A sugar substitute is a food additive that duplicates the effect of sugar in taste, usually with less food energy. Some sugar substitutes are natural and some are synthetic. Those that are not natural are, in general, called artificial sweeteners.
An important class of sugar substitutes are known as high-intensity sweeteners. These are compounds with many times the sweetness of sucrose, common table sugar. As a result, much less sweetener is required and energy contribution is often negligible. The sensation of sweetness caused by these compounds (the "sweetness profile") is sometimes notably different from sucrose, so they are often used in complex mixtures that achieve the most natural sweet sensation.
If the sucrose (or other sugar) that is replaced has contributed to the texture of the product, then a bulking agent is often also needed. This may be seen in soft drinks that are labeled as "diet" or "light" and contain artificial sweeteners and often have notably different mouthfeel, or in table sugar replacements that mix maltodextrins with an intense sweetener to achieve satisfactory texture sensation.
Children given an oral syrup containing the naturally occurring sweetener xylitol may be less likely to develop decay in their baby teeth, according to a report in the July issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Early childhood caries (cavities), also called baby bottle tooth decay or nursing caries, continue to increase in prevalence, according to background information in the article. "Poor children experience rates twice as high as those of their more affluent peers, and their disease is more likely to be untreated," the authors write. "Poor oral health affects diet and nutrition and significantly diminishes quality of life. However, tooth decay is a disease that is largely preventable."
Xylitol, approved in the United States for use in food since 1963, has been shown to effectively prevent tooth decay by acting as an antibacterial agent against organisms that cause cavities. These previous investigations have primarily involved chewing gum or lozenges used in school-age children with permanent teeth. Peter Milgrom, D.D.S., of the University of Washington, Seattle, and colleagues evaluated the effectiveness of applying oral syrup containing xylitol among 94 children age 9 to 15 months in the Republic of the Marshall Islands, where early childhood tooth decay is a serious health care problem.
"Our results suggest that exposure to xylitol (8 grams per day) in a twice-daily topical oral syrup during primary tooth eruption could prevent up to 70 percent of decayed teeth," the authors write. "Dividing the 8 grams into three doses did not increase the effectiveness of the treatment. These results provide evidence for the first time (to our knowledge) that xylitol is effective for the prevention of decay in primary teeth of toddlers." More research is needed to develop vehicles and strategies for optimal public health, but in populations with high rates of tooth decay, xylitol is likely to be a cost-effective preventive measure, they conclude.