Study: Sweetening Oral Care with Erythritol


MINNEAPOLIS—A three-year, double blind, randomized, placebo-controlled study found the non-caloric sweetener erythritol (as Zerose® erythritol, from Cargill) may be more effective at preventing dental caries and reducing plaque formation than xylitol and sorbitol.

“This is good news, especially for our customer partners targeting oral care benefits for their products," said Peter Decock, nutrition and regulatory manager, Cargill Health & Nutrition. “In past clinical trials using xylitol chewing gum, it was generally accepted that sugar substitution in combination with saliva stimulation was responsible for lowering the risk of cavities. We now understand there may be important differences between how sugar substitutes affect the oral microbiota and dental health when used in candies—and that erythritol may offer greater benefits."

Sweet Tooth Test

In the clinical trial—funded by Cargill’s R&D center in Europe and conducted by the University of Tartu, Department of Stomatology, Faculty of Medicine—485 first- and second-grade students were randomly assigned to three groups: erythritol, xylitol and sorbitol. Over the course of three years, only during school days, their teachers distributed and supervised the use of candies three times a day at school: in the morning, immediately after lunch and at the end of the school day. The teachers and students did not know to which sweetener group they belonged.

During their annual dental exams, each participating student was assessed using the International Caries Detection and Assessment System. The differences between the annual caries ratings in intervention groups and placebo reflect each sweetener’s caries preventive effect.

After the second and third years, researchers found the number of dentin (the calcified tissue surrounding the pulp cavity of a tooth and comprising the bulk of the tooth) caries was lowest in the erythritol group. Plaque formation within the erythritol group was lower after the first, second and third years. The significant higher plaque reduction observed for erythritol compared to xylitol and sorbitol was consistent with the finding in a short-term, six-month study (Mäkinen et al. 2005) in which a significant higher plaque reduction also was observed for erythritol compared to xylitol and sorbitol.  

“The new three-year clinical study shows with Zerose erythritol, manufacturers have new opportunities to formulate great-tasting oral care products that have improved dental benefits compared to products using xylitol, which is currently in common use," said Tim Bauer, Zerose erythritol product line manager, Cargill Health & Nutrition. “As companies work hard to offer unique value propositions—and as Cargill works to expand consumer awareness of the benefits of erythritol—we see a strong indication that the use of Zerose erythritol will become a major point of difference in the marketplace."

For more on oral care, check out Inside Cosmeceuticals' digital issue: Balancing the Body's Skin and Oral Ecosystems with Pre- and Probiotics.