Don't Burst Your Bubble: Sugar-free gum can reduce caries, study finds

A recent study from King’s College London published this week in the Journal of Dental Research: Clinical & Translational Research suggests sugar-free gum could actually reduce the development of dental caries in adults and children.

The study found evidence that chewing sugar-free gum can stop the progress of caries. It could also be used as a preventative, the report says.

The goal of the study was to discern the difference in the level of dental caries in adults and children who chew sugar-free gum compared to those who do not chew sugar-free gum or use other alternatives such as lozenges, candies, rinses, and tablets.

Authored by seven Faculty of Dentistry in the Oral & Craniofacial Sciences department at King’s College London, the report analyzed 50-years worth of published studies. Out of those initial studies examined, the authors found 12 which discussed the impact of sugar-free gum on oral health, particularly focusing on dental caries in adults and children. The sugar-free gum was found to incrementally reduce caries, giving it a preventative fraction of 28 percent, the study says.

“There is a considerable degree of variability in the effect from the published data and the trials included were generally of moderate quality,” says Professor Avijit Banerjee, Professor of Cariology & Operative Dentistry at King’s College London and one of the authors of the new study. “However, we felt there was a definite need to update and refresh existing knowledge about sugar-free gum and its effect on dental caries and oral health. We are planning further research to determine the acceptability and feasibility of using this method in public health.”

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Of the eight clinical trials included in the study that used xylitol gum only as the basis of the intervention, the preventative fraction was 33 percent and no adverse effects were reported, the report says. 

“Both the stimulation of saliva which can act as a natural barrier to protect teeth, and the mechanical plaque control that results from the act of chewing, can contribute to the prevention of dental caries. Sugar-free gum can also act as a carrier for antibacterial ingredients including xylitol and sorbitol. No recent conclusive evidence existed prior to this review that showed the relationship between slowing the development of caries and chewing sugar-free gum,” Professor Banerjee says.

This research was supported by a grant from Mars Wrigley and the Wrigley Oral Healthcare Program, which partners with dental professionals to improve their patients’ oral health by supporting independent clinical research and professional development, funding local dental associations, and developing educational materials.

“This new King’s College London study reinforces the important role sugar-free gum can play in improving oral health for people around the world,” Dr. Mike Dodds, lead oral health scientist at Wrigley Oral Healthcare Program says in response to the study’s results. “As our lifestyles and eating behaviors have evolved over time it is important that we look beyond brushing alone to find additional ways to protect our teeth and mouth as part of a regularly exercised oral care routine.”

Gum is considered to be ‘sugar-free’ as long as it contains less than 0.5 grams of sugar per serving, according to the ADA. Sweeteners such as acesulfame-K, aspartame, neotame, saccharin, sucralose or stevia are used in place of sugar. Sugar alcohols such as erythritol, isomalt, maltitol, mannitol, sorbitol, or xylitol are also commonly used as a replacement sweetener, the ADA says.

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The findings of the new study confirm what has been widely viewed as an acceptable practice in the prevention of periodontitis. Both the Centers for Disease Control and the World Dental Federation include chewing sugar-free gum as a beneficial oral health habit.

Chewing gum is also said to increase salivatory flow, with sugar-free gum stimulating the salivatory flow rate by 10-12 times versus unstimulated rate, according to the ADA.

“Stimulated saliva flow provides protection against dental erosion via several mechanisms,” the ADA says. “Saliva buffers the effects of acids in foods or drinks that could otherwise soften teeth’s enamel surface, and swallowing excess saliva created by stimulation clears acid.”

“Now is not the time to be complacent,” Dr. Dodds says. “Research is continuing to show us the connections between oral and general health and wellbeing. This study is a timely reminder of the role sugar-free gum can play in helping improve dental health in both developed and developing countries. It also highlights the possible acceptability and feasibility of the use of sugar-free gum as an effective public health intervention.”

For a list of sugar-free chewing gum that has been awarded the ADA Seal of Acceptance, visit http://bit.ly/ADASugarFree.