Coffey N, O'Leary F, Burke F et al. Oral Nutritional Supplements: Sugar Content and Potential Dental Implications. Gerodontology 2022; 39: 354-358.

…but many have a high sugar content.

Patients with chronic medical conditions, such as COPD, Crohn's disease, depression, anxiety and cancer, and at risk of malnutrition, may be prescribed Oral Nutritional Supplements (ONS). Patients are encouraged to sip the ONS during the day and the sugar content can be high.

During history taking, patients may not inform their dentist that they are taking ONS, as they do not view them as medication. Dieticians in the UK can prescribe ONS and are influenced by nutritional factors, patient acceptability and hospital contracts in their choice of supplement. Sugar content is largely ignored.

Although the sugar content varies from 7 g per 250 ml to 27 g per 200 ml between different pre-formed drinks (powdered forms, mixed with milk, have similar variations), the calorific value across the brands is broadly similar. Recommendations for dental management include asking the patient specifically about ONS in the medical history and/or diet records, liaising with the dietician or GP to discuss the possibility of prescribing a lower sugar preparation with similar calorific value and considering prescribing high-fluoride toothpaste as well as additional fluoride mouthrinses and/or topical fluoride application.