Top

Clinical Oral Investigations

Published in:

01-01-2020 | Candida Balanitis | Original Article

In vitro evaluation of the cariogenic potential of rebaudioside A compared to sucrose and xylitol

Authors: Johanna Ganter, Elmar Hellwig, Sam Doerken, Ali Al-Ahmad

Published in: Clinical Oral Investigations | Issue 1/2020

Abstract

Objectives

The aim of the present study was to evaluate the growth and acid synthesis of cariogenic pathogens in vitro when rebaudioside A was the sole source of carbon, compared to sucrose, xylitol, and a commercial sweetener containing rebaudioside A.

Materials and methods

First, sucrose or sugar substitutes were added to human saliva and the pH was measured over 10 h. Subsequently, the growth and acid synthesis efficiency of Streptococcus mutans, Streptococcus sobrinus, Streptococcus oralis, Lactobacillus rhamnosus, Lactobacillus paracasei, and Candida albicans were investigated: after adding them to minimal culture media containing only one of the carbon sources, the optical density and pH were determined over 10 h.

Results

A significant pH drop only occurred in the sucrose group of human saliva whereas no differences were found between the sugar substitute groups. The individual strains of caries pathogens showed significantly lower growth rates and less acid synthesis in the sugar replacement groups, in comparison to sucrose. However, these groups also showed bacterial growth and a decline in pH.

Conclusion

Xylitol appeared to be superior to rebaudioside A regarding the inhibition of mutans streptococci. The results for the remaining microorganisms indicate that rebaudioside A causes a similar or lower acid synthesis than xylitol. As saliva contains buffer systems, the metabolism of rebaudioside A did not seem to shift the equilibrium to demineralization.

Clinical relevance

Rebaudioside A may not be suitable as a targeted Streptococcus mutans treatment, but it could contribute to a reduction of caries risk as a replacement for sucrose.

Marsh PD (1994) Microbial ecology of dental plaque and its significance in health and disease. Adv Dent Res 8(2):263–271. https://doi.org/10.1177/08959374940080022001 CrossRefPubMed

Ajagannanavar SL, Battur H, Shamarao S, Sivakumar V, Patil PU, Shanavas P (2014) Effect of aqueous and alcoholic licorice (Glycyrrhiza glabra) root extract against streptococcus mutans and lactobacillus acidophilus in comparison to chlorhexidine: an in vitro study. J Int Oral Health 6(4):29PubMedPubMedCentral

Trahan L, Bareil M, Gauthier L, Vadeboncoeur C (1985) Transport and phosphorylation of xylitol by a fructose phosphotransferase system in Streptococcus mutans. Caries Res 19:53–63. https://doi.org/10.1159/000260829 CrossRefPubMed

Assev S, Rølla G (1986) Further studies on the growth inhibition of Streptococcus mutans OMZ 176 by xylitol. Acta Pathol Microbiol Immunol Scand B 94:97–102. https://doi.org/10.1111/j.1699-0463.1986.tb03026.x CrossRefPubMed

Trahan L (1995) Xylitol: a review of its action on mutans streptococci and dental plaque--its clinical significance. Int Dent J 45(1 Suppl 1):77–92PubMed

Kakuta H, Iwami Y, Mayanagi H, Takahashi N (2003) Xylitol Inhibition of Acid Production and Growth of Mutans Streptococci in the Presence of Various Dietary Sugars under Strictly Anaerobic Conditions. Caries Res 37:404–409. https://doi.org/10.1159/000073391 CrossRefPubMed

Li Y, Tanner A (2015) Effect of antimicrobial interventions on the oral microbiota associated with early childhood caries. Pediatr Dent 37(3):226–244PubMedPubMedCentral

Miller WD (1890) The Micro-Organisms of the Human Mouth. The S.S. White Manufacturing Co, Philadelphia

EU Commission (2011) Commission Regulation (EU) No 1131/2011 of 11 November 2011 amending Annex II to Regulation (EC) No 1333/2008 of the European Parliament and of the Council with regard to steviol glycosides. Off. J Eur Union L 295(4):205–211

10.

Lohner S, Toews I, Meerpohl JJ (2017) Health outcomes of non-nutritive sweeteners: analysis of the research landscape. Nutr J 16(1):55. https://doi.org/10.1186/s12937-017-0278-x CrossRefPubMedPubMedCentral

11.

Hansen HJ (2010) Künftiger Einsatz von Steviolglykosiden: Ergebnisse einer Umfrage in der deutschen Getränkeindustrie. J Verbr Lebensm 5(2):237–239. https://doi.org/10.1007/s00003-010-0569-z CrossRef

12.

Das S, Das AK, Murphy RA, Punwani IC, Nasution MP, Kinghorn AD (1992) Evaluation of the cariogenic potential of the intense natural sweeteners stevioside and rebaudioside A. Caries Res 26(5):363–366. https://doi.org/10.1159/000261469 CrossRefPubMed

13.

de Slavutzky SMB (2010) Stevia and sucrose effect on plaque formation. J Verbr Lebensm 5(2):213–216. https://doi.org/10.1007/s00003-010-0555-5 CrossRef

14.

Gamboa F, Chaves M (2012) Antimicrobial potential of extracts from Stevia rebaudiana leaves against bacteria of importance in dental caries. Acta Odontol Latinoam 25(2):171–175PubMed

15.

Giacaman RA, Campos P, Munoz-Sandoval C, Castro RJ (2013) Cariogenic potential of commercial sweeteners in an experimental biofilm caries model on enamel. Arch Oral Biol 58(9):1116–1122. https://doi.org/10.1016/j.archoralbio.2013.03.005 CrossRefPubMed

16.

Brambilla E, Cagetti MG, Ionescu A, Campus G, Lingström P (2014) An in vitro and in vivo comparison of the effect of Stevia rebaudiana extracts on different caries- related variables: a randomized controlled trial pilot study. Caries Res 48:19–23. https://doi.org/10.1159/000351650 CrossRefPubMed

17.

Zanela NL, Bijella MF, Rosa OP (2002) The influence of mouthrinses with antimicrobial solutions on the inhibition of dental plaque and on the levels of mutans streptococci in children. Pesqui Odontol Bras 16(2):101–106. https://doi.org/10.1590/S1517-74912002000200002 CrossRefPubMed

18.

Dawes C (2003) What is the critical pH and why does a tooth dissolve in acid? J Can Dent Assoc 69(11):722–725PubMed

19.

Takahashi N, Nyvad B (2011) The Role of Bacteria in the Caries Process: Ecological Perspectives. J Dent Res 90(3):294–303. https://doi.org/10.1177/0022034510379602 CrossRefPubMed

20.

Bardow A, Moe D, Nyvad B, Nauntofte B (2000) The buffer capacity and buffer systems of human whole saliva measured without loss of CO2. Arch Oral Biol 45(1):1–12. https://doi.org/10.1016/S0003-9969(99)00119-3 CrossRefPubMed

21.

Bender R, Lange S, Ziegler A (2007) Wichtige Signifikanztests. Dtsch Med Wochenschr 132(S 01):e24–e25. https://doi.org/10.1055/s-2007-959034 CrossRefPubMed

22.

Mäkinen KK, Saag M, Isotupa KP, Olak J, Nõmmela R, Söderling E, Mäkinen PL (2005) Similarity of the Effects of Erythritol and Xylitol on Some Risk Factors of Dental Caries. Caries Res 39(3):207–215. https://doi.org/10.1159/000084800 CrossRefPubMed

23.

Lemus-Mondaca R, Vega-Gálvez A, Zura-Bravo L, Ah-Hen K (2012) Stevia rebaudiana Bertoni, source of a high-potency natural sweetener: A comprehensive review on the biochemical, nutritional and functional aspects. Food Chem 132(3):1121–1132. https://doi.org/10.1016/j.foodchem.2011.11.140 CrossRefPubMed

24.

Bowen WH, Koo H (2011) Biology of Streptococcus mutans-derived glucosyltransferases: role in extracellular matrix formation of cariogenic biofilms. Caries Res 45:69–86. https://doi.org/10.1159/000324598 CrossRefPubMedPubMedCentral

25.

Xiao J, Klein MI, Falsetta ML, Lu B, Delahunty CM, Yates JR, Heydorn A, Koo H (2012) The Exopolysaccharide Matrix Modulates the Interaction between 3D Architecture and Virulence of a Mixed-Species Oral Biofilm. PLoS Pathog 8(4):e1002623. https://doi.org/10.1371/journal.ppat.1002623 CrossRefPubMedPubMedCentral

26.

Klein MI, Falsetta ML, Xiao J, Bowen WH, Koo H (2013) The role of extracellular polysaccharides matrix in virulent oral biofilms. In: Jakubovics NS, Palmer RJ Jr (eds) Oral microbial ecology: Current research and new perspectives. Caister Academic Press, Norfolk, pp 63–67

27.

Bowen WH (2002) Do we need to be concerned about dental caries in the coming millennium? Crit Rev Oral Biol Med 13(2):126–131. https://doi.org/10.1177/154411130201300203 CrossRefPubMed

28.

Scheinin A, Mäkinen KK, Ylitalo K (1976) Turku sugar studies V: Final report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man. Acta Odontol Scand 34(4):179–216. https://doi.org/10.3109/00016357608997711 CrossRefPubMed

29.

Marsh PD, Devine DA (2011) How is the development of dental biofilms influenced by the host? J Clin Periodontol 38:28–35. https://doi.org/10.1111/j.1600-051X.2010.01673.x CrossRefPubMed

30.

Wang QP, Browman D, Herzog H, Neely GG (2018) Non-nutritive sweeteners possess a bacteriostatic effect and alter gut microbiota in mice. PLoS One 13(7):e0199080. https://doi.org/10.1371/journal.pone.0199080 CrossRefPubMedPubMedCentral

31.

Moynihan PJ, Kelly SA (2014) Effect on caries of restricting sugars intake systematic review to inform WHO guidelines. J Dent Res 93(1):8–18. https://doi.org/10.1177/0022034513508954 CrossRefPubMedPubMedCentral

Title: In vitro evaluation of the cariogenic potential of rebaudioside A compared to sucrose and xylitol
Authors: Johanna Ganter
Elmar Hellwig
Sam Doerken
Ali Al-Ahmad
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Candida Balanitis
Candida Albicans
Streptococci
Caries
Published in: Clinical Oral Investigations / Issue 1/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02908-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

In vitro evaluation of the cariogenic potential of rebaudioside A compared to sucrose and xylitol

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 1/2020

Different polishing methods for zirconia: impact on surface, optical, and mechanical properties

Letter to the editor regarding “Impact of cigarette smoking and vaping on the outcome of full-mouth ultrasonic scaling among patients with gingival inflammation: a prospective study”

Bibliometric analysis of research trends and characteristics of oral potentially malignant disorders

The mineralizing effect of zinc oxide-modified hydroxyapatite-based sealer on radicular dentin

Effects of fast- and slow-setting calcium silicate–based root-end filling materials on the outcome of endodontic microsurgery: a retrospective study up to 6 years

The effect of aging methods on the fracture toughness and physical stability of an oxirane/acrylate, ormocer, and Bis-GMA-based resin composites