This document discusses different types of sugar substitutes, including nutritive and non-nutritive sweeteners. Non-nutritive sweeteners like aspartame, saccharine, cyclamate, and sucralose are intensely sweet but provide no calories. Nutritive sweeteners provide calories and include sugars like glucose, fructose, lactose, as well as sugar alcohols like sorbitol, mannitol, and xylitol. While some non-nutritive sweeteners have disadvantages like potential cancer risks, nutritive sweeteners and sugar alcohols are less cariogenic than sucrose and may help prevent tooth decay.

2. DEFINITION
Sugar substitute is based on the
concept of replacing sucrose in
food stuff which are proved to
be highly cariogenic

3. TYPES
These are of two types:
(C) Non nutritive sweeteners
(B) Nutritive sweeteners

4. 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

5. 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

6. 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

9. 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

11. DISADVANTAGE
May cause bladder cancer
banned in USA & Canada

12. CYCLAMATE
An organic sweetener
30 times sweeter than sucrose
When ingested,absorbed into
blood streams & excreted almost
unchanged in urine

13. 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

14. NUTRITIVE
SWEETENERS sugar
Caloric sweetener, carbohydrate
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

15. CLASSIFICATION
NUTRITIVE
SWEETENERS
SUGAR SUGAR ALCOHOL
o Glucose Sorbitol
o Fructose Mannitol
o Lactose Xylitol
o Maltose

16. 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

17. 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

18. 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

19. SORBITOL
White, crystalline, water soluble
powder
Used as sugar substitute in
diabetes
Prepared from glucose by
hydrogenation

20. 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

21. MANNITOL
White ,crystalline,water
soluble carbohydrate alcohol

22. 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

23. 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

24. 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

25. SALIVA
1.changes in quantity & quality of saliva
ENAMEL
1.aids remineralisation