Sugar-free chewing gum and dental caries: a systematic review

Authors

  • Steffen Mickenautsch University of the Witwatersrand; Division of Public Oral Health
  • Soraya Coelho Leal University of Brasília
  • Veerasamy Yengopal University of the Witwatersrand; Division of Public Oral Health
  • Ana Cristina Bezerra Catholic University of Brasilia; School of Dentistry
  • Vanessa Cruvinel Catholic University of Brasilia; School of Dentistry

DOI:

https://doi.org/10.1590/S1678-77572007000200002

Keywords:

Sugar free, Chewing gum, Caries, Xylitol, Sorbitol, Remineralisation

Abstract

OBJECTIVE: To appraise existing evidence for a therapeutic / anti-cariogenic effect of sugar-free chewing gum for patients. METHOD: 9 English and 2 Portuguese databases were searched using English and Portuguese keywords. Relevant articles in English, German, Portuguese and Spanish were included for review. Trials were excluded on lack of randomisation, control group, blinding and baseline data, drop out rate >;33%, no statistical adjustment of baseline differences and no assessment of clinically important outcomes. Reviews were excluded on lack of information, article selection criteria, search strategy followed, search keywords, searched databases or lack of study-by-study critique tables. In cases of multiple reports from the same study, the report covering the longest period was included. Two reviewers independently reviewed and assessed the quality of accepted articles. RESULTS: Thirty-nine articles were included for review. Thirty were excluded and 9 accepted. Of the 9 accepted, 2 trials of reasonable and good evidence value did not demonstrate any anti-cariogenic effect of sugar-free chewing gum. However, 7 articles, with 1 of strong, and 6 of good evidence value, demonstrated anti-cariogenic effects of chewing Sorbitol, Xylitol or Sorbitol/Xylitol gum. This effect can be ascribed to saliva stimulation through the chewing process, particularly when gum is used immediately after meals; the lack of sucrose and the inability of bacteria to metabolize polyols into acids. Conclusion: The evidence suggests that sugar-free chewing gum has a caries-reducing effect. Further well-designed randomised trials are needed to confirm these findings.

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Published

2007-04-01

Issue

Section

Review

How to Cite

Sugar-free chewing gum and dental caries: a systematic review . (2007). Journal of Applied Oral Science, 15(2), 83-88. https://doi.org/10.1590/S1678-77572007000200002