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British Dental Journal paper finds products contain acidic additives that can lead to the erosion of tooth enamel.
Sugar-free gum, sweets and soft drinks, marketed as healthy alternatives to sugary products, can damage teeth, cause gastric problems and are unlikely to promote weight loss, research claims.
A study review in the British Dental Journal (BDJ) found that sugar-free foods and drinks contain acidic additives that may cause dental problems by eroding the enamel on consumers' teeth.
Disclosure of what the authors call a "hidden risk" could affect sales of sugar-free products, especially given what the paper describes as consumers' blind confidence in such products as a good thing.
The paper, Are sugar-free confections really beneficial for dental health?, examined the role of sugar substitutes used in products to reduce the risk of tooth decay. While one commonly used group of substitutes, called sugar alcohols, or polyols, do lessen the risk of cavities, they can cause acidity in the mouth that then leads to erosion of teeth enamel, says the paper.
These substitutes include xylitol, which the European commission has allowed to market itself as a "tooth friendly" ingredient in chewing gum. Xylitol is widely-used in sugar-free products sold in the UK.
The literature review, by academics from the universities of Boston, Helsinki and Southern Nevada, concludes: "As the use of sorbitol and xylitol containing products increases, the public should be educated on the hidden risk of dental erosion due to acidic additives, as well as the adverse effects of gastric disturbance and osmotic diarrhoea. Especially in sugar-free products, these adverse effects may be more insidious because the public has blind confidence that they are oral health friendly."
It adds: "Although the presence of acidic flavourings and preservatives in sugar-free products has received less attention, these additives may have adverse dental health effects, such as dental erosion. Furthermore, the term sugar-free may generate false security because people may automatically believe that sugar-free products are safe on teeth."
The review raises the wider question of what health-related claims made on behalf of products can be trusted, said Stephen Hancocks, the BDJ's editor-in-chief. "The claim might well mean what it says and be suitably backed-up by research evidence, but does it fully say what it means, or alternatively, what is it not saying? Sugar-free may seem to indicate that a sweet or other product is tooth friendly, but this is not automatically the case," he wrote in a commentary on the findings.
Given sugar-free products' role in erosion of dental enamel, and doubts over perceptions of them as helping users to consume fewer calories, he continued, "the result is a minefield of confusion for the patient who is trying his or her very best to comply with healthy choices and a complex labyrinth of communication for the professional in attempting to convey practical advice."
Professor Damien Walmsley, scientific adviser to the British Dental Association, which represents dentists, said excess use of sugar-free products containing fruit flavourings could rot the enamel covering the dentine in teeth and ultimately cause teeth to dissolve.
參考譯文：
英國牙科雜志一篇論文發現含有酸性添加劑的產品會侵蝕牙齒琺瑯質。
研究表明，通常作為甜食的健康替代品出售的無糖口香糖、糖果以及軟飲料會損害牙齒，并能導致胃部問題，對減肥也并無效果。
BDJ（英國牙科雜志）的一篇研究評論發現，含有酸性添加劑的無糖食物和飲料可能會腐蝕牙齒琺瑯質。
這個作者所揭露的內容可以稱為一大“隱患”，會影響到無糖產品的銷售，尤其是這篇論文中寫到消費者盲目自信的認為這些是有益食物。
《無糖糖果對牙齒健康真的有益嗎？》這篇論文測試了糖類替代品的作用，它們能降低牙齒侵蝕的風險。該論文說，現在人們普遍采用的替代品，如糖醇或者多元醇，確實能減輕蛀牙的風險，但是會增加口腔的酸度，進而侵蝕牙齒琺瑯質。
這些替代品包括木糖醇，歐盟委員會早已經允許它作為口香糖中的護牙成分。木糖醇廣泛用于英國銷售的無糖產品。
波士頓、赫爾辛基和南內華達州大學的學者的文獻綜述聲稱：“隨著含山梨醇和木糖醇的產品的增多，我們應該讓公眾得知酸性添加劑有導致牙酸蝕病的隱藏風險，并有能引起胃功能紊亂和滲透性腹瀉的副作用。特別是在無糖產品中，這些副作用更為隱蔽，因為公眾盲目的相信它們是有益于口腔健康的。”
它還說：“盡管對無糖產品中含有的酸性調味劑和防腐劑的關注較少，但這些添加劑對牙齒健康可能會產生副作用，如牙酸蝕病。此外，無糖這個說法可能會產生誤導，人們會不假思索的認為無糖產品對牙齒有益。”
這篇論文提出了更廣泛的問題，為了產品的銷售而做出的這些與健康有關的聲明是可以信賴的，BDJ的總編史蒂芬•漢考克斯說。“這些聲明可能就為了解釋這個，并且研究的相關論據正好可以支撐這種觀點，但是這能充分證明這是正確的嗎，或者，還有那些證明不了的呢？無糖似乎表明糖果或者其他產品是護牙的，但是這并不是理所當然的證據，”他在一篇評論中這樣描述他的發現。
考慮到無糖產品會侵蝕牙齒琺瑯質，它們能幫助人們消耗更少的卡路里的這種看法也受到質疑，他繼續說，“結果是，試圖盡力來遵從健康選擇的病人處在一種混亂的狀態，專業人員試圖傳達切實可行的建議時也遭遇了復雜的狀況。”
達米安•沃姆斯利教授，英國牙醫協會——牙醫的代表——的科學顧問，說過多的食用含有水果調味劑的無糖產品會侵蝕牙齒表面的琺瑯質，并最終導致牙齒腐爛。
原文鏈接：Sugar-free drinks and chewing gum may cause damage to teeth
