Publication Details
Abstract
Objective: Sugar-free confectionery can reduce exposure to fermentable sugars, but oral-health relevance depends on the specific polyol matrix, product acidity and pattern of use. We characterized the matrix architecture of an NVTIA herbal hard candy containing 75.685 parts isomalt, 20.000 parts maltitol syrup on a dry-matter basis and 2.500 parts erythritol per 100 parts formulation, together accounting for 98.185% of the dry formulation. Method: The candy also contained low levels of citric acid and sodium citrate, botanical extracts, eucalyptus oil microcapsule powder and menthol. Formulation data were integrated with primary human and in situ studies of erythritol, maltitol and isomalt. Results: A three-year randomized trial in 485 schoolchildren found that erythritol candy was associated with fewer dentin-caries lesions at selected follow-ups and longer times to lesion development or progression than xylitol or sorbitol controls; companion analyses reported lower plaque weight, lower plaque organic-acid levels and reduced mutans streptococci with erythritol. Maltitol randomized studies show favorable effects on plaque acidogenicity, cariogenic bacteria and selected caries-risk variables. Short isomalt exposures have also shown favorable effects on enamel de-/remineralization balance in an in situ study. At the same time, primary studies of sugar-free acidic lozenges and confections demonstrate that low cariogenicity and low erosive potential are distinct product properties. Novelty: Accordingly, the polyol-dominant matrix provides a strong scientific basis for reduced cariogenic substrate exposure, while direct measurement of finished-product pH, titratable acidity, plaque-pH response and enamel-surface effects can further define its complete oral-health profile. The present analysis establishes a formulation-specific framework for oral-health evaluation while retaining the complete product as the principal unit of interpretation.