Best tooth-friendly sugar substitutes
Natural and/or healthy sugar-free sweeteners and alternatives to sugar
While there are many questionable artificial sugar substitutes1 on offer, the following list features a number of tooth-friendly (generally considered safe and arguably healthy) sugar alternatives or replacements. These non-cariogenic (or low-cariogenic), non-erosive and sometimes even zero-calorie alternative sweeteners can be used to satisfy the (at least partially conditioned) need for sugary meals2 ...
All of the following products (listed here in alphabetical order) should be available via various online sellers, if not in health food shops and similar outlets.
Erythritol (E 968)
Chemically a member of the sugar alcohol family, erythritol is my personal favourite for sweetening dishes since it has virtually none of the disadvantages of other sugar-alcohols while boasting all their common advantages (such as sugar-like consistency and practically identical taste).
Unlike other sugar alcohols, erythritol consumption in larger amounts typically does not create flatulence or digestive discomfort such as cramping and diarrhea (though personally, I do experience the "runs" when ingesting larger quantities). Additionally (and somewhat perversely in my eyes), it seems to have zero calories due to the way the body processes (excretes) it before it has a chance to be properly digested.
Isomalt (E 953)
This sugar alcohol is manufactured from sucrose (table sugar) but only half as sweet as its parent.
At least from a certain threshold, isomalt has a laxative effect so you may wish to limit consumption to 50 g per day. The usual caveats regarding sugar alcohols apply. Additionally, some oral bacteria learn to metabolise isomalt after a long adaptation phase, so it may be wisest to use only occasionally.
Lactitol (E 966)
Another synthetic sugar alcool but which in contrast to others listed here, does not occur in nature. Lactitol is manufactured from milk sugar and only 30–40 % as sweet as sucrose.
Lactitol is a laxative and sold as such in commercial preparations. Up to 10g per day however may have little to no impact on the gastrointestinal tract. After extensive studies into side effects, lactitol is generally considered safe. Cavity-producing bacteria are unable to metabolize lactitol (or only in tiny amounts).
Luo han guo (Siraitia grosvenorii)
As you may be able to tell from its name, this is a plant cultivated in China and parts of Thailand. Its fruit is extremely sweet and after drying/extraction is used as a low-calorie sweetener. Additionally, it has been applied by traditional Chinese medicine (TCM) to treat various complaints. You may find the dried fruit online.
Maltitol (E 965) (powder and syrup)
is another sugar alcohol used as a sugar replacement. It also has very similar properties to normal sugar and up to 90% of its sweetness. Maltitol is industrially produced from starch (such as from corn or wheat) and found in many sugar-free sweets and other products.
Like all sugar alcohols (except erythritol), ingestion of larger amounts of maltitol can lead to diarrhea, bloating and intestinal gas. One source suggests that daily ingestion for adults should not exceed 30-50 g.
Sorbitol (E 420)
Sorbitol occurs naturally in many fruits such as pears, apples, peaches, apricots and plums (with higher concentrations found in the dried fruit). Sorbitol is also naturally produced in our body as part of metabolism. Industrially manufactured from wheat and corn starch, sorbitol is frequently added to mouthwash and toothpaste as well as "sugar free" chewing gum. This is somewhat ironic considering that some oral caries bacteria seem to learn to metabolise sorbitol after several months.
Overdoses can be reached easily and lead to serious abdominal pain, cramping, flatulence and diarrhea. Having experienced severe GI stress after ingestion of sorbitol-sweetened jam myself, I try to avoid sorbitol.
As stated under isomalt above, it may be wisest to use sorbitol only occasionally or in small amounts.
Stevia (Stevia rebaudiana)
Stevia is a plant whose leaves contain a number of sweet compounds. According to which source one may read, these can be 40 to 450 times sweeter than sucrose (table sugar). Depending on what stevia or stevia product one uses (quality varies greatly), stevia may impart a bitter taste to whatever one has added it to (don't be discouraged if your first experience with it is disappointing, however, simply search around for a better quality or ask knowledgeable friends for advice which product to use).
Stevia is available as dried leaves, powder, tablets or extract, with Rebaudioside A being an extract from the stevia plant found to be the least bitter.
In addition to being a natural time-honoured non-cariogenic and virtually zero-calorie sweetener (which traditionally has been used in a number of places around the world), stevia also has active tooth benefits. One laboratory study found that while Rebaudioside A did not hinder the growth of cariogenic Streptococcus mutans bacteria, it did hinder the formation of plaque (which of course can be one of the first steps to tooth decay).
Should you live in a country where stevia for various reasons is difficult to obtain, you can grow it yourself in pots or in your garden. Stevia is not overly difficult to cultivate (instructions can be found online). Dry the leaves for several weeks (perhaps best to cut the entire plant and allow to dry), then grind them into a fine powder and add to your sweet dishes (it will confer a greenish shade).
Tip: mix stevia with other sweeteners such as xylitol to drown out any residual aftertaste you may dislike.
Thaumatin (E 957)
Thaumatin is a very sweet tasting powder consisting of three proteins isolated from the berries of African katamfe plant (Thaumatococcus daniellii, also referred to as Ndebion by the natives who have been using it traditionally). These proteins are also found in many other plants. Thaumatin's taste differs from that of sugar, with the sweet sensation taking time to build but lasting much longer and an after-taste reminiscent of liquorice. Thaumatin is considered safe and is fully digested in the stomach.
While being used in some sweets, dietary products and chewing gums, the low-calorie sweetener thaumatin has not found more widespread use due to the prohibitive costs of its production to the desired standard and its instability when cooked.
Xylitol (E 967)
In addition to its outstanding dental benefits, xylitol is on record for helping some people curb their craving for sweets. Xylitol is also the one sugar alcohol the body learns to adapt to so consumption can be gradually increased without incurring any digestive upsets.
Tips for achieving better bowel tolerance of sugar alcohols
1. With most or all sugar alcohols, you may find that you have a personal threshold where they are safe (without side effects) for you to eat but beyond, you will experience gastrointestinal troubles. You may wish to experiment by starting with small amounts.
2. If you ingest erythritol, sorbitol, mannitol, xylitol etc. in conjunction with something "constipating", the laxative effect of these substances can be mildened or cancelled out. The most important rule to observe may be to not ingest large amounts of fluids together with sugar alcohols or they are likely to literally flush out your intestines.
Recipe - how to make your own sugar-free or low sugar chocolate
It is surprisingly simple to create your own sugar-free or low-sugar chocolate. Buy chocolate with the lowest possible or no sugar content, melt it on a very low heat (chocolate can easily get burned so take advantage of the fact that simply putting it in a warm place can suffice to make it melt), then add organic milk powder, organic soy powder or organic rice milk powder as well as powdered xylitol, erythritol (use your blender to reduce the grains to fine powder) etc. to desired sweetness and consistency (you can also experiment with adding healthy coconut fat3). Add nuts or whatever else you like if you wish (if you have cocoa butter available, adding some will make the end result even more chocolatey). Allow to cool and harden and voilà - tasty tooth-friendly chocolate you can indulge in without your teeth getting damaged.
In case the chocolate you used as the basis did contain some table or similarly highly cariogenic sugar, adding xylitol seems to make it innocuous for your teeth.4
Tips how to get rid of sugar cravings
If you feel that you have an "excessive" need for sugary meals, you might find On Food & Drug (Alcohol, Nicotine, Sugar etc.) Cravings and Addictions: Release & Recovery Tips helpful: a craving for sweets in addition to emotional causes can also have a purely biological basis.
Also, simply reducing your sugar intake for a while or only using fruit for sweetening will gradually change your taste perception (incidentally, this works similarly for salt). I was surprised how quickly (in a matter of days) I got used to a less sugary taste sensation in my mouth and that I actually started to find some commercially produced organic ice cream too sweet (while beforehand few things ever seemed to be sweet enough for my tastebuds so I had to add honey etc. to suit my taste)!
And of course, as mentioned above, xylitol has helped some to get their sweet tooth under control.
1 I hope you are already aware of the massive toxicity of certain artificial sweeteners such as aspartame which I've frequently seen listed among the ingredients of sugar-free chewing gum (read here if not).
3 For the potential dental benefits, see Another tooth-friendly oil? Virgin coconut oil.