Did you know that sugar-free products can cause tooth decay?
It may seem counter-intuitive, but it’s true.
Ever since the invention of photography in the late 1800s, the US has become an ever more image-driven culture. Today, mobile devices enable us to snap an image and share it in seconds with friends, family or even the world. Our national obsession with self-image has definitely intensified.
Strangely, at the same time, the obesity rate has skyrocketed. As a result, as of 2020, one out of every three adults – about 36% – is obese.
Supermarkets Are Filled With Sugar-Free Products
It’s well-known that diets high in sugar are bad for your waistline. And, despite what it may seem, millions of people want to lose weight. According to a 2018 study by the CDC, 17% of Americans report being on a diet, and that’s up from 14% just over a decade ago.
Consequently, the food and beverage industry has responded. Supermarket shelves are stacked high with sugar-free products that appeal to dieters, particularly in the soda and candy aisles.
With all the sugar-free products at our fingertips, you might assume that tooth decay is on the decline. Not so. Tooth decay in the US is increasing and is the most common chronic disease in children and adults in the United States.
How Sugar Substitutes Can Cause Tooth Decay – Step-By-Step
So, with the availability of so many sugar-free products, why is tooth decay rising in the US? One reason may be the fact that sugar substitutes can cause tooth decay.
Most sugar-free products contain one or more of these three sugar-substitutes: Sorbitol, Mannitol or Saccharine. When you drink or eat a product containing one of these three sugar-substitutes, your mouth responds the same way as it does when you have a sugary product:
STEP 1: Sugars adhere to your tooth enamel and remain there, especially if you don’t brush your teeth right away.
STEP 2: Bacteria notices the sugars on your teeth and begins to feed on them (I know, gross!)
STEP 3: Bacteria love sugars and begin to multiply very quickly.
STEP 4: As the bacteria feed, the sugars are converted into acidic waste.
STEP 5: The acid begins eating away at your tooth enamel.
STEP 6: Tooth decay!
Are There Any Sugar Substitutes That Not Cause Tooth Decay?
Yes, there is one, and it’s called Xylitol. Xylitol differs from other sugar substitutes such as Sorbitol, Mannitol and Saccharine in that bacteria cannot break it down into acids. This discouragement of bacteria growth dramatically reduces the amount of acid that forms on your tooth enamel.
Here’s why I recommend Xylitol as a sugar substitute for my patients:
- Xylitol can actually strengthen tooth enamel and protect your teeth, and that’s why you often see it in toothpaste and chewing gum.
- Xylitol has been proven to be milder on your stomach. That means no embarrassing dashes to the bathroom.
The Bottom Line
Carefully check the ingredients before buying a sugar-free product because sugar substitutes can cause tooth decay.
Dr. Michael Sinkin has been practicing dentistry for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. You may even receive a healthy dose of Dr. Sinkin’s famous comic relief! To find out more about Dr. Sinkin, click here
Rebecca says
My dentist recommended leaving a tooth mousse on my teeth overnight inside my vivera trays to help even out fluorosis discolouration. He said to do this long term, that over about a year it will give good results. But I’ve just seen that the ingredients include sodium saccharin and D-sorbitol. Will it leave me at risk of tooth decay having a substance like this on all night?
Michael Sinkin says
Rebecca,
Because I don’t know which product your dentist has recommended, it is difficult for me to comment. Some products contain an ingredient called recadent that helps to remineralize hypocalcified enamel (white spots). Because these products were originally intended to be used as toothpaste, the sweeteners are there to make them more palatable. I would like to think your dentist had your dental health in mind when he made the suggestion, but if you’re concerned it’s worth a call to the office.
Best in health,
Dr. Sinkin
Jessica says
Trident chewinggum is said to be ADA approved becuse it contains sorbitol, Xylitol and Mannitol too.
So will it cause decay too?
Michael Sinkin says
Dear Jessica,
Trident and other sugarless gums are certainly better than those containing sugar. I enjoy an occasional chew myself.
That said, bacteria can metabolize many sugar substitutes, but with greater difficulty and less acid production.
If one is a chain-chewer, I would surmise that there is a potential risk factor for tooth decay, not to mention the potential for jaw muscle fatigue and stressing the TMJ (the joint of the jaw.)
Truth be told, for the average consumer, Trident is fine. For people suffering from dry mouth because of salivary gland dysfunction or the side effects of medication, I would be more selective in my sugar substitutes suggestions.
Remember the Trident ad, 4 out of 5 dentists recommend sugarless gum FOR THEIR PATIENTS WHO CHEW GUM? That doesn’t translate that chewing gum is necessarily the best thing to do, especially if you suffer from poor dental health.
So, Jessica, my suggestion is that while I believe that Trident is a good alternative to regular chewing gum, too much of anything can have undesirable consequences.
I hope I gave you a satisfactory answer and information to chew on.
Be well.
Dr. Sinkin
eM says
I am dyslexic so difficult to read all you have posted but may I ask is sorbitol and sodium sacharin are bad for teeth as I cannot understand why they are included in tooth paste. thanking you in advance.
Kindest regards eM
Michael Sinkin says
Excellent question! Yes, sugar substitutes such as the sodium saccharin and sorbitol can be metabolized by decay causing bacteria to produce acids that will dissolved tooth enamel. However, the risk that these sugar substitutes pose to the natural dentin has much to do with quantity and frequency of use as well as oral hygiene practices. One must brush and floss to remove sugar substitute residue lest it becomes a bacterial feast. The sweeteners in toothpaste are brushed, scrubbed and rinsed off during the practice of cleaning the teeth and thus pose a minimal risk. I would like to see a change to xylitol, but with a good brushing technique, I think you are good to good.
Thanks for you input,
Dr. Sinkin
kerdios says
Won’t the sugar substitutes get absorbed into the spit glands after the brushing and rinsing and then stick back to the teeth when we salivate?
Michael Sinkin says
Dear Kerdios,
Interesting question. The major salivary (spit) glands are the paired parotid glands and submandibular glands land the single sublingual gland. There are also minor salivary glands within the oral mucosa of the cheeks and lips. Essentially the salivary glands (major and minor) secrete the saliva through small channels called ducts. They are a one-way conduit for saliva to enter the mouth. It’s a one-way street and sugar and sugar substitutes are not sucked back. However, in certain situations, bacteria can infiltrate these ducts and cause infections, even blockages.
Salivary glands will not function as reservoirs for sugar substitutes and the ducts will not act as mini straws. So no worries.
Best wishes,
Dr. Snkin
Betsy Kent says
So, not only does diet soda expand your waistline (just read THAT recently) but also can lead to tooth decay? I also heard that the brown color in cola is bad for you, too. I am certain that Diet Coke has something in it that causes addiction.
Lisa says
Wow, this is very interesting. You think you are doing good by switching to other products and in reality you are not. Great information. Will have to share.