The Sour Truth Behind Artificial Sweeteners

Choosing sugar-free cola over its sugary counterpart is better for your teeth, right? Shockingly, no —it may be causing cavities! Here’s why:

 artificial sweeteners and your teeth

photo by Steven Depolo via flickr.

If you have a sweet tooth but you need to hold back on the sugar, artificial sweeteners sound like a great option. With diet sodas, sugar-free gum, and other artificially sweetened foods readily available, you’d think you’re doing your teeth a favor by opting for them over their sugar-filled counterparts.

But alas, like many things in life, a low-calorie, sugarless substitute with no health consequences is just too good to be true. In some cases, it can even be detrimental to your smile.

Sugar vs. Artificial Sweeteners


The logic behind consuming artificial sweeteners rather than sugar make sense. Because some types of oral bacteria feed on sugar, exposing your teeth to high amounts of sugar can lead to tooth decay. The bacterial microorganisms break down sugar and release acids that weaken the enamel of your teeth, which is the hard, outer coating. The bacteria, acids, food debris and saliva combine to form a plaque that sticks to the surface of your teeth. The acids in the  plaque dissolve the enamel (called dentin erosion), creating shallow holes called cavities. They can grow deeper over time as the decay spreads down to the pulp of the tooth.

Obviously, consuming excessive amounts of sugary food and beverages isn’t good for your teeth. So, why not trade sugar for artificial sweeteners to keep your teeth healthy without giving up your favorite dessert?

Artificial Sweeteners

Unfortunately, it would appear that sugar substitutes can cause damage to tooth enamel, too. 

A recent study in Australia has found that diet soda and sports drinks that use artificial sweeteners often do as much damage to teeth as those that have real sugar. Researchers in the study were quoted saying:

“There was no significant difference between the erosive potential of sugared and non-sugared soft drink.”

Those scientists at the University of Melbourne found that sugar-free drinks can actually soften dental enamel by 30 to 50 percent. After testing 23 different types of sports and soft drinks, they found that beverages that have low pH levels and contain acidic additives cause significant damage to enamel. All but 2 of the 8 sports drinks that were tested were found to cause dental erosion. (The 2 that didn’t cause dental enamel loss contained higher calcium content).

“Many people are not aware that while reducing your sugar intake does reduce your risk of dental decay, the chemical mix of acids in some foods and drinks can cause the equally damaging condition of dental erosion,” says Professor Eric Reynolds.

“Dental erosion occurs when acid dissolves the hard tissues of the tooth. In its early stages erosion strips away the surface layers of tooth enamel. If it progresses to an advanced stage it can expose the soft pulp inside the tooth.” Teeth are more susceptible to tooth decay when tooth enamel is eroded because it’s more prone to bacterial growth.

The issue is that artificial sweeteners don’t protect your teeth from the damage caused by real sugar: acid. Although artificial sweeteners aren’t fueling the bacteria in your mouth to produce acids the way sugar does, sugar substitutes are often found in beverages and candies that contain potentially harmful acidic ingredients.

The researchers at Melbourne found that citric acid and phosphoric acid play big roles in tooth erosion. They are often found in sugar-free candies and colas for added tanginess, which tastes good, but harms your teeth. Reynolds warns that consumers should be aware of what kind of acidic ingredients are in candies and drinks and stay educated about how they can be detrimental to your oral health.

Is Sugar Free Gum Bad for You?

Now for some good news: you can still have sugar-free gum, as long as you stick to minty flavors (pending further study). The same study at Melbourne found that gum can stimulate saliva flow, rinse away acids, and re-harden tooth enamel.

List of Artificial Sweeteners

In case you didn’t know, there are a TON of artificial sweeteners out there. Below you’ll find a list of common artificial sweeteners and their names:

  • Aspartame
    (AKA: APM, Aspartyl-phenylalanine-1-methyl ester, Equal Classic, NatraTaste Blue, NutraSweet)
  • Erythritol
    (AKA: Sugar alcohol, Zerose, ZSweet)
  • Glycerol
    (AKA: Glycerin, Glycerine)
  • Glycyrrhizin
    (AKA: Licorice)
  • Hydrogenated Starch Hydrolysate (HSH)
    (AKA: Sugar alcohol)
  • Isomalt
    (AKA: Sugar alcohol, ClearCut Isomalt, Decomalt, DiabetiSweet {also contains Acesulfame-K}, Hydrogenated Isomaltulose, Isomaltitol)
  • Lactitol
    (AKA: Sugar alcohol)
  • Maltitol
    (AKA: Sugar alcohol, Maltitol Syrup, Maltitol Powder, Hydrogenated High Maltose Content Glucose Syrup, Hydrogenated Maltose, MaltiSweet, SweetPearl)
  • Mannitol
    (AKA: Sugar alcohol)
  • Polydextrose (Derived from glucose and sorbitol)
    (AKA: Sugar alcohol)
  • Saccharin
    (AKA: Acid saccharin, Equal Saccharin, Necta Sweet, Sodium Saccharin, Sweet N Low, Sweet Twin)
  • Sorbitol
    (AKA: Sugar alcohol, D-glucitol, D-glucitol syrup
  • Sucralose
    (AKA: 1',4,6'-Trichlorogalactosucrose, Trichlorosucrose, Equal Sucralose, NatraTaste Gold, Splenda)
  • Tagatose
    (AKA: Natrulose)
  • Xylitol
    (AKA: Sugar alcohol, Smart Sweet, Xylipure, Xylosweet)

Tips to avoid tooth erosion and decay.

Researchers at Melbourne have a few tips to help prevent dental erosion:

  • Drink water or milk instead of soft drinks. Water can help make the surface of enamel harder, and milk is not erosive at all.
  • Avoid sports drinks, sugar-free or otherwise. With or without sugar, the acidity is bad for dental enamel. Water works great for rehydrating.
  • Be wary of sugar-free candy. They usually contain citric acid that can have serious impact on oral health. Always check the ingredients, and keep consumption to a minimum.
  • Don’t brush your teeth right after drinking or eating acidic foods and beverages. This can actually wear away the enamel with the combination of erosion and abrasion, especially when you brush too hard. Wait around 30 minutes before brushing and drink and rinse with tap water beforehand.
  • Some acidic ingredients are coded on labels. Be sure to check for ingredient numbers 330 (citric acid) and 338 (phosphoric acid).
  • Keep up with regular dental checkups. This will help keep your teeth protected and help your dentist diagnose cavities as early as possible before serious damage is done.

When is it okay to have artificial sweeteners?

So now you know that artificial sweeteners aren’t helpful for preventing cavities. Still, there are a few possible health benefits according to MayoClinic:

Weight Control

If you need to avoid sugar to lose weight or control weight, then artificial sweeteners may be helpful. They are non-nutritive, meaning they have virtually no calories. Still, there is some research implying that the consumption of artificial sweeteners may cause increased weight gain, although the cause is still unknown.


Unlike sugar, artificial sweeteners are not carbohydrates. Because they don’t generally raise blood sugar, they may be a good option for those who have diabetes. Still, it’s important to first check with your dietitian or doctor before using artificial sweeteners or sugar substitutes.

If you are considering using artificial sweeteners to help with health issues like weight control or diabetes, it would be wise to still limit your consumption, especially when it comes to acidic drinks or desserts.


So, now you know the good, the bad, and the ugly about all things sugar-less. After facing the facts, it would seem that artificial sweeteners should be treated the same as sugar (and just about any other kind of food): If you’re going to have it, you should take in moderation.

So are artificial sweeteners right for you? Honestly, the best thing to do would be to ask your doctor or dental professional at your next check up. Let us know your thoughts in the comments below!

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