POLYOLS and Dental Health - Swedish Nutrition Foundation (SNF ...

POLYOLS and Dental Health
- Swedish Nutrition Foundation (SNF)
- US FDA 21CFR §101.80
- American Dental Association (2001). Role of Sugar-Free Foods and Medications in
Maintaining Good Oral Health.
http://www.ada.org/prof/resources/positions/statements/sugarfre.asp
- FDA (1996) Health claims: dietary sugar alcohols and dental caries. Federal Register 61
(154) 43433-43445, August 23, 1996, and 21CFR §101.80
- FOSHU Japan:
(1) FOSHU approved products classified by ingredients used and intended benefit or effect
1991-1997 at website of the International Association of Consumer Food Organisation at
http://www.cspinet.org/reports/functionalfoods/table4.html;
(2) website of the Japan Health Nutrition Food Association (JHNFA);
(3) Shimizu, T. (2003) Health claims on functional foods: the Japanese regulations and an
international comparison. Nutrition Research Reviews 16, 241-252.
[Note: the Japanese name of isomalt is “hydrogenised Palatinose”]
- Swiss Lebensmittelverordnung (LMV) of March, 1, 1995, as amended, Art. 176 Zuckerfreie
Lebensmittel.
- WHO/FAO (2003) Diet, Nutrition and the Prevention of Chronic Diseases. Report of a Joint
WHO/FAO Expert Consultation. WHO Technical report Series 916. WHO, Geneva.
- EU Directive 94/35/EC (Sweeteners, Preamble)
- European Commission, Health and Protection Directorate-General: Revision of the scientific
opinion on the effects of xylitol and other polyols on caries development adopted by the
Scientific Committee on Medicinal Products and Medical Devices on 2 June 1999. Opinion
adopted by the Scientific Committee on Medicinal Products and Medical Devices on 26th
September 2002.
Reviews
Polyols
- Edgar WM, Dodds MWJ (1985) The effect of sweeteners on acid production plaque. Int
Dent J 35, 18-22.
- Imfeld T (1993) Efficacy of sweeteners and sugar substitutes in caries prevention. Caries
Res 27 (suppl 1) 50-55.
- Imfeld TN (1994) Clinical caries studies with polyalcohols – a literature review. Schweiz
Monatsschr Zahnmed 104 (8) 941-945.
- Imfeld T, Mühlemann HR (1978) Cariogenicity and acidogenicity of food, confectionery and
beverages. Pharmacology and Therapeutics in Dentistry 3, 53-68.

- Scheie AA, Fejerskov, OB (1998) Xylitol in caries prevention – what is the evidence for
clinical efficacy. Critical review. Oral Diseases 4, 268-278.
- Sentko A, Tietze W, Stoesser L (2006) Zuckerfreie Süßwaren in der Karieprophylaxe.
[Sugarfree foods and their role in caries prevention]. Prophylaxe Impuls 10, 174-183.
- Van Loveren C (2004) Sugar alcohols – what is the evidence for caries-preventive and
caries therapeutic effects? Caries Research 38, 286-293.
Isomalt
- Featherstone JDB (1994) Effects of isomalt sweetener on the caries process: A review. J
Clin Dent 5, 82 – 85.
- Gehring F, Karle EJ (1981). The sugar substitute Palatinit® [isomalt] with special emphasis
on microbiological and caries-preventing aspects. Zeitschrift Ernährungswiss. 20, 96 – 106.
Individual Studies
Polyols
- Edgar WM, Dodds MWJ (1985) The effect of sweeteners on acid production plaque. Int
Dent J 35, 18-22.
- Imfeld T, Muehlemann HR (1978) Cariogenicity and acidogenicity of food, confectionery
and beverages. Pharmacology and Therapeutics in Dentistry 3, 53-68.
Isomalt
a) Human studies in situ (pH telemetry)
- Gehring F, Hufnagel HD (1983) Intra- and extra-oral pH measurements on human dental
plaque after rinsing with some sugar and sucrose substitute solutions. [Intra- und extraorale
pHMessungen an Zahnplaques des Menschen nach Spülungen mit einigen Zucker- und
Saccharoseaustauschstoff- Lösungen]. Oralprophylaxe 5, 13-19.
- Imfeld TN (1983) Identification of Low Caries Risk Dietary Components. Karger, Basel.
- Imfeld T, Mühlemann HR (1978) Cariogenicity and acidogenicity of food, confectionery and
beverages. Pharmacology and Therapeutics in Dentistry 3, 53-68.
- Takatsuka T (2002) Enamel remineralisation by isomalt toothpaste in situ. J Dent Res 81
(speciss) ( Seq No 259, Presentation 2815).
b) in vitro and animal studies
- Ciardi J, Bowen WH, Rolla G, Nagorski K (1983) Effect of sugar substitutes on bacterial
growths, acid production and glucan synthesis. J Dent Res 62, 182 [AADR Abstracts No.
110].
- Gehring F (1978) Cariogenic properties of sugar substitutes examined in gnotobiotic rat
experiments. Proc. ERGOB Conf., Geneva, 229-234.
- Gehring F (1979) Sucrose replacers and their role in caries prevention with particular
emphasis on microbial aspects. [Saccharose.Austauschstoffe und ihre Bedeutung für die
Kariesprophylaxe, unter besonderer Berücksichtigung mikrobiologischer Aspekte].
Kariesprophylaxe 1, 77-96.
- Gehring F, Karle EJ (1981). The sugar substitute Palatinit ® with special emphasis on
microbiological and caries-preventing aspects. Zeitschrift Ernährungswiss. 20, 96 – 106.
- Grenby TH, Mistry M (1996) Laboratory studies of sweets re-formulated to improve their
dental properties. Oral Diseases 2, 32-40.

- Karle EJ, Gehring F (1978) Palatinit® [isomalt] - a new sugar substitute and its
carioprophylactic assessment. [Palatinit®, ein neuer Zuckeraustauschstoff und seine
kariesprophylaktische Beurteilung]. Dtsch Zahnärztl Z 31, 189-191.
- Karle EJ, Gehring F (1979) Study of the cariogenicity of sugar substitutes in xerostomized
rats. Dtsch Zahnärztl Z 34, 551-554.
- Karle EJ, Gehring F (1981) Palatinit® [isomalt] and xylitol in gnotobiotic rat studies.
[Palatinit® und Xylit im Rattenversuch]. Dtsch Zahnärztl Z 36, 673-676.
- Takatsuka T (2000) Influence of Palatinit (isomalt) and xylitol on demineralisation /
remineralisation on bovine enamel. Cariology Today 1, 27-40.
- Van der Hoeven JS (1979) Influence of disaccharide alcohols on the oral microflora. Caries
Res 13, 301-306.
- Van der Hoeven JS (1980) Cariogenicity of disaccharide alcohols in rats. Caries Res 14,
61-66.