SÃO PAULO, Brazil: Sugar substitutes have been promoted as a healthier alternative because of their low cariogenic potential and role in reducing caries risk. Research has also suggested that they have minimal effects on blood glucose levels, making them a common choice for individuals with diabetes. However, a recent study has found an association between the consumption of sugar substitutes and cognitive decline.1 This highlights the importance of considering both systemic and oral health effects when evaluating their overall benefits.