Non-nutritive sweeteners (NNSs) are sugar substitutes widely used to reduce the negative health effects of excessive sugar consumption. Dental caries, one of the most prevalent chronic diseases globally, results from a pathogenic biofilm with microecological imbalance and frequent exposure to sugars. Some research has shown that certain NNSs possess less cariogenic potential than sucrose, indicating their putative effect on oral microbiome. To uncover the alterations of acidogenic pathogens and alkali-generating commensals, as well as the biofilm cariogenic potential under the influence of NNSs, we selected four common NNSs (acesulfame-K, aspartame, saccharin, and sucralose) and established single-, dual-, and multispecies in vitro culture model to assess their effects on Streptococcus mutans (S. mutans) and/or Streptococcus sanguinis (S. sanguinis) compared to sucrose with the same sweetness. The results showed that NNSs significantly suppressed the planktonic growth, acid production, and biofilm formation of S. mutansor S. sanguinis compared with sucrose in single-species cultures. Additionally, decreased S. mutans/S. sanguinis ratio, less EPS generation, and higher pH value were observed in dual-species and saliva-derived multispecies biofilms with supplementary NNSs. Collectively, this study demonstrates that NNSs inhibit the cariogenic potential of biofilms by maintaining microbial equilibrium, thus having a promising prospect as anticaries agents.
The present study showed that the low/no calorie sweeteners acesulfame-potassium, aspartame, saccharin, and sucralose inhibit the cariogenic potential of biofilms by maintaining microbial equilibrium, a finding supporting the potential benefit of low/no calorie sweeteners in dental caries, when consumed in place of sugars.
The aim of this in-vitro study was to assess the effect of four low/no calorie sweeteners, acesulfame-potassium, aspartame, saccharin, and sucralose on the cariogenic potential of biofilms by measuring the growth, biofilm formation, and acid/ extracellular polysaccharides production of Streptococcus mutans and Streptococcus sanguinis after they were cultured alone or in dual- and multispecies biofilm models, and comparatively evaluated the results of the sweeteners’ groups with reference to sucrose of the same sweetness.
The results showed that all tested low/no calorie sweeteners significantly suppressed the planktonic growth, acid production, and biofilm formation of Streptococcus mutans or Streptococcus sanguinis compared with sucrose in single-species cultures. Additionally, decreased Streptococcus mutans/ Streptococcus sanguinis ratio, less extracellular polysaccharides (EPS) generation, and higher pH value were observed in dual-species and saliva derived multispecies biofilms with supplementary low/no calorie sweeteners.
The authors concluded that the tested sweeteners, acesulfame-K, aspartame, saccharin, and sucralose, possess less cariogenic potential than sucrose and suggested that the benefit of low/no calorie sweeteners for bacterial equilibrium in biofilm may have a promising prospect in caries management.