Sugar replacers and the FDA noncariogenicity claim

In 1996, the U.S. Food and Drug Administration (FDA) approved the use of a "health claim" based on the association between sugar replacers and the nonpromotion of dental caries. Small packages of products containing such sweeteners may state "Does not promote tooth decay" or "May reduce the risk of tooth decay." Larger packages must include additional information, such as "Frequent eating of foods high in sugars and starches as between-meal snacks can promote tooth decay." FDA criteria state that these products must not only be "sugar-free," but they must also contain a noncariogenic sugar replacer and not lower plaque pH below 5.7 either during consumption or up to 30 minutes after consumption when tested by in vivo pH telemetry. Many people might reduce their caries risk by using sugar-free products, and the FDA claim can help consumers identity such products. Dental hygienists are ideal sources of consumer information about sugar replacers, and can help clients distinguish between the new FDA claim and advertising claims that are not regulated by FDA. The purpose of this article is to provide dental hygienists with information on sugar replacers that will help clients make appropriate nutrition choices.