Chewing Gums and Dental Health

Did you know that chewing gums can promote dental health?

Abstract

Chewing gum has been a part of human culture since ancient times, evolving from natural substances to the wide variety of flavors and types available today. While often considered a means for freshening breath or as a distraction from hunger or boredom, chewing gum also holds potential benefits for dental health. This blog post delves into the relationship between chewing gums, specifically sugar-free varieties, and their impact on dental health.

The Historical Context of Chewing Gum

The tradition of chewing gum dates back thousands of years (1), with evidence at an archeological site in Sweden, where lumps of birch bark tar with tooth impressions of children and adolescents, dating back 9,000 years, have been found . This suggests that early forms were derived from birch bark tar and other natural substances. The ancient Greeks seemed to have chewed on a similar substance, known as mastic, from which the word “mastication” likely derives. Native American Indians and Inuit chewed gum from spruce trees, a custom adopted by the Europeans who settled in New England. In India, the precursor for chewing gums was betel nuts; while in China it was ginseng, and early settlers in USA preferred tobacco leaves. These ancient practices laid the groundwork for the modern chewing gum industry, which now offers products ranging from sugar-laden options to those sweetened with non-cariogenic polyols like xylitol.

Types of chewing gums

Chewing gums can be divided into three types (2):

1. Sugar containing chewing gums
2. Sugar free chewing gums
3. Functional chewing gums

Let us delve deeper into each of these and see which one has what effects on the oral health.

Oral effects of Sugar containing Gums

Monosaccharides and disaccharides are used in sugar-containing chewing gum. These fermentable carbohydrates can be metabolized by oral bacteria. The bacteria (particularly S. mutans and Lactobacillus spp.) in turn produce dental biofilm and acid, which can lead to enamel demineralization and caries. (3). Hence, sugar containing gums are best avoided for oral health enhancement. The potential cariogenicity of sugar-containing gum depends on the physical consistency, oral retention time of the gum, the frequency with which it is chewed, and the sequence of consumption (for instance, chewing sugar-containing gum before eating foods that reduce acid production will be less cariogenic than the reverse)

Sugar-Free Gum: A Friend to Dental Health

As defined by the Food and Drug Administration (FDA), a food substance can be labeled as “sugar-free” if it contains less than 0.5 g of sugars per serving. (4) In place of sugar, these gums use high-intensity sweeteners such as

• aspartame
• acesulfame-K
• neotame
• saccharin
• sucralose or
• stevia. (5)

They also may be sweetened with sugar alcohols such as

• erythritol,
• isomalt,
• maltitol
• mannitol
• sorbitol, or
• xylitol. (5)

Salivary Stimulation and Acid Neutralization

One of the primary ways in which sugar-free chewing gum promotes oral health is through the stimulation of saliva production. Chewing triggers mechanical action and taste receptors in the mouth, leading to increased salivary flow. Simply chewing unsweetened, unflavored chewing gum basestimulates the salivary flow rate by 10-12 times that of the unstimulated rate. Saliva plays a crucial role in diluting and neutralizing acids produced by plaque bacteria on teeth surfaces. These acids can lead to enamel erosion and cavities over time. Furthermore, saliva contains calcium and phosphate ions that contribute to the remineralization process of tooth enamel. Clinical trials have found decreased caries incidence in subjects who chewed sugar-free gum for 20 minutes after meals. (6)