The Value of Maltitol-containing Cookies as a Food for the Elderly

Abstract

 Purpose: There is a need for food products that can assure the quality of life (QOL) of elderly people who are at risk of tooth decay (particularly those who require long-term care and are unable to ensure adequate oral hygiene). In this study, we focused on maltitol, a leading alternative sweetener.
 Methods: We made maltitol-containing cookies and investigated their effect on calcification on the enamel surface layer of teeth, and also carried out a questionnaire survey regarding the test cookies. Enamel blocks for use as test materials were made from healthy premolars extracted for orthodontic reasons. Saliva (450 ml) was collected from volunteer participants. Test samples were created containing saliva only as well as saliva with the addition of 5% maltitol, 5% sucrose, flour, unsalted butter, egg yolk, baking powder, cookie dough made with maltitol, or cookie dough made with sucrose. Enamel blocks were immersed in saliva solutions for 1 week in an incubator at 37°C. Before and after immersion, their pH was measured, the surface was observed by scanning electron microscopy and contact microradiography (CMR), and calcification levels were analyzed. Double-blind taste tests were also carried out by 102 healthy adults who responded to a questionnaire.
 Results: There was almost no evidence of decalcification after immersion in saliva alone or in saliva containing 5% maltitol, flour, egg yolk, unsalted butter or baking powder. Considerable decalcification occurred after immersion in saliva containing 5% sucrose or cookie dough made with sucrose, but almost no decalcification after immersion in saliva containing cookie dough made with maltitol. Questionnaire results revealed that, though some respondents felt that maltitol-containing cookies were insufficiently sweet, they were highly satisfied with how easy they were to masticate and swallow, and a large number said they would be willing to purchase them.
 Conclusion: Our results suggest that maltitol-containing cookies may be a valuable food for preventing tooth decay, which is a major problem in elderly subjects.