 Hello everyone, welcome back to any new session on dentistry and what today we have a continuation session on epidemiology of Tendulkeries. So far we have covered epidemiology of Tendulkeries that was part one then that and epidemiological studies that was part two and this is sugar substitutes. So it will be in continuation of Tendulkeries. So let's see about the sugar or sucrose which is known as arch-criminal. So we have discussed in detail about the sucrose and its role in Tendulkeries, how Tendulkeries is starting by action of bacteria. Those are mutant septuococcal, lactobacillus and anachnomysus on sucrose and acid producing acid production then deminulization and ultimately it leads to a cavity. So frequent consumption of fermentable carbohydrate which has a etiological role in Tendulkeries. So let's see what are the sugar substitutes. These are artificial sweeteners which are added to food to provide sweetness without providing any extra calories. So basically two types, nutritive and non-nutritive. So this is a classification, caloric and non-caloric. Non-caloric we have saccharin, aspartame, sucralose, neotame, cyclimate and caloric this classification is that polyalcohols, hydrogenated starch, hydrolysate, coupling sugars. In polyalcohols we have, so the little of it all very common, acetylol, then hydrogenated starch, hydrolysate, we have lecacin and palatinate. So coupling sugar we have, so both are palatinate. The names are very confusing. So the so many names. So commonly we see in this isylutylsopitol, aspartame, saccharin, asacralose. So just remember this classification. So another classification based on its origin, natural and artificial, natural armonulin, licorice and maraculin. So basically any product should have sweetness with no unpleasant taste without any calories and should not be carcinogenic or mutagenic, should be economical and it should not be degraded by heat when cooked. So this is commonly we seen in our clinical hours that is how to calculate sweet score. So sweet score calculated by frequency into score. So liquid solid slowly dissolving has 5, 10 and 15 scores each, which should be multiplied by the frequency of sugar consumption that is per day. Sorry, so how many times a person consumes as a cruise or sugar? Items multiplied with this scores and we get the ultimate score which can be interpreted as if it is less than 5, as excellent if it is 10, it is good 15 or more, the patient should be put into a watch out song. So this pyramid we have already seen. So as we go higher, this is sweets and the consumption should be reduced. So these should be the maximum consumption, which is more of vitamins and nutrients with vegetables, nuts and seeds, vegetables, dairy and eggs. So as we go at the tip should be limited consumption and at the bottom maximum consumption. So as you go upward, it has more proteins, here it is more carbohydrates, vegetable vitamins, here it is proteins, fatty acids, it is based on the amount a person should consume and sunlight, water and exercise. So it is a food pyramid. So health benefits of artificial sweetness can be used for weight loss because it has no calorie, dental care, there is no direct link between artificial sweetness and dental caries and diabetes, malitis, less chances because it is non-calorie and a low cost. So the first one is saccharine which was discovered by Ramson and Falberg in 1879 which is very oldest one, which has 200 to 700 times sweeter than sucrose which is available in liquid and tablet. Benefits which is calorie free and pharmacologically inert and is stable under moist conditions and it is also heat stable. So it is commonly seen as a brand name under brand name sweet and low and sweet and low and sugar twin. Benefits we already discussed, sorry, the dental aspect if it is 0.5% is used, it can significantly reduces both fissure and smooth surface caries. So second one is aspartame, it is almost 200 times sweet as sucrose and it is a combination of aspartic acid and phenylalanine. So calorie value is 4 calorie per gram and it is under brand name nutrasweet equal. So which has toxic effect both acute and chronic like dry mouth, dizziness, nausea, vomiting and chronic usage might cause lymphomas and liver dysfunction. SSL5MK is 200 times sweeter than sucrose, it was first approved by FT1988 which is commonly seen in yogurt and refrigerated desserts and syrups. It is under brand name sunnet and sweet one, so it is calorie free and it has excellent shelf life and used in candies and canned food which is no evidence of carcinogenicity or cytotoxicity, headache is a disadvantage. Sucrose was discovered in 1976, it is non-nutrient, nutritive and non-caloric, it is 6 cent times sweeter than sucrose which is sold under the trade name Splenda which is seen in tea coffee, carbonated and non-carbonated beverages. So advantages as same as non-carcinogenic and zero-nutrient value, diarrhea and dizziness and stomach pain are the disadvantages. So polyalcohols are commonly seen in sobitol and under the name xylitol, sobitol we know we have seen the truingum orbit which has a sobitol which is commonly seen in cherries, plums, pears and apples which is prepared from glucose by high pressure, dehydrogenation or by electrolytic production, 1 gram gives 4 calories. So it has advantage is that only 5 to 10 percentage of this can be applied, it can be produced bacteria for a acid production, so the rest of the products is untouched by bacteria so it can be used as an alternative to sucrose because it will not cause caries or if the caries production will be very less, but the disadvantages too much sobitol consumption might cause diarrhea because it has a laxative property because of the osmotic transfer of water into bubble. So xylitol is another product, another polyalcohol which is commonly commercially obtained from which trees which is seen in strawberries, raspberries, plum, sods which is commonly used by diabetic patients on high dosage again can cause diarrhea like sobitol. Pim study we have seen in our second chapter that is second session diet and dental caries took sugar study which was done in Finland where the most effective product was xylitol where the caries reduction was highest was seen in among xylitol group. So oral health benefit it is significantly reduces caries and also it reduces carogenic bacteria plaque level and zero stomach and gingival inflammation and erosion. So it is highly stable, can be used in baking, promotes colon health as a prebiotic and it has a laxative effect to prevent constipation, platelets and diarrhea are the disadvantages. So high fructose corn syrup is another mixture of glucose and fructose there are two types that is 42 and 55 which has 42 percent fructose and 55 percent fructose respectively. So roles are it can be used in baked goods yogurt and sauces condiments and canned and frozen fruits and also in beverages but it has a fat opposition in liver there will be narrowing of blend vessels, triggers asthma and food allergies are also reported. Some natural products are available like stavioside which is found in leaves of stavia, ribadiana which is calorie free non-carogenic which is 300 times sweeter than sucrose another one is miraculin which is a shrub grown in West Africa which produce berries that have properties of causing sour substance to taste sweet. So which is commonly used under the trade name Mirallin Miracle Fruit drops. So another one is licorice which is derived from licorice root which is 50 times sweet than sucrose which is used as expectorant and also it has pharmaceutical value. Then it is seen in red berries which is 3000 times sweeter than sucrose. So tooth friendly sweet concept started in Switzerland where if it is tooth friendly the product will be labeled as happy tooth. So all these products are happy tooth so it will not cause much caries. So that is all about artificial sweetness or sugar substitutes which are not very important which commonly asked as a short note or as a part of a long essay. So only thing we need to classify it a little bit about its ear and its oral benefits or oral role and so bit all and xylitol are little bit important because it is commonly used as anti-karyogenic products and also some other products like sucrose, S.S. alfine, aspartame and saccharin. So that's all about artificial sweetness I will come up with a new session on dentistry and more. Thank you.