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Dental Tribune Middle East & African Edition Jan. 2015

Dental Tribune Middle East & Africa Edition | February 2015 37ORAL HEALTH < Page 36 remineralisation.33, 34 Calcium lactate added to chewing gum has also been shown to provide an enhanced remineralisation benefit.35, 36 Potential negative effects of chewing gum It is worth acknowledging that there are some concerns over chewing gum use, including its potential to be a choking hazard in young children, be subject to littering, and exert a laxative effect. Consumers should be re- minded not to give gum to chil- dren younger than school age and to dispose of chewed gum responsibly. The laxative thresh- old of most polyol sweeteners used in gum is typically more than 15 g/day, which would require consumption of 10 or more sticks of chewing gum per day to achieve. Conclusion The scientific evidence support- ing the non-specific benefits of chewing sugar-free gum has been reviewed and endorsed by key dental organizations across the globe including FDI (World Dental Federation), the ADA (American Dental Association) and the EFSA (European Food Safety Authority). Traditionally, preventive dentistry has focused on sugar restriction, plaque re- moval/oral hygiene, fluoride usage, fissure sealants and edu- cation. More recently, these ap- proaches have been modified by improved diagnostic methods to allow early identification of disease, together with an accu- rate assessment of disease activ- ity. There is an opportunity for chewing gum to be considered as another preventive modality to provide an additional layer of prevention by helping maintain the oral ecology in high and low- er risk individuals and popula- tions.Whilstitisnottheintention of this article to provide clinical guidelines for the use of sugar- free chewing gum, the aim is to inform practitioners so they can accurately answer his or her pa- tients’ questions regarding this topic and be able to provide ap- propriate guidance about chew- ing sugar-free gum and it’s oral health benefits when used as a complement to usual oral care regimens. While chewing gum may not be a treatment for oral diseases, by helping generate a healthy flow of saliva, it may help offset the perturbations in the oral ecology that lead to clin- ical disease states. References 1. Burt BA. The use of sorbitol- and xylitol-sweetened chewing gum in caries control. J Am Dent Assoc. 2006 Feb;137(2):190-6. 2. Deshpande A, Jadad AR. The impact of polyol-containing chewing gums on dental caries: a systematic review of original randomized controlled trials and observational studies. J Am Dent Assoc. 2008 Dec;139(12):1602-14 3. Edgar WM. Sugar substitutes, chewing gum and dental caries- -a review. Br Dent J. 1998 Jan 10;184(1):29-32. 4. Imfeld T. Chewing gum- -facts and fiction: a review of gum-chewing and oral health. Crit Rev Oral Biol Med. 1999;10(3):405-19. 5. Mickenautsch S, Leal SC, Yengopal V, Bezerra AC, Cruvi- nel V. Sugar-free chewing gum and dental caries: a systematic review. J Appl Oral Sci. 2007 Apr;15(2):83-8. 6. Twetman S. Consistent evi- dence to support the use of xy- litol- and sorbitol-containing chewing gum to prevent den- tal caries. Evid Based Dent. 2009;10(1):10-1. 7. Dawes C, Macpherson LM. Effects of nine different chew- ing-gums and lozenges on sali- vary flow rate and pH. Caries Res. 1992;26(3):176-82. 8. Dawes C, Kubieniec K. The ef- fects of prolonged gum chewing on salivary flow rate and com- position. Arch Oral Biol. 2004 Aug;49(8):665-9. 9. Fu Y, Li X, Ma H, Yin W, Que K, Hu D, Dodds MWJ, Tian M. As- sessment of chewing sugar-free gums for oral debris reduction: a randomized controlled cross- over clinical trial. Am J Dent. 2012;25(2):118-22. 10. Manning RH, Edgar WM. pH changes in plaque after eat- ing snacks and meals, and their modification by chewing sug- ared- or sugar-free gum. Br Dent J. 1993 Apr 10;174(7):241-4. 11. Park KK, Schemehorn BR, Bolton JW, Stookey GK. Effect of sorbitol gum chewing on plaque pH response after ingesting snacks containing predominant- ly sucrose or starch. Am J Dent. 1990 Oct;3(5):185-91. 12. Dodds MWJ, Hsieh SC, John- son DA. The effect of increased mastication by daily gum-chew- ing on salivary gland output and dental plaque acidogenicity. J Dent Res. 1991 Dec;70(12):1474- 13. Jenkins GN, Edgar WM. The effect of daily gum-chewing on salivary flow rates in man. J Dent Res. 1989 May;68(5):786- 90. 14. Bots CP, Brand HS, Veerman EC, Valentijn-Benz M, Van Am- erongen BM, Nieuw Amerongen AV, Valentijn RM, Vos PF, Bijlsma JA, Bezemer PD, ter Wee PM. The management of xerostomia in patients on haemodialysis: comparison of artificial saliva and chewing gum. Palliat Med. 2005 Apr;19(3):202-7. 15. Davies AN. A comparison of artificial saliva and chew- ing gum in the management of xerostomia in patients with ad- vanced cancer. Palliat Med. 2000 May;14(3):197-203. 16. Creanor SL, Strang R, Gil- mour WH, Foye RH, Brown J, Geddes DA, Hall AF. The ef- fect of chewing gum use on in situ enamel lesion remin- eralization. J Dent Res. 1992 Dec;71(12):1895-900. Full list of references is available from the author. www.wrigleyoralcare.com LOOKING FOR THE HIGHEST QUALITY HANDPIECE AT THE LOWEST PRICE? YOU FOUND IT! 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