Sugar Alcohols and Sugar Substitutes

Sugar alcohols, also referred to as polyols, are sweeteners used in reduced calorie foods. Chemically, they are neither sugars nor alcohols. Scientists refer to them as sugar alcohols because part of their structure chemically resembles sugar and part is similar to alcohols. Sugar alcohols approved for use in the United States include sorbitol, mannitol, xylitol, lactitol, maltitol, and isomalt. Their most common use is in “sugar-free” candies, gums, and syrups. The sweetness of different types of sugar alcohols varies , ranging from about half as sweet as sugar to roughly as sweet.

Sugar alcohols are best known for their modest effect on blood glucose levels. They are slowly and incompletely absorbed from the small intestine and are converted to energy by processes that require little or no insulin. Extensive studies of sugar alcohols show that they result in limited acid production by plaque bacteria. In fact, frequent use of chewing gum sweetened with xylitol or xylitol/sorbitol mixtures has been found to reduce plaque as well as levels of S. mutans in plaque and saliva.19 This may be explained by the stimulatory effect of chewing on saliva flow coupled with the noncariogenic effects of these reduced-calorie sweeteners. However, in individuals with impaired salivary gland function, the limited acid production seen with sorbitol-and mannitol-sweetened gums and candies may be enough to stimulate tooth erosion.20

Non-caloric sweeteners, including aspartame, acesulfame potassium, and saccharin, do not promote dental caries because oral bacteria do not metabolize these sweeteners. Therefore they do not convert them into plaque or the acids that cause tooth decay.5,11