense sweeteners, non caloric
sweeteners

Much sweeter than sugar

Yield little or no energy,provide no bulk

Used in small quantities in drinks or blended

with sugar substitutes in food & snacks
Approved products in market
are
ASPARTATE
SACCHARINE
CYCLANATE
SUCRALASE
ACESULFAME-K

From dental point of view caloric

sweeteners are very useful as they are
not fermented to acid by oral bacteria
 ASPARTATE
White, crystalline, odourless, slightly
water soluble non carbohydrate powder

About 150 to 200 times sweeter than

sucrose

Used as low calorie sugar substitute in

soft drinks,table sweeteners & other
food products
 SACCHARINE
White, crystalline, odourless, slightly water
soluble powder produced synthetically
500 times sweeter than sugar in dilute
solution
Its soluble sodium salt is used as a non
caloric sugar substitute
Also called as benzosulfimide or gluside
Widely used in “diet” soft drinks, dietic
foods,mouth washes,medicines & as a
sweetener for table use since 1940
 DISADVANTAGE

May cause bladder cancer

banned in USA & Canada

 CYCLAMATE
An organic sweetener

30 times sweeter than sucrose

When ingested,absorbed into

blood streams & excreted almost
unchanged in urine
However part of it is converted to
Cyclohexylamine by microorganism in lower
intestinal tract

Banned in USA & Canada as it can cause

cancer

Cyclohexylamine can produce

vasoconstriction & hypertensive effect by
affecting sympathetic nervous system
 NUTRITIVE
SWEETENERS
Caloric sweetener, carbohydrate sugar
substitute

Includes a large number of

monosaccharide & disaccharides,
various polyols & starch hydrolysates
& hydrogenates

Relative sweetness of these

compounds is only occasionally more
than equal to sucrose, in most
instances it is lower
 CLASSIFICATION
NUTRITIVE SWEETENERS
SUGAR SUGAR ALCOHOL
o Glucose Sorbitol
o Fructose Mannitol
o Lactose Xylitol
o Maltose
 SUGARS
Sugars other than sucrose used now a
days in a large scale in various food
items,reason for this is not dental but
rather technological or economical

Lactose used in most of baby foods

Has lower cariogenicity than

sucrose,glucose & fructose
Since people can not tolerate its large amount
so it has a little practical importance as a
sugar substitute

Now palatinose is used as a sugar substitute

It is a disaccharides & “coupling sugar” & a

mixture of various fructose –glucose polymers
SUGAR ALCOHOLS
Not good substrate for plaque
bacteria & therefore produces only a
minimal drop in plaque pH

On metabolism it get oxidized to

either to ketose or aldose
 SORBITOL
White, crystalline, water soluble powder

Used as sugar substitute in diabetes

Prepared from glucose by hydrogenation

About half as sweet as sucrose &
used alone or with other polyalcohols
to provide a sweetener in dairy foods,
especially in chewing gums

Following absorption,dietary sorbitol

is oxidised to fructose by “sorbitol
dehydrogenase” & further metabolism
is like fructose

WHO recommended intake rate of

sorbitol is up to 150mg/kg/day
 MANNITOL

White ,crystalline,water
soluble carbohydrate alcohol
 XYLITOL
Well established that it is non cariogenic & is
used in chewing gums

It is one of a sugar sweetner approved for use

in food & other items in many countries

It has specific as well as non specific effects

on oral flora & especially on certain strains of
mutans streptococci add to its caries
preventive profile
 PLAQUE
1.non fermentability by plaque organism
2.reduction in plaque quantity
3.selective reduction of mutans
streptococci
4.introduction of mutans streptococcus
strain with reduced virulence.
It has some proposed actions
5.increased conc. Of ammonia in plaque
6.accumulation of xylitol-5PO4 in some
plaque streptococci
7.participation in a futile metabolic
cycle in some plaque organisms
8.reduced adhesion of plaque flora
9.reduced transmission of mutans
streptococci
SALIVA
1.changes in quantity & quality of saliva
ENAMEL
1.aids remineralisation