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8 Dental Tribune Middle East & Africa Edition | September - October 2013oral HYGiene 3399E VITA shade, VITA made. 40 years. 3 letters. 1 original. For generations VMK has been the synonym for metal ceramics. With the power of the original, VITA VMK is the benchmark for easy, safe and cost-efficient handling. With VITA VMK Master this is more true than ever. Thanks to its firing tempera- ture and chemical and physical characteristics, VITA VMK Master is best suited for the veneering of non-precious metal alloy frameworks. Furthermore, the standard layering continues to provide the most simple handling. VITA VMK Master stands above all for one thing: quality without compromise. www.vita-zahnfabrik.com facebook.com/vita.zahnfabrik The new VITA metal ceramic with the familiar layering you’re accustomed to. VITA VMK Master® Innovation in the third generation! Available in VITA SYSTEM 3D-M ASTER ® and VITA classical A1– D4 shades! 3399E_210x297 neu.indd 1 11.07.13 10:57 Oral Health Benefits Of Chewing Gum T he use of sugar-free gum provides a proven anti- caries benefit, but other oral health effects are less clearly elucidated. Oral health, par- ticularly caries-reducing, benefits of sugar-free chewing gums have been well documented in many studies and reviews.1-6 In addition, chewing gum is increasingly being viewed as a delivery system for active agents that could potentially provide direct oral care benefits. Chewing sugar-free chewing gum promotes a strong flow of stimulated saliva, which helps pro- vide a number of dental benefits; • the higher flow rate promotes more rapid oral clearance of sugars; • the high pH and buffering capacity of the stimulated saliva help neutral- ise plaque pH after a sugar challenge; • studies have shown enhanced rem- ineralisation of early caries-like le- sions and ultimately prospective clinical trials have shown reduced caries incidence in children chewing sugar-free gum. Scientific evidence shows that chew- ing gum has a place as an additional mode of dental disease prevention to be used in conjunction with the more traditional preventive methods. benefits of chewing sugar-free gum oral clearance and saliva stimula- tion, plaque pH neutralisation The major benefits of sugar-free chewing gum are mediated through oral physiology: stimulation of the salivary glands to produce a strong flow of saliva (a 10-12 fold increase over unstimulated saliva) is elicited by a combination of masticatory and gustatory stimuli.7 Although saliva flow rates are highest during the first five to seven minutes of chewing, when the sweeteners and flavour re- lease is maximal, a two-fold increase in flow rate (over unstimulated flow) is maintained for as long as the gum continues to be chewed.8 One of the immediate short-term ef- fects of this enhanced saliva flow is the increased clearance of sugars and food debris from the oral cavity.9 The higher flow rate, pH and buffer capac- ity of stimulated saliva further help neutralise acids found in the mouth, and in particular help raise the plaque pH.10,11 The short-term neutralisation of plaque pH out of the demineralisa- tion danger zone can also be supple- mented by medium-term benefits, as it has been shown that frequent chew- ing increases baseline (unstimulated) saliva flow rate and increases the rest- ing plaque pH and subsequent ability of the plaque to form acid from sug- ar.12, 13 Some studies have suggested that chewing gum is better tolerated than artificial saliva for symptomatic relief of xerostomia.14, 15 remineralisation and clinical caries reductions In addition to the pH neutralising effect, the increased rate of delivery of soluble calcium and phosphate ions from the stimulated saliva helps to remineralise surface enamel le- sions, as shown in a number of in situ remineralisation studies.16-19 Clinical studies conducted in children who chewed gum at least three times daily for two or three years show that they have significantly lower rates of de- cay than children who do not chew gum.20-22 Furthermore, these caries- reducing effects have been confirmed by systematic reviews.2, 5, 23 Indeed, the American Dental Association has re- cently provided clinical guidelines for the use of sucrose-free polyol chew- ing gums in high caries-risk children and adults.23 extrinsic stain reduction Chewing gum can reduce extrinsic tooth stain, either by removing exist- ing stain or inhibiting its formation,24 whilst the addition of specific active agents (typically polyphosphates) may provide additional efficacy.25, 26 However, it should be noted that these types of claims are cosmetic and do not directly affect oral health, and the magnitude of the effect is small com- pared to bleaching therapies. On the other hand, accelerated oral clearance of staining agents such as tea or cof- fee, by chewing gum stimulated saliva could conceivably reduce the forma- tion of extrinsic stain over time and help prolong the benefits of a dental prophylaxis. Interestingly, chewing gum has been found to counteract the short-term sensitivity associated with professionally-applied bleaching treatments,27 although the mecha- nism of this effect is not clear. effects on plaque and gingivitis There is evidence that regular use of chewing gum, in conjunction with normal oral hygiene procedures, pro- vides a slight, but significant, reduc- tion in plaque scores,28-30 although one other study did not show this ef- fect.31 In addition, two of these stud- by michael WJ dodds, bds, Phd, Wm. Wrigley Jr. company Excerpt from paper originally published in the Journal of the Irish Dental Association. ________________________ Michael WJ Dodds, BDS, PhD,Wm.Wrigley Jr. Company