Adaptation of dental plaque to metabolise maltitol compared with other sweeteners

There is some evidence that plaque can adapt to regular exposure to some bu lk sweeteners, leading to increased metabolism and acidogenic potential of the sweetener. This potential for adaptation varies between non-sugar sweet eners and has important implications for manufacturers of food, confectione ry and medicines used long-term. Maltitol (99% purity crystalline D-maltito l) is a relatively newly approved non-sugar sweetener and appears to have p otentially good dental properties. Objectives: To compare plaque adaptation to pure sucrose, sorbitol, xylitol or maltitol and the effect of their prolonged use on acid production by pl aque from sucrose, in vivo. Methods: Two series of plaque pH experiments were carried out. Each experim ent involved a 14 day adaptive period when four 5 g lozenges of the sweeten er were taken between meals each day. Each experiment was separated by a 14 day wash-out period. Acid production was quantified as: (a) minimum pH; an d (b) cH area (difference between plaque pH curve and resting value, expres sed as cH units). Results: Thirteen adults, of mean age 41 years completed the study. When ad aptation of dental plaque to the metabolism of sweeteners was compared, the re was a statistically significant difference (p = 0.033) between xylitol a nd sorbitol, and between xylitol and sucrose but not between xylitol and ma ltitol. When the effect of prolonged use of sweeteners on acid production a fter sucrose rinsing was compared, there were no statistically significant differences between the sweeteners. Conclusion: Dental plaque does not adapt to metabolise xylitol or maltitol following prolonged exposure over 14 days. (C) 1999 Elsevier Science Ltd. A ll rights reserved.