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Nonnutritive sweeteners (NNS) have been widely used in various therapeutic and dairy   products and have become an inseparable part of our routine life. They deliver far less calories and intense sweetness than their sugar-containing counterparts. The United States Food and Drug Administration recognizes Aspartame, saccharine, sucralose, neotame, acesulfame-K, and stevia safe for consumption by diabetics. They also aid in weight loss. However, there is inconclusive evidence to support most of their uses. In addition, the lack of interventional studies has proven inadequate to evaluate their efficacy in different populations like pregnant, breastfeeding women. Furthermore, the susceptible population comprising of diabetics, epileptic patients are more likely to sustain the deteriorating effects of NNS-containing products. The current review signifies the benefits and the potential risks of using them based on dietary guidelines.

Background: Mouthwashes are adjunct to regular brushing and flossing. Chlorhexidine is considered as a gold standard among mouth rinses. However, the most commonly known side effects include discolouration of teeth and the tongue particularly on the dorsum part. Hence the study was conducted to evaluate the effectiveness of Bromelain mouth rinse in gingival inflammation and bacterial plaque among adolescents. Methods and methodology: This double-blinded, randomized controlled trial was conducted in accordance with Consolidated Standards of reporting Trials (CONSORT) in Public Health Dentistry Department at Saveetha University. The protocol was approved by the Institutional Review Board (IRB). 30 patients with moderate gingivitis were included in the study. All subjects signed an IRB-approved consent form. Participants from 15 to 19 years are recruited from the Urban health programmes through dental camps. Results: No attempt was made for oral prophylaxis before the commencement of the study. The severity of gingivitis and plaque accumulation were assessed by gingival and plaque indices. Gingival index (Löe and Silness, 1963) and plaque index (Löe, 1967) were measured initially at baseline The trial was followed up for 30 days. The participants were instructed to rinse with plain water thoroughly. They were then directed to spit into a sterile plastic container after 5 minutes.At baseline, there was no significant difference in GI and PI scores among the groups (P=0.78 and 0.62) respectively. At one month follow up, there was significant difference in the mean GI and PI scores (P=0.02 and P=0.01) respectively. Conclusion: Bromelain mouthwash is beneficial in improving gingival status due to its profound styptic action, with sufficient reduction in plaque scores without any adverse effects.

Nonnutritive sweeteners (NNS) have become an important part of everyday life and are increasingly used nowadays in a variety of dietary and medicinal products. They provide fewer calories and far more intense sweetness than sugar-containing products. Six of these agents (aspartame, saccharine, sucralose, neotame, acesulfame-K, and stevia) have previously received a generally recognized as safe status from the United States Food and Drug Administration, and two more (Swingle fruit extract and advantame) have been added in the recent years to this ever-growing list. They are claimed to promote weight loss and deemed safe for consumption by diabetics; however, there is inconclusive evidence to support most of their uses and some recent studies even hint that these earlier established benefits regarding NNS use might not be true. There is a lack of properly designed randomized controlled studies to assess their efficacy in different populations, whereas observational studies often remain confounded due to reverse causality and often yield opposite findings. Pregnant and lactating women, children, diabetics, migraine, and epilepsy patients represent the susceptible population to the adverse effects of NNS-containing products and should use these products with utmost caution. The overall use of NNS remains controversial, and consumers should be amply informed about the potential risks of using them, based on current evidence-based dietary guidelines.

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