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.