Sugarfree Gum: How It Can Benefit Oral Health

Chewing gum has been around for hundreds of years, and we have all dealt with it in some form or fashion. It could be that your child enjoys chewing gum while trying to perfect his or her bubble-blowing skills. Maybe you have unpleasantly found it by stepping in the sticky goo while walking through a parking lot. Many keep gum stashed in their pockets or purses as a quick way to freshen their breath, particularly after a meal ridden with garlic or onions. Or, just maybe you have stuck a piece of chewed gum to the infamous Market Theater Gum Wall in Seattle. Either way, gum has played a minuscule role in your life.

Did you know that chewing gum is actually beneficial when it comes to your oral health? Studies have shown that chewing sugar-free gum daily can reduce plaque and prevent caries.

History of Chewing Gum

The Greeks were known to chew a plant-derived substance called mastich, while the Scandinavians chewed birch-bark tar thousands of years ago.¹ However, it was the Aztecs and Mayans who created chewing gum from chicle, a resin from the sapodilla tree. By slicing the bark, they were able to extract the resin, cook it, and dry it to create gum. This gum served to freshen the breath, quench thirst, and put off hunger. Interestingly, they thought chewing gum in public was socially unacceptable for adults, particularly men.

An American inventor, Thomas Adams Sr. acquired a load of chicle from an exiled Mexican president and began boiling and hand rolling it into chewing gum. By the 1880s, he was producing five tons of chewing gum daily.¹

Around the same time, a soap salesman named William Wrigley came out with a marketing strategy to give free chewing gum to soap vendors who placed large orders. It was when he realized that the chewing gum was more popular than the soap that he developed the William Wrigley Jr. Company.

Chewing gum today is mainly comprised of petroleum, wax, and other substances.¹ Annually, 364 billion pieces of gum are sold worldwide, which comprises 187 billion hours of chewing if each piece is chewed for 30 minutes.² Chewing gum sweetened with sucrose decreases the oral pH and increases the risk of decay.  In the 1950s, a dentist by the name of Dr. Petrulis developed the first sugar-free gum.²

The Benefits of Xylitol

Sugar-free gum is often sweetened with xylitol, a natural sweetener found in fruits and vegetables. This five-carbon sugar polyol is widely researched and globally accepted by the US Food and Drug Administration (FDA) and the American Academy of Pediatric Dentistry.³  Xylitol helps eliminate the growth of Streptococcus mutans, which is the harmful oral bacteria that is responsible for tooth decay.³  Xylitol contributes to the promotion of remineralization by increasing the salivary flow and a rise in pH, as well as decreasing plaque.

Studies report that children who chewed gum containing xylitol had significantly lower caries progression than those who did not.³ “Studies show that an ideal range of xylitol use for prevention of caries in adults is approximately 6.9 to 10.3 grams spread throughout each day, which is about two tsp.”⁶

Research reports that when chewing gum, the salivary flow is stimulated from a resting value of 0.4-0.5ml/min to 5-6ml/min.⁴ The stimulation increases the amount of bicarbonate in the saliva, which in turn raises the pH and acts as a buffer in the oral cavity. Acidic environments allow for increased risk of carious lesions; thus, the importance of balancing the oral pH is vital for optimal oral health. A large and sustained rise in plaque pH when gum was chewed after ingesting sugar has been thoroughly confirmed in many studies conducted in respected laboratories around the world.⁴

Besides controlling the pH, saliva is saturated with ions that the teeth are comprised of (calcium, phosphate, and hydroxyl ions) when the pH is above 5.5. A pH below this value causes the tooth to deteriorate. When the pH is within the critical level or higher, the ions repair the damaged mineral crystals in the enamel through a process called remineralization.

Essentially, any time a sugar component is introduced into the mouth, bacteria metabolizes those sugars and produces a byproduct, acid, which demineralizes enamel. The introduction to acidic food and drinks is another culprit that lowers pH in the mouth, making the conditions vulnerable. By raising the pH with salivary stimulation, the ions can saturate the tooth and begin the process of repair or remineralization.

Xerostomia, or dry mouth, is induced by chemotherapy, radiation treatment, particular disease/disorders, aging, and from a plethora of pharmaceuticals. It is estimated that up to 10% of the general population experiences xerostomia.⁵ Because chewing gum stimulates saliva, chewing sugar-free gum is a temporary resolution. In fact, some oral care companies have developed gums particularly for this purpose. Studies report that the initial stimulated salivary flow rate while chewing sugar-free gum is seven times greater than the unstimulated flow rate making it one of the most preferred treatments for xerostomia.⁴

Conclusion

Chewing a sugar-free, xylitol-containing gum, particularly after eating, appears to decrease the chance of carious lesions. While there is a lot more involved in maintaining oral health, chewing gum can certainly not hurt. Keep in mind that the excess chewing of gum can create temporomandibular disorders and, therefore, should be done in moderation. The least you can accomplish is fresh breath, and that’s a win, either way, you chew it.

Now Listen to the Today’s RDH Dental Hygiene Podcast Below:

References

1. Fiegl, A. (2009, June 16). A Brief History of Chewing Gum. Smithsonian Magazine. Retrieved from https://www.smithsonianmag.com/arts-culture/a-brief-history-of-chewing-gum-61020195/
2. Imfeld, T. Chewing Gum-Facts and Fiction: A Review of Gum-chewing and Oral Health. Critical Reviews in Oral Biology and Medicine: An Official Publication of the American Association of Oral Biologists. 1999; 10(3): 405-19. doi:10.1177/10454411990100030901.
3. Nayak, P.A., Nayak, U.A., Khandelwal, V. The Effect of Xylitol on Dental Caries and Oral Flora. Clinical, Cosmetic and Investigational Dentistry. 2014; 6: 89-94. doi:10.2147/CCIDE.S55761.
4. Edgar, M., et al. A Clinical Overview of Sugarfree Gum in Oral Health. American Dental Hygienists’ Association. Retrieved from https://www.adha.org/resources-docs/7161_Clinical_Overview_of_Sugarfree_Gum.pdf
5. Cox, P.C. (2018, September 14). Xerostomia: Recognition and Management. Colgate Professional. Retrieved from https://www.colgateprofessional.com/education/professional-education/topics/caries/xerostomia-recognition-and-management
6. Pierce, K. (2019, December 25). All about Xylitol, the New Sugar: Sweetness with Benefits. Today’s RDH. Retrieved from https://www.todaysrdh.com/all-about-xylitol-the-new-sugar-sweetness-with-benefits/