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The tooth-friendly label distinguishes products which are non-cariogenic and non-erosive, i.e. safe for teeth.^[1] To replace sugar, toothfriendly products often contain sweeteners (polyols, intense sweeteners) that are not fermented by the microflora of the dental plaque. Products that are certified as toothfriendly also do not contain excessive amounts of food acids.

History

In 1983, a WHO working group recommended that the consumption of non-cariogenic "toothfriendly" confectionery should be encouraged.^[2]

To provide consumers with easy guidance to toothfriendly products, the Swiss University dental schools decided in the early 1980s to launch a new public information campaign on nutrition and oral health. Instead of advising against the consumption of sweets, the new campaign took a different approach. The basic idea was that consumers should be educated and encouraged to eat only confectionery products that would not harm their teeth.^[3] Toothfriendly ("Happy Tooth") label was created. This registered trademark distinguishes products (confectionery, beverage, sweeteners, medicine) that have been proven in a scientific test to lack both significant cariogenic and erosive potential.^[4]

The "toothfriendliness" of a product is tested by means of intraoral pH telemetry. Applying a standardized method, the plaque pH is measured at least in four volunteers during and for 30 minutes after consumption of the product with an indwelling, interproximally-placed, plaque-covered electrode. Products that do not lower plaque pH below 5.7, under the conditions of this test, lack a cariogenic potential. The erosive potential is measured with a plaque-free electrode. The acid exposure of the teeth must not exceed 40 micromol H min.^[5]^[6]^[7]^[8]^[9]^[10]

The scientific basis for the use of the "Toothfriendly" label has been evaluated and accepted by the Swiss Federal Office of Health, the US-FDA,^[11] EFSA,^[12] the German Food Control^[13] and the competent Australian authorities.^[14]

Some examples of toothfriendly sweeteners are: sorbitol, maltitol, isomalt, xylitol, sucralose, stevia, isomaltulose, tagatose, mogroside, and erythritol.^[15]^[16]

Toothfriendly International certifies products that have been tested and proven to be safe for teeth. It is a non-profit association established in 1989 in Basel, Switzerland. Since then, the association has been granting the rights for the Toothfriendly label to distinguish products that are not harmful for teeth. The members of the organization are dentists, dental and public health institutions, confectionery and oral care manufacturers.

The Toothfriendly Foundation is the charitable arm of the association. The Foundation is responsible for caries prevention projects in less-developed countries.

References

^ Imfeld T. (1983). Identification of low caries risk dietary components in: “Monographs in Oral Science”. Vol. 11: 1-198. Myers H.M. (ed.), Karger, Basel.
^ WHO, World Health Organization Technical Report Series, Geneva, 1984, no 713, p.19.
^ T.Imfeld and B.Guggenheim (1991) Sugarless - the Way Forward. A.J. Rugg-Gunn (ed.), Elsevier Applied Science, London 1991, p. 197.
^ De Paola D.P. (1986). Executive summary. Proceedings of scientific consensus conference on methods for assessment of the cariogenic potential of foods. J. Dent. Res. 65 (Spec. Iss.): 1540-1543.
^ Firestone A.R., Imfeld T., Schiffer S. and Lutz F. (1987). Measurement of interdental plaque pH in humans with an indwelling glass pH electrode following a sucrose rinse: A long-term retrospective study. Caries Res., 21: 555-558.
^ Imfeld T. (1983). Identification of low caries risk dietary components. In: "Monographs in Oral Science". Vol. 11: 1-198. Myers H.M. (ed.), Karger, Basel.
^ Igarashi K., Lee I.K. and Schachtele Ch.F. (1989). Comparison of in vivo human dental plaque pH changes within artificial fissures and at interproximal sites. Caries Res., 23: 417-422.
^ Schachtele Ch.F. et al. (1986). Human plaque acidity models - Working Group Consensus Report. J. Dent. Res. 65 (Spec. Iss.):1530-1531.
^ Lussi A., Jaeggi T. and Zero D. (2004). The role of diet in the aetiology of dental erosion. Caries Res., 38 (1): 34-44.
^ Stösser L., Tietze W., Künzel W. and Limberger K. (1990). Intra-orale pH-Messung zur Bestimmung des azidogenen Potentials von Nahrungsmitteln. Oralprophylaxe, 12: 145-153.
^ FDA (1997). Food and Drug Administration. Letter from J.J. Saltsman, (CFSAN) to D. McColl (Hyman Phelps & McNamara), 2 July 1997.
^ ESFA Journal 2011;9(4):2076
^ ALÜ (1989). Ausschuss Lebensmittelhygiene und Lebensmittelüberwa-chung. Ergebnisprotokoll betr. lebensmittelrechtliche Bewertung der "Aktion Zahnfreundlich e.V.". Sitzung vom 7./8. November 1989.
^ ACCC (1997). Final assessment issued by the Australian Competition & Consumer Commission in regard to Certification Trade Mark Application Nos. 572400 to 572402 (inclusive) and 601904 - Aktion Zahnfreundlich.
^ International Dental Federation (FDI) (2000). Consensus Statement on Diet of 2nd World Conference on Oral Health Promotion. Int. Dent. J., 50(3): 174.
^ • Riva Touger-Decker and Van Loveren C. (2003). Sugars and dental caries. Americal Journal of Clinical Nutrition; 78 (suppl) 881S-92S.