Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
College of Dentistry, The Ohio State University, Columbus, OH, USA; Nationwide Children's Hospital, Columbus, OH, USA.
J Dent. 2024 Jul;146:105069. doi: 10.1016/j.jdent.2024.105069. Epub 2024 May 16.
This study aimed to systematically review the effect of sugar substitute consumption on caries prevention in permanent teeth among children and adolescents.
Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing the clinical effect of sugar substitutes (both high- and low-intensity sweeteners) in preventing caries in permanent teeth among children and adolescents aged 6-19 were included.
A systematic search was conducted in three databases (PubMed, Web of Science and Embase) without any restrictions on publication year.
The initial search found 1,859 items, and finally, 15 studies (11 RCTs and 4 CCTs) with a total of 6325 participants (age: 6-18 years) were included. The Cochrane risk-of-bias assessment tools were used for quality assessment. Most (80%, 12/15) were graded as having a 'moderate' or 'high' risk of bias. All trials investigated sugar alcohol, which is a low-intensity sweetener. Xylitol was the most commonly investigated (73.3%, 11/15), followed by sorbitol (46.7%, 7/15), and erythritol (13.3%, 2/15). Results of the meta-analysis showed that both xylitol (standardized mean difference [SMD]: -0.50, 95% confidence interval [CI] -0.85 to -0.16, P = 0.005) and sorbitol (SMD: -0.10, 95% CI: -0.19 to -0.01, P = 0.03) had a significant effect in preventing dental caries compared to no treatment/placebo. No clinical trials on high-intensity sweeteners such as aspartame and saccharin were found.
The consumption of xylitol or sorbitol is potentially effective in preventing caries in permanent teeth among children and adolescents. No clinical evidence is available regarding the role of high-intensity sweeteners in caries prevention.
The use of xylitol or sorbitol as sugar substitutes has a beneficial effect in preventing dental caries among children and adolescents.
本研究旨在系统综述糖替代品对儿童和青少年恒齿龋病预防的效果。
纳入了比较儿童和青少年（6-19 岁）中使用糖替代品（高强度甜味剂和低强度甜味剂）预防恒齿龋病的临床效果的随机对照试验（RCT）和对照临床试验（CCT）。
在三个数据库（PubMed、Web of Science 和 Embase）中进行了系统检索，对发表年份没有任何限制。
最初的搜索发现了 1859 项，最终纳入了 15 项研究（11 项 RCT 和 4 项 CCT），共有 6325 名参与者（年龄：6-18 岁）。使用 Cochrane 偏倚风险评估工具进行质量评估。大多数（80%，12/15）被评为“中度”或“高度”偏倚风险。所有试验均研究了糖醇，糖醇是一种低强度甜味剂。木糖醇的研究最为广泛（73.3%，11/15），其次是山梨糖醇（46.7%，7/15）和赤藓糖醇（13.3%，2/15）。荟萃分析的结果表明，与无治疗/安慰剂相比，木糖醇（标准化均数差 [SMD]：-0.50，95%置信区间 [CI]：-0.85 至 -0.16，P=0.005）和山梨糖醇（SMD：-0.10，95%CI：-0.19 至 -0.01，P=0.03）在预防龋齿方面均有显著效果。未发现关于阿斯巴甜和糖精等高强度甜味剂在龋病预防中的作用的临床试验。
儿童和青少年食用木糖醇或山梨糖醇可能有助于预防恒齿龋病。高强度甜味剂在龋病预防中的作用尚无临床证据。
在儿童和青少年中使用木糖醇或山梨糖醇作为糖替代品具有预防龋齿的有益作用。
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