Comparision of properties of sorbitol, xylitol, sucrose, and fructose:

Background

What causes dental caries

Decay-causing bacteria called Streptococcus mutans are normal mouth inhabitants. These bacterias can convert sugars and starches from foods into acids. Plaque is formed when bacteria, acid, food debris and saliva combine in the mouth.

This sticky mixture accumulates on teeth within 20 minutes after eating. Plaque that remains on the teeth forms tartar. Both plaque and tartar irritate the gums, resulting in gingivitis and, ultimately, periodontitis.

The number one strategy for keeping teeth healthy is good dental hygiene, including frequent brushing and flossing and use of fluoride products.

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Role of sugar in dental caries

• Relationship of sugar to level of decay is very weak. Frequency of consumption a better predictor, but still weak. Dietary methods to prevent caries have not been effective. Mos effective: routine use of flouride toothpaste and proper oral hygiene practices
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All carbohydrates, including starchy foods, especially highly processed starches in savoury snacks, and foods containing sugars such as cakes, biscuits, jam, honey, fruits and fruit juices can be used by bacteria to produce acids, which accelerate demineralisation of tooth enamel. Saliva contains protective minerals (calcium and phosphates) that buffer the bacterial acids and promote remineralisation. The greater the salivary flow, the more rapid the remineralisation. It is the balance between acid production and salivary recovery that determines susceptibility to caries.

Fruits and dental caries

• Do raisins cause dental decay, or do raisins help prevent dental caries
  • Plus is they may have compounds that could inhibit enzymes involved in dental caries
  • Other sources believes the stickiness of raisins causes more decay
  • Some think that fruits and some starchy staples are cariogenic, this is not supported by epidemiological data. Several studies show that high intakes of starchy staple foods, such as vegetables and fruits, are associated with low levels of dental caries. Low intake of vegetables and fruits have been shown to triple the risk of tooth decay.
  • Sticky foods are generally more cariogenic than non-sticky foods
  • Sticky foods should be part of a meal rather than between-meal snacks
  • Diary foods are implicating in causing diabetes, perhaps by creating auto-immune reactions against insulin making cells

• In a report by the UK COMA Committee in 1989, sugars were classified as being extrinsic or intrinsic. A similar definition was proposed in a WHO Report (916).
  • Extrinsic sugars were defined as those added to a food
  • intrinsic sugars as those “naturally integrated into the cellular structure”, eg those in fruits and vegetables.
  • The report added that the physical location of sugars influenced their availability for bacterial metabolism and therefore their influences on caries. However, research has shown that extrinsic and intrinsic sugars impact plaque acidity equally. And the rate of metabolism of sugars in whole fruits to acids by plaque bacteria is identical to that of fruit juices.
  • From "The World Sugar Research Organisation Limited" (WSRO), a worldwide alliance of sugar producers, processors, marketers, users and their associations - link

How starch can cause decay

A pair of identical twins was brought into Tufts dental clinic while I was there. One twin had perfect teeth without a single cavity. The other had rampant decay all over his mouth. Being from the same family, they both ate the same things at each meal (mom was adamant that she gave them almost no sweets) and being identical twins, they were genetically identical, so neither one should have been any more susceptible to cavities than the other. No one could pry out of the twins any differences in their eating habits. Finally, one of my older professors cornered the two of them and after much prodding finally discovered that the cavity prone one liked to suck on bread balls. "Bread balls?? What are bread balls?" "Well you take the soft middle out of a slice of bread, ball it up real tight and suck on it!" Bread is not sweet. How could that cause cavities? Actually, bread is made of starch which normally does not cause decay, but when kept in the mouth for a long time, an enzyme in the saliva called amylase begins to break down the starches into their constituent parts, and those parts are simply sugar. Try it sometime. If you keep a piece of bread in your mouth for a while it begins to taste sweet. This is not to imply that bread, potato chips or other starchy foods are major causes of tooth decay. The sugar is released if the starch is kept in the mouth for a long time without being swallowed.

From Doctorspiller.com

Foods which may help prevent dental caries

Certain other dietary components have been shown to have protective properties against dental caries:

• Cow’s milk (cheese) contains calcium, phosphorus, and casein which are believed to inhibit caries. (However, diary products may be a cause of diabetes, and a cause of calcium loss in bones)
• Wholegrain foods require more chewing thereby stimulating the flow of saliva and protecting against caries.
• Peanuts, hard cheeses, and chewing gum also stimulate salivary flow and protect against caries.
• Black tea extract increases fluoride concentration in tooth plaque thereby reducing the risk of developing caries linked to a diet rich in sugars.
• greenfacts - link

The Prevention of Dental Caries and Oral Sepsis - 1912

• Chapter 15 - Diet of Races relatively immune to caries - Esquimaux (Eskimo) and Maori
  • Maori - 1.2% incidence of caries
  • Maoris thought to be cannibals, high protein diet "The consumption of human flesh only occurred on more or less rare occassions after a war party had returned home with prisoners, and then not all the prisoners were eaten; a large number were always reserved as slaves... The consumption of prisoners was confined almost entirely to the warriors. Human flesh was strictly taboo, i.e. forbidden, to women (except for the high priestess), and only the elder boys were allowed a very small portion.
  • Staple food of Maoris - kumara, or sweet potato (ipomoea chrysorrhiza), rarauhe, fern-root (Pteris aquilina or esculenta) but only young roots with the least fibre, must break crisply, dried, roasted, outer shell removed, pounded to powder, fibres removed.
    • fresh taro
    • hue - pumpkin like fruit
    • many kinds of raw berries
    • fish and birds (no mammals indigineous to New Zealand except for small rats and dogs, and it was taboo to eat dogs)
    • eels, crayfish, shell fish
  • Realtive immunity of Maori was due to the habitual and constant mastication of salivary stimulants and masticatories, thus producing a constant flow of alkaline and diastatic saliva.
  • Several races create fermented drinks from masses chewed by women
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Xylitol based chewing gums

• http://www.thefind.com/beauty/info-spry-gum-fruit
• http://www.amazon.com/dp/B000MIIQIS

How Xylitol in chewing gum works to inhibit caries development

• Xylitol is not fermented by cariogenic plaque bacteria and, thus, does not lower the pH of plaque. Because plaque pH does not decrease, enamel demineralization is prevented, and plaque bacteria do not proliferate.
• Xylitol reduces the accumulation of plaque on the tooth surface
• Since plaque pH does not drop when xylitol-sweetened gum is chewed, remineralization is enhanced
• Regular chewing of xylitol-sweetened gum has specific inhibiting effects on the growth of mutans streptococci in the mouth. This suggests that there may be permanent reduction in oral mutans streptococci levels from this practice.
• Chewing any gum stimulates the flow of saliva, which enhances the buffering effect in plaque. This property is not unique to xylitol-sweetened gum, the chewing effect by itself is seen as beneficial.

References

www.dentistrytoday.com/ce-articles/325.html

Beighton D, Brailsford SR, Gilbert SC, Clark DT, Rao S, Wilkins JC, Tarelli E & Homer KA (2004) Intra-oral acid production associated with eating whole or pulped raw fruits. Caries Research 38:341-349

Department of Health (1989) Dietary Sugars and Human Disease. Committee on Medical Aspects of Food Policy. Report on Health and Social Subjects No 37. HMSO, London

Food and Agriculture Organisation / World Health Organisation Expert Consultation (1998). Carbohydrates in Human Nutrition. FAO Food and Nutrition Paper No 66. FAO, Rome

Gibson S and Williams S (1999) Dental caries in pre-school children: associations with social class, toothbrushing habit and consumption of sugars and sugar-containing foods. Caries Research 33: 101-113

Gustafsson BE, Quensel CE, Lanke LS, Lundqvist C, Grahnen H, Bonow BE & Krasse B (1954) The Vipeholm dental caries study. The effect of different levels of carbohydrate intake on caries activity in 436 individuals observed for five years. Acta Odontologica Scandinavica 11:232-365

Hussein I, Pollard MA and Curzon MEJ (1996) A comparison of the effects of some extrinsic and intrinsic sugars on dental plaque pH. International Journal of Paediatric Dentistry 6(2):81-87

Kandelman D (1997) Sugar, alternative sweeteners and meal frequency in relation to caries prevention: new perspectives. British Journal of Nutrition 77(suppl 1):S121-S128

König KG (1990) Changes in the prevalence of dental caries: how much can be attributed to diet? Caries Research 24 (suppl 1) 16-18

König KG and Navia JM (1995) Nutritional role of sugars in oral health. American Journal of Clinical Nutrition 62 (suppl): 275S-83S

Luke GA, Gough H, Beeley JA, Geddes DAM (1999) Human salivary sugar clearance after sugar rinses and intake of foodstuffs. Caries Research 33: 123-129

Misspellings

• xylotol
• xilitol