What is the link between stevia and the development of oral cavities (tooth decay)?

Stevia and Oral Cavities: Potential Benefits and Considerations

Stevia is non-cariogenic and may help prevent dental caries when used as a sugar substitute, potentially contributing to better oral health outcomes.

How Stevia Affects Oral Health

Non-Cariogenic Properties

• Stevia (Stevia rebaudiana Bertoni) is a natural, non-caloric sweetener that does not promote tooth decay 1, 2
• Unlike sucrose (table sugar), stevia is not metabolized by oral bacteria to produce acids that demineralize tooth enamel 2
• Research indicates that pure stevia extracts can significantly reduce lactate production (by approximately 92%) compared to sucrose 3

Antimicrobial Effects

• Studies suggest that steviosides and related compounds may have anti-bacterial properties against oral bacteria 1
• A 2024 randomized controlled trial showed significant differences in total colony-forming units per mL (CFU/mL) and salivary pH between stevia, D-tagatose, and sucrose groups, indicating a possible partial inhibitory effect of stevia on bacterial metabolism 4

Important Considerations

Commercial vs. Pure Stevia Products

• Pure stevia extracts show non-cariogenic properties, but some commercial stevia products may be cariogenic 3
• A 2021 study found that commercial sweeteners containing stevia were as cariogenic as sucrose, possibly due to the presence of other ingredients like lactose 3
• When choosing stevia products for cavity prevention, it's important to select pure forms rather than commercial blends with added ingredients 3

Sugar Consumption Guidelines

• The World Health Organization (WHO) recommends limiting free sugars intake to less than 10% of total energy intake, with a further reduction to below 5% for additional health benefits 5
• Dental caries is strongly associated with frequent consumption of sugar-containing foods, particularly in children 5
• Replacing sugar with non-cariogenic sweeteners like pure stevia can be part of a strategy to reduce caries risk 2

Broader Context for Oral Health

Risk Factors for Dental Caries

• Populations at increased risk for dental caries include those with low socioeconomic status, limited access to dental care, and those without dental insurance 5
• Individual risk factors include active dental caries, high levels of cariogenic bacteria, reduced salivary flow, and dietary practices conducive to dental caries 5
• Risk decreases with adequate exposure to fluoride 5

Preventive Strategies

• Using non-cariogenic sweeteners like pure stevia is just one component of a comprehensive approach to preventing dental caries
• Other important preventive measures include:
  • Regular exposure to fluoride (drinking fluoridated water and using fluoride toothpaste) 5
  • Good oral hygiene practices
  • Regular dental check-ups
  • Limiting frequency of sugar-containing food and beverage consumption 5

Conclusion

While pure stevia extracts show promise as a non-cariogenic alternative to sugar, consumers should be aware that commercial stevia products may contain additional ingredients that could promote dental caries. For those looking to reduce caries risk, pure stevia extracts are preferable to commercial blends, and should be used as part of a comprehensive oral hygiene regimen that includes regular fluoride exposure and dental care.