The oral health advantages of chewing sugarfree gum.
This article was previously published in a supplement for Dentistry magazine in the UK.
With chewing gum now a universally accepted habit, Juliette Reeves considers the oral health benefits from which your patients can benefit.
For hundreds of years, people have chewed on natural materials including thickened resin and latex from certain trees, sweet grasses, leaves, grains and waxes. Ancient Greeks chewed gum thousands of years ago and were believed to chew tree resin taken from bark of the Mastic tree.
American Indians used to quench their thirsts by chewing the gum-like resin that forms on spruce trees when the bark is cut. Spruce became the first commercial chewing gum, being sold and traded in lumps. The use of spruce continued until the 1850s when paraffin wax became the new popular base for chewing gum.
During World War II, US military personnel spread the popularity of chewing gum by trading it and giving it as gifts to people in Europe, Africa, Asia and around the rest world. Today Wrigley’s ORBIT is the leading dental brand of sugarfree gum in the UK.
Chewing gum is a unique substance because it is chewed for a prolonged period but contributes relatively few calories or nutrition. Its effects on the oral tissues, therefore, have been studied for many years. William F Semple, an Ohio dentist, used rubber to create a product for jaw exercise and gum stimulation. He received the first patent to manufacture chewing gum in December 1869.
This article looks at the oral health benefits of sugarfree gum that we as a profession can explain to patients when recommending gum as part of the oral care routine.
Oral health
Chewing gum itself does contribute to plaque reduction, and some studies have shown beneficial effects on oral hygiene, calculus and/or gingivitis. In addition to this, there is an increasing body of evidence emerging that chewing of sugarfree gum like Wrigley’s ORBIT can remineralise the tooth surface and help prevent caries.
Remineralisation
Saliva is normally secreted continuously at about 500ml per day but can be stimulated by mastication. Chewing a sugarfree gum can increase the initial salivary flow rate by a factor of 10.
In addition to the more effective clearance of carbohydrate from the mouth, stimulated saliva contains higher concentrations of remineralising ions and bicarbonate to buffer the acids formed in plaque.
The use of sugarfree gum after eating meals and snacks, therefore, promotes the remineralisation of enamel lesions and has been shown to reduce clinical caries development – in one study by up to 40%.
It has also been shown that this stimulated saliva is more effective in its ability to buffer and remineralise. Research has suggested that salivary stimulation from chewing sugarfree gum after the consumption of sugary foods not only prevents the fall in plaque pH normally seen, but also results in an increased remineralising effect in previously demineralised enamel.
Caries prevention
Chewing sugar free gum has been proven, in a number of clinical studies, to reduce caries by stimulating the production of saliva, which neutralises the plaque acids that cause tooth decay. It has been calculated that people chewing sugarfree gum three times a day reduce their risk of caries by 40% compared with those who do not chew gum.
The protective effect of stimulated saliva has the most impact during the plaque acid attack, which occurs about 20 to 30 minutes after a cariogenic food intake. However, most salivary stimulation ceases shortly after swallowing the food, and salivary composition returns to normal within about five minutes.
The protective effects of saliva, therefore, are not mobilised when it is most needed. In order to enhance salivary protection during the caries attack, a stimulant is needed that is not itself cariogenic. Chewing a sugarfree gum, like ORBIT‚ for 20 minutes after eating provides the stimulus needed.
Changes in the composition of stimulated saliva leads to a greater ability to prevent a fall in salivary pH, following the consumption of refined carbohydrates. The greater volume and rate of flow of stimulated saliva also results in an increased ability to clear sugars and acids from around the teeth. At the same time the plaque microflora are unable to produce significant amounts of acid. Thus, these properties of stimulated saliva reduce the overall caries susceptibility of the individual.
Studies have shown that chewing sugarfree gum leads to fewer caries compared to non-chewing controls. The implication is that sugarfree products actually inhibit caries’ activity due to dietary carbohydrate.
For over 25 years Wrigley has worked in partnership with the dental profession and pioneered independent research into the oral care benefits of chewing sugarfree gum, helping the dental profession understand the importance of saliva in dental health.
Currently 22 dental associations accredit or endorse the Wrigley dental care brand and many dental professionals recommend Wrigley’s ORBIT sugarfree gum as an aid to oral health and to help prevent tooth decay as part of the oral care routine.
References
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Ainamo J, Sjoblom M, Ainamo A, Tainen L (1977) Growth of plaque while chewing sucrose and sorbitol flavoured gum. J Clin Periodontol 4: 151-60
Ainamo J (1987) Prevention of plaque growth with chewing gum containing chlorhexidine acetate. J Clin Periodontol 14: 524-7
Dawes C, Macpherson LMD (1992) Effects of nine different chewing gums and lozenges on salivary flow rate and pH. Caries Res. 26: 176-182
Edgar WM, Bibby BG, Mundorff S, Rowley J (1975) Acid production in plaques after eating snacks: modifying factors in foods. J Amer Dent Assoc 90: 418-25
Edgar WM (1990) Saliva and Dental health. Br Dent J. 169: 96-98
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The author would like to acknowledge the work of Michael Edgar DDsc, PhD, FDS, RCS: A review of the positive effects of chewing sugar free gum on oral health as the primary reference in the writing of this article.