Maltitol based sugar-free chocolates may not promote dental caries: An open-label clinical study

Background: Sugar substitutes like maltitol are reported to be noncariogenic ingredients and may not lead to the development of dental caries (DC), in contrast to sugars and other fermentable carbohydrates. The current study aimed to investigate the effects of maltitol-based sugar-free chocolates on factors associated with DC. Methods: : This was an open-label study involving healthy human volunteers. A total of 15 healthy human subjects were screened and enrolled in the study after obtaining their signed informed consent. The subjects were administered the test product, maltitol-based sugar-free chocolate, which contains no added sugar (sucrose). Sucrose was completely replaced with the sweeteners maltitol (minimum 45%) and steviol glycoside (0.05%). Salivary pH was measured using a digital pH meter at baseline and 0 h, 1 h, 2 h, and 4 h after test product consumption. The saliva samples were collected for measurement of Streptococcus mutans colonies at baseline and at 0 h and 4 h after test product consumption. The data were subjected to two-sided tests, at a 5% level of significance using Statistical Analysis System (SAS) 9.4 software (SAS Institute Inc., NC Cary). Results: : A statistically significant increase in the salivary pH level from the baseline at 0 h measurement (p = 0.0181) and a reduction in S. mutans formation from baseline to 0 h and 4 h, respectively (p = 0.0001) were noted. Conclusion: Maltitol-based sugar-free chocolates were found to be safe for consumption and were devoid of cariogenic potential.