Role of sweeteners in the etiology and prevention of dental
caries*
Shigeyuki Hamada
Department of Oral Microbiology, Osaka University Faculty
of Dentistry, Suita-Osaka, 565-0871, Japan
Abstract: Dental caries is a multifactorial disease
that is caused by an interplay of three major factors, i.e., teeth,
cariogenic bacteria, and fermentable sugars. Streptococcus mutans
and S. sobrinus, collectively termed mutans streptococci (MS),
are principal causative agents of dental caries. Initial MS-tooth surface
attachment is followed by firm and irreversible adhesion of MS to the
tooth surface, accompanied by the synthesis of water-insoluble glucan
from sucrose via enzymatic action of glucosyltransferases (GTases).
MS induce severe dental caries in rats fed on a high-sucrose diet. Epidemiological
surveys indicate that frequent sucrose intakes are associated with high
prevalence of dental caries in humans. In contrast, dietary sucrose
restrictions and/or use of nonfermentable sucrose substitutes clearly
influence the GTase activities of MS, resulting in decreased caries
development. Structural isomers of sucrose (i.e., disaccharides composed
of glucose and fructose with different linkages) will not function as
substrates for GTases of MS, nor be utilized as energy sources by MS.
Palatinose and trehalulose are included in this category, and are produced
in commercial scales in Japan. Glucose oligomers containing a-1,
6 and/or a-1, 4 linkages are found to inhibit
glucan synthesis by MS from sucrose, although these oligomers are hydrolyzed
by MS to release acids. Lastly, sugar alcohols, including maltitol and
palatinit, are useful as noncaries-inducing sweeteners.
* A special topic issue on the
science of sweeteners.
** Corresponding author.
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