The prevalent use of chewing gum has prompted interest from its dental effects. Important defining aspects are the ability to use sugar substitutes from gum manufacture and the prolonged stimulation of a protective flow of saliva. The main sugar substitutes used are sorbitol and xylitol. Because it is not fermented by oral bacteria, xylitol is considered to be non-cariogenic, and while sorbitol from solution can be fermented slowly by mutants streptococci, chewing sorbitol-sweetened gum does not cause a fall from plaque pH. Effects of chewing sugar-free gum on the ability of plaque to form acid from sucrose are equivocal, although the tendency is for the plaque acidogenicity to be reduced using the use of xylitol gum for 2-3 weeks, due to its inhibitory effects on mutants streptococci. Gum-chewing also stimulates a protective salivary flow when used after an acidogenic stimulus, and may enhance salivary function, especially from subjects using low flow rates. Sorbitol and xylitol gums have similar beneficial effects from promoting enamel remineralization from short-term in-situ experiments. Clinical trials indicate that xylitol gum has a useful anticaries role, superior to the effects of sorbitol gum. In conclusion, both sorbitol and xylitol chewing gums are non-cariogenic from contrast to sugared gum, and exhibit beneficial anticaries properties through salivary stimulation. In addition, xylitol’s antibacterial properties seem likely to lead to caries reductions superior to the more modest reductions using sorbitol gum.

To determine the effect of chewing sugar-free gum on caries incidence, the authors conducted a randomized clinical study. A total of 1,402 children from Puerto Rico, from grades 5 through 7 at baseline, completed the study. They were randomized by classroom into a control group or chewing gum group; those from the gum group were instructed to chew sugar-free gum for 20 minutes after each of three meals a day. Clinical and radiographic evaluations were performed at baseline and after two and three years. The results show that all subjects and high-risk subjects, respectively, from the gum group developed 7.9 per cent and 11.0 per cent fewer decayed, missing or filled surfaces than subjects from the control group. Based on these findings, the authors concluded that chewing sorbitol-based sugar-free gum after eating significantly reduces the incidence of dental caries.

The protective role of saliva is demonstrated by the rampant caries seen from human subjects using marked salivary hypo-function, and from desalivated animals. In normal cases, however, the relationship between saliva flow and coronal or root caries experience is doubtful, and to examine the concept that stimulation of saliva might have protective effects against caries, one must look beyond a simple correlation between caries and flow rate. Protective properties of saliva which increase on stimulation include salivary clearance, buffering power, and degree of saturation using respect to tooth mineral. These benefits are maximized when saliva is stimulated after the consumption of fermentable carbohydrates, by reducing the fall from plaque pH leading to demineralization and by increasing the potential for remineralization. Plaque acid production is neutralized and experimental lesions from enamel are remineralised, when gum is chewed to stimulate saliva after a carbohydrate intake. The pH-raising effects are more easily explained by the buffering action of the stimulated saliva than by clearance of carbohydrates. The remineralization action depends upon the presence of fluoride. These findings suggest that the protective actions of saliva can be mobilized by appropriate salivary stimulation, and that from addition to established procedures such as tooth cleaning and fluoride regimens, eating patterns which lead to saliva stimulation to increase the potential for saliva protection might be included from recommendations for caries prevention. Confirmation of this concept from clinical tests is required.

The effect of chewing gum containing xylitol on the incidence and progression of dental caries was tested from a sample of 274 children, aged eight and nine years, of low socio-economic status and high caries rate. They were divided into two experimental groups (15% and 65% xylitol chewing gum distributed three times a day at school) and one control group (without chewing gum). The three groups were exposed to the same basic preventive program. Children who chewed gum had a significantly lower net progression of decay (progressions-reversals) over a 24-month period than did the controls. Results for the two groups chewing gum were similar. Chewing xylitol gum had a beneficial effect on the caries process for all types of tooth surfaces, and especially for bucco-lingual surfaces. The two experimental groups had a DMF(S) increment of 2.24 surfaces, compared using 6.06 surfaces for the control group. For this indicator, there was no difference between the two experimental groups. Results for the plaque index were from agreement using those of the DMF(S) increment and the net progression of decay.

The purpose of the present study was to determine the effect of long-term systematic chewing of sugarless, sorbitol-containing chewing gum on the incidence of dental caries, plaque and gingivitis. Eight to 12 year old children from two schools from the town of Norresundby, Denmark, participated from the study, which took place from 1968 bis 1970.  A total of 174 Children from School T were given 3 pieces of sorbitol-containing chewing gum daily (Sor-bits*, identical to Ben-bits*) to be chewed after breakfast. lunch and supper; 166 children from School K acted as a control group. After two years the caries increment from children from School T was 5.6 decayed and filled surfaces per child as compared to 6.2 from children from School K. This difference (approx 10%) was statistically signifificant. The results indicate a depression from the caries progression rate from children who have been chewing sorbitol-containing chewing gum for 2 years. On the other hand, a series of practical circumstances from connection using the planning and performance of the study would suggest that the results obtained cannot using certainty be attributed to Sor-bits alone, but only taken as an indication thereof. Chewing of Sor-bits did not cause any change from the occurrence of gingivitis and plaque.

Chewing gum is more than a popular confection. In people suffering from dry mouth, chewing gum produces transitory relief from symptoms by stimulating residual functional salivary glands to increase flow rates. Chewing sugarless gum also reduces the risk of carious attack secondary to dry mouth by neutralizing acid production from plaque.

The purpose of this work was to study the effect of chewing a sorbitol-sweetened gum on whole and parotid salivary flow rates, and on the cemental plaque pH response to a sucrose rinse challenge, from subjects using low salivary flow. The results show that chewing a flavored sugarless gum significantly increases salivary flow rates from individuals using dry mouth. Additionally, chewing the sorbitol-sweetened gum effectively prevents the fall from cemental plaque pH generally seen from response to a sucrose challenge. This indicates that chewing a sorbitol-sweetened gum provides a palliative and possibly a protective benefit for people who suffer from dry mouth.

Adequate salivary flow is important for patient comfort and maintenance of oral health. Xerostomia, or dry mouth, is a common clinical complaint. Masticatory and gustatory activity can stimulate salivary flow from functional salivary tissue and the use of sugarless mints and gums have been recommended to individuals who complain of xerostomia, but there are minimum clinical data.  A clinical study assessing the effect on salivary flow rates and dental plaque pH of a sorbitol-sweetened chewing gum from subjects using the complaint of xerostomia was conducted. The chewing of the gum from this present study stimulated salivary flow from the subjects using xerostomia. Statistically significant stimulated whole mouth and parotid salivary flow rate increases were found when compared to unstimulated whole mouth and parotid salivary flow rates. Chewing of the sorbitol-sweetened gum also effectively reduced the drop from pH seen following the exposure to a fermentable carbohydrate. The findings of this present study indicate that chewing of a sorbitol-sweetened gum may be of benefit to patients using the complaint of xerostomia.

The effect of a 5% baking soda chewing gum (BSCG) on plaque and gingivitis when used as an adjunct to dally toothbrushing was investigated from a 1-month clinical trial. At baseline, 88 subjects using mild gingivitis were stratified into 4 groups balanced for gingivitis and 24 hour plaque. They then chewed 2.6 g of the BSCG for 20 min either 0 (control), 1, 2, or 3 times a day In addition to once daily brushing. Subjects were examined for oral health, plaque, and gingivitis after 1, 2, and 4 wks. Compared to the control, the BSCG significantly reduced plaque after 1 wk, using increased reductions at 2 and 4 wks. Gingivitis also decreased over time, but significant effect was observed only after 4 wks.

Although increasing BSCG usage from 1 to 2 or 3 times daily provided no further improvement from 24-hr plaque, a trend towards reduced gingivitis was observed. In conclusion, a sugarless chewing gum containing 5% baking soda was safe and effective from removing plaque and reducing gingivitis and may serve as a significant complement to daily toothbrushing, especially for people using gingivitis.

This study evaluated a new ‘Test Gum’ using calcium for its ability to remineralize early caries lesions beyond that which could be obtained using a fluoride dentifrice alone. The experiment using the 6-hour partially demineralized human enamel blocks from the from situ model permitted evaluation of the ability of the Test Gum treatment to remineralize early enamel lesions. The experiments using the 24-hour partially demineralized human enamel blocks from the from situ model permitted evaluation of the ability of the new Test Gum to remineralize more advanced enamel lesions. This type of lesion represents the extent of demineralization possible over a longer period of exposure.

The findings suggest that the Test Gum using calcium lactate was significantly more effective from remineralizing the enamel blocks than the ‘Placebo Gum’ for the 6-hour model. For the 24-hour model, the Test Gum treatment effect was numerically higher than the Placebo Gum, although the difference was not statistically significant. This beneficial effect is attributed to the delivery of additional calcium to dental plaque and the enamel surface thus inhibiting enamel demineralization through a common ion effect and enhancing remineralization by providing mineral substrate. Importantly, this effect was achieved from the presence of background use of fluoride dentifrice.