Use of sugar-free gum as complement in the prevention of dental caries. Narrative review.
Abstract
Tooth decay is one of the diseases most prevalent, being ranked as one of the major public health problems worldwide. For this reason it has been emphasized the development of new preventive methods, as the use of sugar-free gum. With this strategy it is possible to obtain significant benefits for oral health product by: (1) stimulation of salivation, which favors the clearance and regulates the pH; (2) promotion of remineralization as a consequence of this stimulation and the addition of minerals to the gum; (3) mechanical plaque control; (4) replacement of sugar with sweeteners harmful for bacteria, of which the most widely used is the xylitol; and (5) addition of active agents such as bicarbonate, casein, urea, chlorhexidine and chitosan, among others. Despite providing these benefits, is considered that the effect of gum is weak in preventing caries when the order is sought in the absence of toothbrushing and therefore should be proposed for implementation in addition to routine oral hygiene and not as a preventive measure alone, being necessary to perform a greater number of short and long term clinical trials to evaluate the effectiveness in a context of high biological variability, including patients of different sex, age, socioeconomic status and systemic health.References
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3. Tangade P, Mathur A, Chaudhary S, Gupta R. The effect of sugar-free and sugar chewing gums on plaque deposition. Dent Res J. 2012; 9(3): 309-13.
4. Panesso E, Calle M, Meneses E. Salud bucal y xilitol: usos y posibilidades en caries y enfermedad periodontal en poblaciones “PEPE”. Univ Salud 2012; 14(2): 205-215.
5. Cuadrado D, Peña R, Gómez J. El concepto de caries: hacia un tratamiento no invasivo. Rev ADM 2013; 70(2): 54-6.
6. Keukenmeester R, Slot D, Rosema N, Van Loveren C, Van der Weijden G. Effects of sugar-free chewing gum sweetened with xylitol or maltitol on the development of gingivitis and plaque: a randomized clinical trial. Int J Dent Hyg. 2014; [Epub ahead of print].
7. Núñez D, García L. Bioquímica de la caries dental. Rev Haban Cienc Méd. 2010; 9(2): 156-166.
8. Galhotra V, Sofat A, Dua H, Rohila S. Anticariogenic And Cariostatic Potential Of Components Of Diet: A Review. Indian J Dent Sci. 2014; 6(4): 079.
9. Kumar S, Sogi S, Indushekar K. Comparative evaluation of the effects of xylitol and sugar-free chewing gums on salivary and dental plaque pH in children. J Indian Soc Pedod Prev Dent. 2013; 31(4): 240-4.
10. Imfeld T. Chewing gum--facts and fiction: a review of gum-chewing and oral health. Crit Rev Oral Biol Med. 1999; 10(3): 405-19.
11. Mickenautsch S, Coelho S, Yengopal V, Bezerra A, Cruvinel V. Sugar-free chewing gum and dental caries: a systematic review. J Appl Oral Sci. 2007; 15(2): 83-88.
12. Dodds M. The oral health benefits of chewing gum. J Ir Dent Assoc. 2012; 58(5): 253-61.
13. Dodds M, Chidichimo D, Haas M. Delivery of Active Agents from Chewing Gum for Improved Remineralization. Adv Dent Res. 2012; 24(2): 58-62.
14. Al-Haboubi M, Zoitopoulos L, Beighton D, Gallagher. The potential benefits of sugar-free chewing gum on the oral health and quality of life of older people living in the community: a randomized controlled trial. Community Dent Oral Epidemiol. 2012; 40(5): 415-24.
15. Jagodzińska M, Zimmer-Nowicka J, Nowicki M. Three months of regular gum chewing neither alleviates xerostomia nor reduces overhydration in chronic hemodialysis patients. J Ren Nutr. 2011; 21 (5): 410-7.
16. Simeone S. Usos y efectos del fosfato de calcio amorfo (FCA) en la odontología restauradora y preventiva. Acta Odontol Venez. 2010; 48 (3): 1-12.
17. Hanham A, Addy M. The effect of chewing sugar-free gum on plaque regrowth at smooth and occlusal surfaces. J Clin Periodontol. 2001; 28(3): 255-7.
18. Loveren C, Broukal Z, Oganessian E. Functional foods/ingredients and dental caries. Eur J Nutr 2, 2012; 51:15-25.
19. Tuncer D, Önen A, Yazici, A. Effect of chewing gums with xylitol, sorbitol and xylitol-sorbitol on the remineralization and hardness of initial enamel lesions in situ. J Dent Res. 2014; 11 (5): 537-543.
20. Hanno A, Alamoudi N, Almushayt A, Masoud M, Sabbagh H, Farsi N. Effect of xylitol on dental caries and salivary Streptococcus mutans levels among a group of mother-child pairs. J Clin Pediatr Dent. 2011; 36(1): 25-30.
21. Cobos C, Valenzuela Emilia, Araiza M. Influencia de un enjuague a base de fluoruro y xilitol en la remineralización in vitro del esmalte en dientes temporales. Rev Odont Mex. 2013; 17(4): 204-209.
22. Portilla J, Pinzón M, Huerta E, Obregón A. Conceptos actuales e investigaciones futuras en el tratamiento de la caries dental y control de la placa bacteriana. Rev Odont Mex. 2010; 14(4): 218-225.
23. Seki M, Karakama F, Kawato T, Tanaka H, Saeki Y, Yamashita Y. Effect of xylitol gum on the level of oral mutans streptococci of preschoolers: block-randomised trial. Int Dent J. 2011; 61(5): 274-80.
24. Söderling E, Elsalhy M, Honkala E, Fontana M, Flannagan S, Eckert G, Kokaras A, Paster B, Tolvanen M, Honkala S. Effects of short-term xylitol gum chewing on the oral microbiome. Clin Oral Investig. 2014; [Epub ahead of print].
25. Hashiba T, Takeuchi K, Shimazaki Y, Takeshita T, Yamashita Y. Chewing Xylitol Gum Improves Self-Rated and Objective Indicators of Oral Health Status under Conditions Interrupting Regular Oral Hygiene. Tohoku J Exp Med. 2015; 235 (1): 39-46.
26. Thabuis C, Cheng C, Wang X, Pochat M, Han A, Miller L, Wils D, Guerin-Deremaux L. Effects of maltitol and xylitol chewing-gums on parameters involved in dental caries development. Eur J Paediatr Dent. 2013; 14(4): 303-8.
27. Alamoudi N, Hanno A, Masoud M, Sabbagh H, Almushayt A, Masoud I. Effects of xylitol on salivary mutans streptococcus, plaque level, and caries activity in a group of Saudi mother-child pairs. An 18-month clinical trial. Saudi Med J. 2012; 33(2): 186-92.
28. Keukenmeester R, Slot D, Putt M, Weijden G. The effect of medicated, sugar-free chewing gum on plaque and clinical parameters of gingival inflammation: a systematic review. Int J Dent Hyg. 2014; 12 (1): 2-16.
29. Splieth C, Alkilzy M, Schmitt J, Berndt C, Welk A. Effect of xylitol and sorbitol on plaque acidogenesis. Quintessence Int. 2009; 40(4): 279.
30. Ly K, Milgrom P, Rothen M. The Potential of Dental-Protective Chewing Gum in Oral Health Interventions. J Am Dent Assoc. 2008; 139: 553-563.
31. Wilczynska-Borawska M, Rodakowska E, Lewkowski A, Baginska J, Wilczko M. Chitosan in the chewing gum, an innovative caries prevention method? Initial in vitro study. Healthmed. 2012; 6(12): 3957-3960.
32. Tubert-Jeannin S, Auclair C, Amsallem E, Tramini P, Gerbaud L, Ruffieux C, Schulte A, Koch M, Rège-Walther M, Ismail A. Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children. Cochrane Database Syst Rev. 2011:CD007592.
33. Miñara V. El flúor y la prevención de la caries en la infancia. Actualización. Acta Pediatr Esp. 2010; 68(3): 129-134.
34. Rojas T, Romero M, Navas R, Álvarez C, Morón A. Flujo salival, pH y capacidad amortiguadora en niños y adolescentes cardiópatas: factor de riesgo para caries dental y enfermedad periodontal. Estudio preliminar. Cienc Odontol. 2008; 5(1): 17-26.
35. Anderson L, Orchardson R. The effect of chewing bicarbonate-containing gum on salivary flow rate and pH in humans. Arch Oral Biol. 2003; 48(3): 201-4.
36. Porciani P, Chazine M, Grandini S. A clinical study of the efficacy of a new chewing gum containing calcium hydroxyapatite in reducing dentin hypersensitivity. J Clin Dent. 2014; 25(2): 32-6.
37. de Castro L, Delbem A, Danelon M, Passarinho A, Percinoto C. In vitro effect of sodium trimetaphosphate additives to conventional toothpastes on enamel demineralization. Clin Oral Investig. 2015; [Epub ahead of print]
38. Manarelli M, Delbem A, Lima T, Castilho F, Pessan J. In vitro remineralizing effect of fluoride varnishes containing sodium trimetaphosphate. Caries Res. 2014; 48(4): 299-305.
39. Reema S, Lahiri P, Roy S. Review of casein phosphopeptides-amorphous calcium phosphate. Chin J Dent Res. 2014; 17(1): 7-14.
40. Cochrane N, Shen P, Byrne S, Walker G, Adams G, Yuan Y, Reynolds C, Hoffmann B, Dashper S, Reynolds E. Remineralisation by chewing sugar-free gums in a randomised, controlled in situ trial including dietary intake and gauze to promote plaque formation. Caries Res. 2012; 46(2): 147-55.
41. Yengopal V, Mickenautsch S. Caries preventive effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP): a meta-analysis. Acta Odontol Scand. 2009; 67 (6): 321-332.
42. Prestes L, Souza B, Comar L, Salomão P, Rios D, Magalhães A. In situ effect of chewing gum containing CPP-ACP on the mineral precipitation of eroded bovine enamel-a surface hardness analysis. J Dent. 2013; 41(8): 747-51.
43. Reyes É, Martín J, Yévenes I, Neira M, Palma P, Gordan V, Moncada G. Actividad y efectos de ureasa y arginina deiminasa en saliva y biopelícula oral humana. Rev Fac Odontol Univ Antioq 2012; 23(2): 343-352.
44. Hayashi Y, Ohara N, Ganno T, Ishizaki H, Yanagiguchi K. Chitosan-containing gum chewing accelerates antibacterial effect with an increase in salivary secretion. J Dent. 2007; 35(11): 871-4.
45. Hayashi Y, Ohara N, Ganno T, Yamaguchi K, Ishizaki T, Nakamura T, Sato M. Chewing chitosan-containing gum effectively inhibits the growth of cariogenic bacteria. Arch Oral Biol. 2007; 52(3): 290-4.
46. Gopinath V, Tandon S, Shirwaikar A. The effect of chewing gums on acidogenicity of plaque after a sucrose challenge. J Clin Pediatr Dent. 1997; 22(1): 77-81.
47. Dodds M, Reeves J. Sugar-free gum and dental caries: a high-impact approach. Dental Nursing. 2014; 10 (7): 175-177.
48. Wang, X, Zhong B, Chen Z, Stewart M, Zhang C, Zhang K, Ni J, Dodds M, Hanley A, Miller L. History of frequent gum chewing is associated with higher unstimulated salivary flow rate and lower caries severity in healthy chinese adults. Caries Res. 2012; 46 (6): 513-518.
2. Velásquez C, Narvárez C. Effect of xylitol chewing gum on dental plaque, saliva flow and saliva buffer capacity in Chilean youngsters. Int J Odontostomat. 2013; 7(1): 133-137.
3. Tangade P, Mathur A, Chaudhary S, Gupta R. The effect of sugar-free and sugar chewing gums on plaque deposition. Dent Res J. 2012; 9(3): 309-13.
4. Panesso E, Calle M, Meneses E. Salud bucal y xilitol: usos y posibilidades en caries y enfermedad periodontal en poblaciones “PEPE”. Univ Salud 2012; 14(2): 205-215.
5. Cuadrado D, Peña R, Gómez J. El concepto de caries: hacia un tratamiento no invasivo. Rev ADM 2013; 70(2): 54-6.
6. Keukenmeester R, Slot D, Rosema N, Van Loveren C, Van der Weijden G. Effects of sugar-free chewing gum sweetened with xylitol or maltitol on the development of gingivitis and plaque: a randomized clinical trial. Int J Dent Hyg. 2014; [Epub ahead of print].
7. Núñez D, García L. Bioquímica de la caries dental. Rev Haban Cienc Méd. 2010; 9(2): 156-166.
8. Galhotra V, Sofat A, Dua H, Rohila S. Anticariogenic And Cariostatic Potential Of Components Of Diet: A Review. Indian J Dent Sci. 2014; 6(4): 079.
9. Kumar S, Sogi S, Indushekar K. Comparative evaluation of the effects of xylitol and sugar-free chewing gums on salivary and dental plaque pH in children. J Indian Soc Pedod Prev Dent. 2013; 31(4): 240-4.
10. Imfeld T. Chewing gum--facts and fiction: a review of gum-chewing and oral health. Crit Rev Oral Biol Med. 1999; 10(3): 405-19.
11. Mickenautsch S, Coelho S, Yengopal V, Bezerra A, Cruvinel V. Sugar-free chewing gum and dental caries: a systematic review. J Appl Oral Sci. 2007; 15(2): 83-88.
12. Dodds M. The oral health benefits of chewing gum. J Ir Dent Assoc. 2012; 58(5): 253-61.
13. Dodds M, Chidichimo D, Haas M. Delivery of Active Agents from Chewing Gum for Improved Remineralization. Adv Dent Res. 2012; 24(2): 58-62.
14. Al-Haboubi M, Zoitopoulos L, Beighton D, Gallagher. The potential benefits of sugar-free chewing gum on the oral health and quality of life of older people living in the community: a randomized controlled trial. Community Dent Oral Epidemiol. 2012; 40(5): 415-24.
15. Jagodzińska M, Zimmer-Nowicka J, Nowicki M. Three months of regular gum chewing neither alleviates xerostomia nor reduces overhydration in chronic hemodialysis patients. J Ren Nutr. 2011; 21 (5): 410-7.
16. Simeone S. Usos y efectos del fosfato de calcio amorfo (FCA) en la odontología restauradora y preventiva. Acta Odontol Venez. 2010; 48 (3): 1-12.
17. Hanham A, Addy M. The effect of chewing sugar-free gum on plaque regrowth at smooth and occlusal surfaces. J Clin Periodontol. 2001; 28(3): 255-7.
18. Loveren C, Broukal Z, Oganessian E. Functional foods/ingredients and dental caries. Eur J Nutr 2, 2012; 51:15-25.
19. Tuncer D, Önen A, Yazici, A. Effect of chewing gums with xylitol, sorbitol and xylitol-sorbitol on the remineralization and hardness of initial enamel lesions in situ. J Dent Res. 2014; 11 (5): 537-543.
20. Hanno A, Alamoudi N, Almushayt A, Masoud M, Sabbagh H, Farsi N. Effect of xylitol on dental caries and salivary Streptococcus mutans levels among a group of mother-child pairs. J Clin Pediatr Dent. 2011; 36(1): 25-30.
21. Cobos C, Valenzuela Emilia, Araiza M. Influencia de un enjuague a base de fluoruro y xilitol en la remineralización in vitro del esmalte en dientes temporales. Rev Odont Mex. 2013; 17(4): 204-209.
22. Portilla J, Pinzón M, Huerta E, Obregón A. Conceptos actuales e investigaciones futuras en el tratamiento de la caries dental y control de la placa bacteriana. Rev Odont Mex. 2010; 14(4): 218-225.
23. Seki M, Karakama F, Kawato T, Tanaka H, Saeki Y, Yamashita Y. Effect of xylitol gum on the level of oral mutans streptococci of preschoolers: block-randomised trial. Int Dent J. 2011; 61(5): 274-80.
24. Söderling E, Elsalhy M, Honkala E, Fontana M, Flannagan S, Eckert G, Kokaras A, Paster B, Tolvanen M, Honkala S. Effects of short-term xylitol gum chewing on the oral microbiome. Clin Oral Investig. 2014; [Epub ahead of print].
25. Hashiba T, Takeuchi K, Shimazaki Y, Takeshita T, Yamashita Y. Chewing Xylitol Gum Improves Self-Rated and Objective Indicators of Oral Health Status under Conditions Interrupting Regular Oral Hygiene. Tohoku J Exp Med. 2015; 235 (1): 39-46.
26. Thabuis C, Cheng C, Wang X, Pochat M, Han A, Miller L, Wils D, Guerin-Deremaux L. Effects of maltitol and xylitol chewing-gums on parameters involved in dental caries development. Eur J Paediatr Dent. 2013; 14(4): 303-8.
27. Alamoudi N, Hanno A, Masoud M, Sabbagh H, Almushayt A, Masoud I. Effects of xylitol on salivary mutans streptococcus, plaque level, and caries activity in a group of Saudi mother-child pairs. An 18-month clinical trial. Saudi Med J. 2012; 33(2): 186-92.
28. Keukenmeester R, Slot D, Putt M, Weijden G. The effect of medicated, sugar-free chewing gum on plaque and clinical parameters of gingival inflammation: a systematic review. Int J Dent Hyg. 2014; 12 (1): 2-16.
29. Splieth C, Alkilzy M, Schmitt J, Berndt C, Welk A. Effect of xylitol and sorbitol on plaque acidogenesis. Quintessence Int. 2009; 40(4): 279.
30. Ly K, Milgrom P, Rothen M. The Potential of Dental-Protective Chewing Gum in Oral Health Interventions. J Am Dent Assoc. 2008; 139: 553-563.
31. Wilczynska-Borawska M, Rodakowska E, Lewkowski A, Baginska J, Wilczko M. Chitosan in the chewing gum, an innovative caries prevention method? Initial in vitro study. Healthmed. 2012; 6(12): 3957-3960.
32. Tubert-Jeannin S, Auclair C, Amsallem E, Tramini P, Gerbaud L, Ruffieux C, Schulte A, Koch M, Rège-Walther M, Ismail A. Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children. Cochrane Database Syst Rev. 2011:CD007592.
33. Miñara V. El flúor y la prevención de la caries en la infancia. Actualización. Acta Pediatr Esp. 2010; 68(3): 129-134.
34. Rojas T, Romero M, Navas R, Álvarez C, Morón A. Flujo salival, pH y capacidad amortiguadora en niños y adolescentes cardiópatas: factor de riesgo para caries dental y enfermedad periodontal. Estudio preliminar. Cienc Odontol. 2008; 5(1): 17-26.
35. Anderson L, Orchardson R. The effect of chewing bicarbonate-containing gum on salivary flow rate and pH in humans. Arch Oral Biol. 2003; 48(3): 201-4.
36. Porciani P, Chazine M, Grandini S. A clinical study of the efficacy of a new chewing gum containing calcium hydroxyapatite in reducing dentin hypersensitivity. J Clin Dent. 2014; 25(2): 32-6.
37. de Castro L, Delbem A, Danelon M, Passarinho A, Percinoto C. In vitro effect of sodium trimetaphosphate additives to conventional toothpastes on enamel demineralization. Clin Oral Investig. 2015; [Epub ahead of print]
38. Manarelli M, Delbem A, Lima T, Castilho F, Pessan J. In vitro remineralizing effect of fluoride varnishes containing sodium trimetaphosphate. Caries Res. 2014; 48(4): 299-305.
39. Reema S, Lahiri P, Roy S. Review of casein phosphopeptides-amorphous calcium phosphate. Chin J Dent Res. 2014; 17(1): 7-14.
40. Cochrane N, Shen P, Byrne S, Walker G, Adams G, Yuan Y, Reynolds C, Hoffmann B, Dashper S, Reynolds E. Remineralisation by chewing sugar-free gums in a randomised, controlled in situ trial including dietary intake and gauze to promote plaque formation. Caries Res. 2012; 46(2): 147-55.
41. Yengopal V, Mickenautsch S. Caries preventive effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP): a meta-analysis. Acta Odontol Scand. 2009; 67 (6): 321-332.
42. Prestes L, Souza B, Comar L, Salomão P, Rios D, Magalhães A. In situ effect of chewing gum containing CPP-ACP on the mineral precipitation of eroded bovine enamel-a surface hardness analysis. J Dent. 2013; 41(8): 747-51.
43. Reyes É, Martín J, Yévenes I, Neira M, Palma P, Gordan V, Moncada G. Actividad y efectos de ureasa y arginina deiminasa en saliva y biopelícula oral humana. Rev Fac Odontol Univ Antioq 2012; 23(2): 343-352.
44. Hayashi Y, Ohara N, Ganno T, Ishizaki H, Yanagiguchi K. Chitosan-containing gum chewing accelerates antibacterial effect with an increase in salivary secretion. J Dent. 2007; 35(11): 871-4.
45. Hayashi Y, Ohara N, Ganno T, Yamaguchi K, Ishizaki T, Nakamura T, Sato M. Chewing chitosan-containing gum effectively inhibits the growth of cariogenic bacteria. Arch Oral Biol. 2007; 52(3): 290-4.
46. Gopinath V, Tandon S, Shirwaikar A. The effect of chewing gums on acidogenicity of plaque after a sucrose challenge. J Clin Pediatr Dent. 1997; 22(1): 77-81.
47. Dodds M, Reeves J. Sugar-free gum and dental caries: a high-impact approach. Dental Nursing. 2014; 10 (7): 175-177.
48. Wang, X, Zhong B, Chen Z, Stewart M, Zhang C, Zhang K, Ni J, Dodds M, Hanley A, Miller L. History of frequent gum chewing is associated with higher unstimulated salivary flow rate and lower caries severity in healthy chinese adults. Caries Res. 2012; 46 (6): 513-518.
Published
2015-04-13
How to Cite
MATTHEWS, Francisca.
Use of sugar-free gum as complement in the prevention of dental caries. Narrative review..
Journal of Oral Research, [S.l.], v. 4, n. 2, p. 129-136, apr. 2015.
ISSN 0719-2479.
Available at: <https://joralres.com/index.php/JOralRes/article/view/joralres.2015.026>. Date accessed: 04 may 2024.
doi: https://doi.org/10.17126/joralres.2015.026.
Issue
Section
Reviews
Keywords
Chewing gum; Caries; Carbohydrates; Primary prevention.
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