The World Health Organization and two dental associations this year drew attention to how sugar plays a role in the formation of cavities, which gives food and beverage manufacturers more reason to focus on the oral health aspects of their products.
An article appearing this month in the Journal of Dental Research stated "extensive" scientific evidence shows free sugars are the primary necessary factor in the development of dental caries.
"Processed starches have cariogenic potential when accompanying sucrose, but human studies do not provide unequivocal data of their cariogenicity," said researchers from University College London and London School of Hygiene & Tropical Medicine in the United Kingdom after reviewing the literature on the role of sucrose in the cariogenic process (the development of caries).
The International Association for Dental Research and the American Association for Dental Research publish the Journal of Dental Research.
The article appeared about five months after the World Health Organization, Geneva, on March 5 released guidelines recommending adults and children reduce daily intake of free sugars to less than 10% of total energy intake. A further reduction to below 5% per day would provide additional benefits, according to the W.H.O.
Free sugars refer to monosaccharides, including glucose and fructose, and disaccharides, including sucrose, added to foods and drinks by manufacturers, cooks or consumers, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, according to the W.H.O.
Evidence shows keeping intake of free sugars to less than 10% of total energy intake reduces the risk of overweight, obesity and tooth decay, said Francesco Branca, M.D. and Ph.D., director of the W.H.O.'s Department of Nutrition for Health and Development. Although exposure to fluoride reduces dental caries and delays the onset of the cavitation process, it does not completely prevent dental caries, according to the W.H.O.
Ingredients designed to prevent cavities are available for use in foods and beverages.
Beneo, Inc., Morris Plains, N.J., offers a special form of sugar as a unique way to give products oral health benefits. Palatinose (isomaltulose) may be used in functional dairy drinks and tea, chocolate, confectionery, cereal and energy bars, and baked foods.
Palatinose differs from many other sugars/carbohydrates in its molecular structure. The so-called pH plaque telemetry is a globally-recognized methodology to test whether products are non-cariogenic. If the pH-value remains above the critical value of 5.7 within a half hour of consumption, the test material is considered "toothfriendly."
"The toothfriendliness of Palatinose is a result of its high microbiological stability, which is caused by the enzymatic rearrangement of the alpha 1,2 bond between the glucose and fructose molecule in the raw materials, sucrose, producing a more stable alpha 1,6 bond," said Jon Peters, president of Beneo, Inc. "This bond cannot be split by the bacteria present in the mouth, and therefore tooth-damaging acids are not produced."
Beneo also offers isomalt, a sugar-free bulk sweetener. Isomalt, a sugar replacer, also does not produce any tooth-damaging acids during consumption due to its stable molecular structure, Mr. Peters said. It particularly is used in sugar-free confectionary such as candy and chewing gum, he added.
The Food and Drug Administration has said U.S. food manufacturers may use the health claim "does not promote tooth decay" for food products made with Palatinose and isomalt, Mr. Peters said. The European Food Safety Authority also has recognized the dental health benefits of Palatinose and isomalt, he said.
Isomalt and other polyols like erythritol, xylitol and sorbitol are known for being tooth friendly.
Cargill, Minneapolis, points to research conducted on erythritol at the University of Tartu in Estonia. A three-year clinical study found erythritol provided a significant reduction of cavities, dental plaque and the oral bacteria Streptococcus mutans, which is considered a cause of tooth decay. In the double-blind, randomized controlled study, dental plaque was reduced by 24% by weight among school children who ate candy with erythritol.