chewing gum

Does Chewing Gum Belong in Your Medicine Chest?

chewing gumXylitol is a sugar alcohol often found in sugarless gum. You’ve probably heard something about its potential to actively prevent cavities. What you might not know is that the evidence for its effectiveness is still not totally settled.

Last year, Cochrane Reviews published an analysis of 10 studies comparing products containing xylitol with various controls. Overall, the authors found

some low quality evidence to suggest that fluoride toothpaste containing xylitol may be more effective than fluoride-only toothpaste for preventing caries in the permanent teeth of children, and that there are no associated adverse-effects from such toothpastes. The effect estimate should be interpreted with caution due to high risk of bias and the fact that it results from two studies that were carried out by the same authors in the same population. The remaining evidence we found is of low to very low quality and is insufficient to determine whether any other xylitol-containing products can prevent caries in infants, older children, or adults.

This doesn’t sound a death knell for xylitol, though. It does suggest that better research needs to be done so we can more fully understand the consistently reported oral health benefits of xylitol. Among these, as we noted before, are its ability to

  • Keep S. mutans – one of the main pathogens involved in tooth decay – from clinging to teeth.
  • Reduce the growth of S. mutans.
  • Inhibit demineralization of tooth enamel.

Of course, its other benefit is that it’s not sugar and so can’t do the dental damage sugar can. Additionally, using something like xylitol gum will generate more saliva in the mouth, which itself helps protect your teeth.

Could that make xylitol gum a possible oral health intervention? A recent UK study looked at whether chewing xylitol gum might prevent the high cost of dental treatment by reducing decay in teens. The authors used current disease risk and chewing gum habits of English 12 year olds, as well as results from a 2001 Lithuanian study. (The 2001 research is notable because it was also reviewed and approved by Health Canada in 2014 for use in making caries risk reduction claims on sugar-free chewing gum.)

What did they find? An astonishing $1.4 to $11.6 million in savings to the UK National Health Service. Just from chewing more xylitol gum.

According to study author, Professor Elizabeth Kay,

The findings of this study are hugely exciting as they reveal a new and easy way of helping people improve their oral health. Clinical evidence has already proved that sugar-free gum can help prevent caries, and now we can see a clear financial advantage.

These findings mirror an older analysis (1996) that likewise found significant savings during the decade after gum use began, due to fewer first dental restorations needing to be placed.

Which leaves us with one question: If xylitol chewing gum can reduce the yearly cost of dental treatment, why do so many continue to be so dead-set on less effective measures such as fluoridation?

Image by Jun, via Flickr