Sugar and Other Sweeteners

Question 1

what are the effects of sugar on teeth

Answer 1

• intake of sugar increases risk for caries
• dose-response relationship between sugar consumption and dental caries
• caries considered highly prevalent oral disease negatively impacting quality of life for all ages
• impact of fluoride has been positive, even as sugar consumption increases around the world

Question 2

what is sugar used for

Answer 2

• sweetening agent
• flavor blender/ modifier
• texture
• dispersing agent
• color agent
• bulking agent

Question 3

as higher amounts of sugar are consumed:

Answer 3

your brain requires more sweetness to satisfy reward levels in your brain

Question 4

how much sugar should we consume

Answer 4

• no DV for total sugars that occur naturally in our food
• DV for added sugars: 50g/day for a 2,000 cal diet

Question 5

what is the average sugar consumption of US daily

Answer 5

17 grams/day

Question 6

what percentage of sugar comes from what in daily diet

Answer 6

• 25% soda
• 11% fruit drinks
• 3% sports drinks and energy drinks
• 7% added sugar in coffee and tea

Question 7

what are the 3 classes of alternative sweeteners

Answer 7

• polyols
• intense sweeteners
• nonnutritive sweeteners

Question 8

describe polyols as sweeteners

Answer 8

• sugar alcohols
• 40% of caloric content of sucrose
• physical characteristics to sucrose
• not typically great in baking
• also used in toothpastes and mouth washes

Question 9

decsribe sorbitol

Answer 9

• occurs naturally in fruits and berries
• only 60% as sweet as sucrose
• considered noncariogenic however is slowly fermented by S. mutans
• shown to be cariogenic in patients with decreased salivary gland function
• can cause GI issues if large quantities digested

Question 10

describe mannitol

Answer 10

• naturally occuring polyol found in seaweed
• virtually no cariogenic activity due to slow metabolization from oral microorganisms
• used as a dusting agent for chewing gum and bulking agent in powdered foods
• 50-70% of the relative sweetness of sugar
• lingers in intestines and may cause bloating. diarrhea

Question 11

describe erythritol

Answer 11

• sweetness level is 60-80% of sucrose
• safe for diabetics; does not affect blood glucose levels after ingestion
• sugar alcohol containing zero calories
• when eaten in excessive amounts may cause GI discomfort
• noncariogenic; inhibits the growth of S mutans

Question 12

describe xylitol

Answer 12

• naturally occuring caloric 5- carbon sugar alcohol
• nonfermentable by oral bacteria and exhibits antibacterial properties
• produced commercially from birch trees, corncobs and waste from sugarcane
• sweetness approximates that of sucrose; however it is 10x more costly to produce
• primarily used in chewing gum, mints, mouth rinses, toothpaste and sometimes found in syrup and candy

Question 13

describe xylitol as an antibacterial

Answer 13

-decreases bacterial metabolism and produces a drop in dental plaque pH
- promotes the selection of xylitol resistant mutans streptococci
- stimulates salivary secretion

Question 14

describe patient based caries management with xylitol

Answer 14

recommend using xylitol containing products in addition to daily fluoride exposure

Question 15

at least ______ of xylitol per day needed to achieve optimum therapeutic effect on S mutans

Answer 15

5g

Question 16

how should xylitold be ingested daily

Answer 16

should be divided into 3 or 4 doses with exposure time 5-10 minutes per dose

Question 17

xylitol products that actively stimulate _____ should be recommeneded

Answer 17

salivary flow

Question 18

products should ideally have _______ as the single sweetender

Answer 18

xylitol

Question 19

what is xylitol highly toxic to and what happens

Answer 19

dogs
- causes rapid/ severe increase of insulin productions and leads to hypoglycemia
- higher amounts of xylitol can lead to death

Question 20

what are the amounts of xylitol in epic gum? ice cubes? trident? orbit?

Answer 20

• epic: 1.06g per piece
• ice cubes: 1.15g per piece
• trident: 0.17g per piece
• orbit: 0.009-0.3g xylitol per piece

Question 21

describe saccharin

Answer 21

• 200-700 times sweeter than sucrose
• nonnutritive and noncariogenic
• oldest artifical sweetener used in the US
• AKA Sweet N low
• used as sweetener in some toothpastes

Question 22

describe aspartame

Answer 22

• 200 times sweeter than sucrose
• soft drinks account for more than 70% of aspartame consumption
• FDA requires foods containing aspartame have the following label: PHENYLKETONURICS: CONTAINS PHENYLALANINE
• limited evidence that consumption of aspartame might cause cancer

Question 23

describe sucralose

Answer 23

• noncariogenic, nonnutritive sweetener that is 600 times sweeter than sucrose
• poorly absorbed and is largely excreted in the feces and urine, unchanged
• no carcinogenic risks posed to humans

Question 24

decsribe stevioside

Answer 24

• stevia
• natural sweetener extracted from the leaves of a shrub found in south america
• 100-300 times sweeter than table sugar
• heat stable ( good for baking)
• supports the prevention of caries; streptococcus mutans experience growth suppression and secretes less acid with presence of stevioside
• FDA approved in 2008 as generally recognized as safe

Question 25

describe monk fruit

Answer 25

• natural, zero calorie sweetener extracted from monk fruit
• high in antioxidants, called mogrosides- making it 100-250 times sweeter than table sugar
• used for centuries in traditional chinese medicine; FDA approved sweetener in 2010
• often mixed with other natural sweetners such as erythritol to reduce the intensity of its sweetness