After hearing from a reader with diabetes and dry mouth who was searching for hard sugar-free candy with no sugar alcohols, I replied that if there are any products without these types of sweeteners, they did not come up on my radar.

I soon received a note from Mary O. in Richmond, Virginia: “It took me a few seconds to find candy free of both sugar and sugar alcohols by searching for candy and stevia together.” Attached to her letter was ingredient information for a sugar-free candy made with the sweetener stevia.

I was intrigued by the the Nutrition Facts label on this product. It clearly shows the sugar alcohol content is 0. Yet on the ingredient label, which lists the product’s contents from most to least, the very first ingredient is isomalt, a sugar alcohol.

How can this be? If a food product contains less than half a gram of sugar alcohol per serving, it can be labeled as 0, according to regulations by the Food and Drug Administration. So, although it's a very small amount, this product does contain some sugar alcohol.

Jeanne G. from St. Louis had another take: “You talked a lot about xylitol and other sugar alcohols. You failed to mention how toxic these products are to dogs. Dogs have died after eating sugar free gum products that contain xylitol. Please alert your readers to hazards to their pets when these products are ingested.”

You are indeed correct, Jeanne. In 2016, the FDA released a warning that xylitol—a sugar alcohol found in everything from breath mints to chewable vitamins—is toxic to dogs. Symptoms such as weakness, staggering and seizures can happen within 10 minutes to an hour after a dog ingests this sweetener.

Xylitol is safe for humans although it can cause diarrhea if consumed in large doses. This sugar alcohol has also been shown to help reduce bacteria in the mouth, which helps prevent cavities. That’s why it’s popular in sugar-free gums and candies.

Some recent studies have linked high levels of xylitol in the blood to an increased risk for heart attack and stroke. Yet the amount of xylitol consumed to get these effects was at least 30 times higher than the amount found in a typical piece of sugar-free gum or candy, according to Consumer Reports.

Lastly, Ann in Monterey, California, writes: “I have no idea whether this suggestion would work with dry mouth, but maybe? A couple of years ago I cut back on sugar when my lab results indicated I was in the pre-diabetic area. At some point, I had overbought grapes, and rather than see them rot, I rinsed them off, drained and froze them, thinking I could somehow still use them. It turns out that I really enjoy them frozen -- they crunch a bit like popsicles, and are sweet.

Sounds good to me, Ann. Although grapes contain some natural sugar, many dental experts do recommend them as a healthful snack for teeth!

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