Comparative Evaluation of Cariogenic Potential of Natural Sweeteners on Streptococcus mutans Biofilm Formation and Enamel Demineralization: In Vitro Study

Objectives: The purpose of this study is to examine cariogenicity of commercial sweeteners, including Stevia sweetener, coconut sugar, monk fruit sugar, and date molasses, and their influence on Streptococcus mutans (S. mutans) biofilms, in comparison to sucrose.Methods: Bacterial optical density was measured after culturing Streptococcus mutans with different sugar solutions using colony forming unit (CFU) assay. Moreover, twenty-five human caries-free premolars were incubated in sugar solutions with Streptococcus mutans and brain heart infusion growth medium for 21 days. Results: We found that monk fruit and date molasses showed significant differences in bacterial optical density when compared to sucrose (p<0.0001). On the other hand, a mild noticeable reduction was associated with coconut sugar. Furthermore, microhardness tests of sucrose recorded significantly the lowest levels, while monk fruit showed the highest levels, with statistical significance (p<0.001).Conclusion: According to our findings, all the experimental natural sweeteners evaluated in the present study have reduced cariogenicity and demineralizing effect, when compared to sucrose. However, they should be taken cautiously and in small doses because they have not been demonstrated to be completely cariogenic.