Effect of sweetener containing Stevia on the development of dental caries in enamel and dentin under a microcosm biofilm model.

Objective: This study compared the effect of commercial and pure sweetener containing stevia to that of aspartame, to sucrose and xylitol on the development of dental caries.

Methods: 228 bovine enamel and root dentin were exposed to microcosm biofilm model using human saliva. From the 2 to the 5 day, the samples were exposed daily to McBain saliva supplemented with 0.2% of the respective sweeteners/sugar, under 5% CO and 37 °C. The lactic acid and the colony-forming units (CFU) were quantified. The demineralization was analyzed by TMR. The data were compared statistically (Kruskal-Wallis/ Dunn, p<0.05).

Results: Pure stevia, pure aspartame, xylitol and control were able to significantly reduce 92% of lactate production compared to sucrose. Stevia finn, aspartame finn and sucrose showed similar production of lactic acid (around 0.45±0.12 g/L and 0.67±0.18 g/L, for enamel and dentin, p<0.0001). With respect to total lactobacilli and S. mutans/S. sobrinus CFU, xylitol and control did not show growth on enamel, while CFU numbers were found in stevia finn, aspartame finn and sucrose groups for both tissues. Enamel and dentin demineralization was significantly reduced for xylitol, control, pure stevia and pure aspartame (85% and 83% reduction, respectively) compared to stevia finn, aspartame finn and sucrose, which in turn did not differ from each other (sucrose ΔZ: 2913.7 ± 646.7 vol%.µm for enamel and 3543.3 ± 432.5 vol%.µm for dentin).

Conclusions: Commercial sweeteners containing stevia and aspartame proved to be as cariogenic as sucrose, which may be due to the other components, since the pure forms were not cariogenic.

Clinical Relevance: Our study showed that some commercial sweeteners (aspartame and stevia) are as cariogenic as sucrose, which may be due to the presence of lactose. The population should be advice about the presence of lactose in such brand names, to avoid their consume.