Artificial Sweeteners Are Not Necessarily Bad for Your Teeth

Artificial Sweeteners Are Not Necessarily Bad for Your Teeth
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Artificial Sweeteners Are Not Necessarily Bad for Your TeethClinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. Types
  2. Sugar & Your Teeth
  3. Artificial Sweeteners vs Sugar & Your Teeth
  4. Artificial Sweeteners & Oral health
  5. Are They Bad for You?
  6. Tips for Oral Health
  7. Frequently Asked Questions
  8. References

If you were to pick people randomly on the street and ask if sweet foods and beverages are bad for teeth, a significant majority would say yes without a second thought. While this may be true in some cases, there’s more than meets the eye.

In fact, according to The National Institutes of Health (NIH), sugar increases your risk of tooth decay and cavities. But a variety of foods and beverages that people consider sweet today do not have sugar as an ingredient. Instead, they have artificial sweeteners.

Artificial sweeteners are sugar substitutes that replicate the sweetness of sugar but, unlike sugar, have little to no calories.

Most artificial sweeteners are sweeter than actual sugar, but the lack of real sugar means bacteria cannot use food debris as fuel and cannot set the stage for rotting teeth.
On the other hand, notes the Harvard Medical School, all artificial sweeteners are not created equal.

Types of Artificial Sweeteners

Artificial sweeteners, also called sugar substitutes, are made from chemicals and natural substances and are found in various foods and drinks labeled as “sugar-free.”

The following sweeteners are approved by the FDA as food additives in the United States:

  • Aspartame
  • Saccharin
  • Acesulfame potassium (Ace-K)
  • Suclarose
  • Advantame
  • Neotame
Aspartame
  • Does not contain calories
  • 200 times sweeter than sucrose
  • Brand names include NutraSweet, Sugar Twin, Equal.
  • Primarily used to sweeten diet soft drinks but also used as a general-purpose sweetener for chewing gum, cold breakfast cereals and as a tabletop sweetener
Saccharin
  • Does not contain calories
  • 200 to 700 times sweeter than sugar
  • Brand names include Sweet ’N’ Low, Necta Sweet, Sweet and Low, and Sweet Twin
  • Used in beverages, processed foods, cooking or table use substitute for sugar, fruit juice drinks
Acesulfame Potassium (Sunette, Sweet One)
  • Contains few calories
  • Often combined with other sweeteners
  • 200 times sweeter than sucrose
  • Used in baked goods, frozen desserts, beverages, and candies
  • Often combined with saccharin in diet soft drinks
Sucralose (Splenda)
  • 600 times sweeter than sucrose
  • Used in baked goods, chewing gum, beverages, frozen dairy desserts and gelatins
  • Found in many diet drinks and foods
Advantame
  • Made from vanillin and aspartame but 100 times sweeter than aspartame and 20,000 times sweeter than sucrose
  • Used as a food flavor enhancer (except in poultry and meat), general-purpose sweetener
Neotame (Newtame)
  • 30-60 times as sweet as aspartame but 7,000 to 13,000 times as sweet as sugar
  • Used as a general-purpose sweetener, food flavor enhancer (except poultry and meat)

Sugar and Your Teeth

According to the Journal of Dental Research,.>) sugar (sucrose) is the most cariogenic dietary carbohydrate, which means it is the one most likely to cause tooth decay. However, sugar does not cause tooth decay directly – it is just a catalyst.

Bacteria in the mouth feed on the fermentable sugar left behind and break it down into acids which combine with food debris, saliva, and bacteria to form plaque. This substance sticks to your teeth and wears away at your tooth enamel which eventually creates cavities.

Cavities can grow deeper over time as the decay spreads down to the tooth's pulp.

Dietary Guidelines for Americans recommend that the consumption of added sugar should not exceed 10 percent of your daily calorie intake. In addition to the potential risk of weight gain and lifestyle diseases, sugar is harmful to your teeth. 

Common sources of added sugar include:

  • Candy
  • Soft drinks
  • Fruit drinks
  • Ready-to-eat cereals
  • Yeasty breads
  • Grain-based desserts

Artificial Sweeteners vs. Sugar and Your Teeth

In contrast to sugar, artificial sweeteners are not fermentable and are considered non-cariogenic. Additionally, most have little or no calories.

In effect, bacteria cannot use artificial sweeteners as food like they would with natural sugar. Without another food source, the bacteria will die, which essentially protects your teeth.

However, most foods and drinks that use artificial sweeteners instead of sugar also have other elements that can cause tooth decay. Case in point, although some artificial sweeteners used in diet soft drinks may not cause cavities, the drinks are very acidic, which by itself erodes the enamel and can cause cavities.

How Do Artificial Sweeteners Affect Oral Health & Your Teeth?

A study by The International Journal of Basic & Clinical Pharmacology (IJBCP), artificial sweeteners do not contribute to tooth decay. An article in the British Dental Journal also notes that sucralose does not affect tooth decay.

The IJBCP study shows that artificial sweeteners do not contribute to tooth decay and, in fact also work against it by balancing your salivary pH and thus decreasing the amount of decay-causing bacteria in the mouth.

Are Artificial Sweeteners Bad for You?

While artificial sweeteners provide some benefits for your teeth and oral health, this does not mean that foods and drinks containing non-nutritive sweeteners are superior. Regardless, dental professionals urge patients to cut back on sugar.

Replacing sugary foods and drinks with foods containing artificial sweeteners is just flipping different sides of the same coin. In the case of diet soda, it does not give you extra calories or deliver the nutrition you need, even though its acidity can contribute to decay.

However, as mentioned above, consumption of sweeteners should be limited to the FDA-recommended acceptable daily intake (ADI) as follows:

  • Saccharin - 15 milligrams per kilogram body weight per day 
  • Aspartame - 50 milligrams per kilogram body weight per day
  • Acesulfame Potassium - 15 milligrams per kilogram body weight per day
  • Neotame - 0.3 milligrams per kilogram body weight per day
  • Sucralose - 5 milligrams per kilogram body weight per day
  • Advantame - 32.8 milligrams per kilogram body weight per day

Tips for Good Oral Health with Eating Artificial Sweeteners

Among the top tips for improving your dental health while eating foods with artificial sweeteners:

  • Drink more water (preferably fluoridated) to reduce tooth decay.
  • Consume the foods or drinks with artificial sweeteners quickly to give your saliva a better chance to neutralize pH in your mouth quickly.
  • Use a straw to keep damaging sugars and acids away from your teeth.
  • Rinse your mouth with water after having drinks or foods sweetened with artificial sweeteners to wash away remnant sugars and acids, then wait 30 to 60 minutes before brushing your teeth. Brushing immediately can erode the recently attacked softened tooth layer.
  • Avoid acidic foods and drinks before bedtime.
  • Keep up with regular dental checkups.

Frequently Asked Questions

What sweetener is not bad for your teeth?
Xylitol, which is a natural sugar replacement found in many sugar-free gums, is not bad for your teeth since bacteria cannot break it down as use it as food.
Can aspartame damage your teeth?
Yes. Aspartame leads to high amounts of acidity in the mouth, which causes cavities
Are Stevia or Splenda bad for your teeth?
Stevia does not contain fermented carbohydrates which means it cannot be broken down by mouth bacteria into acid and turned into plaque. A study published by The Journal of Carries Research concluded that Stevia is non-acidogenic which means it supports oral health. However, Splenda causes high amounts of acidity in the mouth which is bad for teeth and oral health.

References

Diabetes, Gum Disease, & Other Dental Problems.  (September 2014). National Institutes of Health.

Artificial sweeteners: sugar-free, but at what cost? (January 2020). Harvard Medical School.

High-Intensity Sweeteners. (December 2017). The US Food and Drug Administration.

The Role of Sucrose in Cariogenic Dental Biofilm Formation—New Insight.>). (February 2008). Journal of Dental Research.

Sugar substitutes and dental health. (September 2018). The International Journal of Basic & Clinical Pharmacology.

Sugar Substitutes: Mechanism, Availability, Current Use, and Safety Concerns-An Update. (October 2018). Open Access Macedonian Journal of Medical Sciences.

Nutrition: What You Eat Affects Your Teeth. Mouth Healthy

High-Intensity Sweeteners. (December 2017). U.S. Food & Drug Administration.

Additional Information About High-Intensity Sweeteners Permitted for Use in Food in the United States. (August 2018). U.S. Food & Drug Administration.

Added Sugars on the New Nutrition Facts Label. (November 2020). U.S. Food & Drug Administration.

Sugar Substitutes and Their Role in Caries Prevention. (Date Fetched January 2022). FDI World Dental Federation.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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