Role of acidic additives in noncaloric sweeteners in causation of dental erosion

Abstract

Dental erosion is a nondestructive carious process, slowly dissolving tooth structure because of extrinsic, intrinsic, and idiopathic causes, resulting in painless loss of tooth structure without the involvement of microorganisms. Polyols/noncaloric sweeteners are promoted extensively owing to cariostatic action and low-glycemic response, but pose a risk of dental erosion because of acidic additives incorporated into sugar-free products which cause demineralization of enamel. Erythritol, sorbitol, mannitol, and xylitol are some of the polyols publicized in maintaining good oral health by the American Dental Association. A review of the existing literature was done by searching through databases such as PubMed, EBSCO, Hinari, and Sage on noncaloric sweeteners from February to end of May 2016 using keywords noncaloric sweetener, polyols, dental erosion, casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP), nanohydroxyapatite, and prevention of erosion. Novel preventive strategies by infusing CPP ACP, milk protein casein, and fluoride into sugar-free formulations may resolve the cause of dental erosion.