Sugar substitutes in relation to the incidence of clinical and experimental caries.

Examination of several human studies shows the relationship between sugar intake and dental caries to be complex and partly independent of dosage. Under certain conditions frequent consumption, even in combination with surprisingly low dosage, may lead to high caries incidence. The potential use of sugar substitutes may be based on the concept of replacing sucrose particularly in foodstuffs proven to be highly cariogenic. So far, the evaluation of the cariogenicity of specific sugar substitutes has usually been carried out in comparison to sucrose. Glucose and fructose have thus been found somewhat less cariogenic than sucrose. Some polyols, however, may be considered virtually or completely noncariogenic in man. The low caries incidence observed in the clinical trials and most of the experimental studies have to be viewed as a natural consequence of the microbiological and biochemical behavior of these substances. As an entity, perorally administered polyols should be considered to stimulate a number of existing defense mechanisms to caries.