WHAT ROLE DOES CHEWING GUM HAVE ON YOUR ORAL HEALTH

Chewing gum is a common habit among people globally, used to freshen up one’s breath or to enjoy the flavor. Thousands of years ago, people chewed gum in its natural form, directly taken from the sap of trees. Later in the 19th century, commercial chewing gums were made by adding softeners, sweeteners, and flavoring agents. 

According to a statistic, around 374 billion chewing gum pieces are sold every year globally. In 2020, ~ 160 million Americans were reported to consume chewing gums.

The benefits of chewing gum have been hotly debated and its impact on oral health is not clear. In this article, we help you understand the benefits and harm caused by chewing gum on your oral health. 

What are the different types of chewing gums and what are they made up of? 

In the U.S, chewing gum can be broadly divided into sugar-containing and sugar-free gums. 

Sugar-containing gums are composed of gum bases (resins, humectants, elastomers, emulsifiers, fillers, waxes, antioxidants, and softeners), sweeteners, and flavoring agents. Beet sugar or cane sugar and corn syrup color are commonly used as sweeteners. Mint plants and a variety of fruit and spice essences are used as flavoring agents. 

Meanwhile, in the sugar-free gums, sugar alcohols such as xylitol, erythritol, mannitol, sorbitol, isomalt, maltitol, etc. along with artificial sweeteners such as saccharin, aspartame, acesulfame-K, cyclamate, etc. These sweeteners are not easily metabolized by decay-causing oral bacteria. This lowers the risk of acid production which causes tooth decay. Additionally, sugar-free gums provide 2-5 calories a piece compared to 10 calories for sugar-containing gums. So, sugar-free gums are considered better than sugar-containing gums. 

What are the benefits of chewing gum?

Here are some of the benefits of sugar -free chewing gums.

• Increase the salivary flow: Chewing gums stimulate the salivary glands (the organ that produces saliva) which increases the flow of saliva (resulting in ~10-12-fold increase). Increased salivary flow flushes away the leftover food debris on or between the tooth surfaces. This helps to maintain oral hygiene. In addition, buffering action of saliva (due to high bicarbonate concentration) neutralizes the acids present in the mouth which weaken the tooth surface. The use of both sugar-containing gum and sugar-free gum increases the salivary flow. However, the sugar present in sugar-containing gums is used by bacteria in the mouth to produce acids that weaken the tooth surface, causing decay.              
• Increase the remineralization of weakened tooth surfaces: The chewing gums increase the saliva flow which carries high levels of calcium and phosphate ions. These ions help in the remineralization of initial tooth decay. Even the presence of fluoride ions in saliva strengthens the tooth enamel, making it resistant to tooth decay. Overall, remineralization helps to build the mineral composition of the tooth, reverse the initial tooth decay, and strengthen the enamel. 
• Reduce the external staining on teeth: Chewing gums reduce the external tooth stain either by removing the existing stain or by inhibiting its formation. This can be achieved by the addition of chemicals such as tripolyphosphate and pyrophosphate in the chewing gums. Additionally, the flushing action of the chewing gum-stimulated saliva doesn’t allow staining agents such as tea, coffee, or wine to stay on the tooth surface for a long, inhibiting the stain formation. Research suggests that chewing sugar-free gum multiple times a day for more than 4 weeks prevents or removes external stains. 
• Reduce plaque: Research suggests that chewing gums reduce the quantity of plaque (slimy layer of bacteria present on the tooth) on the tooth surface. However, only a small quantity of plaque is reduced.  
• Reduce the dryness of mouth: Chewing sugar-free gum increases salivation and helps individuals with a dry mouth or the feeling of dry mouth. 
• Reduce bad breath (malodor): Regular chewing of sugar-free gums reduces the production of volatile sulfur compounds which are known to cause bad breath. Additionally, the incorporation of agents such as zinc in the sugar-free gums further reduces the bad breadth either by interfering with volatile sulfur compounds or by targeting bacteria causing malodor. 

What are the drawbacks of chewing gum?

Here are some of the drawbacks of sugar-containing gum and sugar-free gum:

• Sugar-containing chewing gum

Sugar-containing chewing gum contains sucrose, a natural sugar. Sucrose is easily broken down by oral bacteria, producing acids. These bacteria also produce a slimy layer that attaches to the tooth surface (dental biofilm) which becomes the breeding ground for bacteria. The production of acids and the formation of biofilm damage the tooth enamel and cause decay. The ability of sugar-containing chewing gum to create tooth decay depends on factors such as consistency, frequency, and duration of chewing gum along with the sequence of consumption (chewing gum before or after eating food). 

• Sugar-free chewing gum

  Sugar-free chewing gum is usually beneficial to oral health. However, here are a few concerns:
  • Research suggests that the use of artificial sweeteners for a long time may have adverse implications on overall health.
  • Excessive chewing of gum (most of the hours in a day) may cause continuous stress on the jaws. This can lead to temporomandibular joint disorders which cause pain in the jaws while opening or closing the mouth.
  • The continuous chewing of gum doesn’t allow the stomach to rest, increasing the stress levels in the stomach. 

What is the best time to have sugar-free chewing gum?

Chewing sugar-free gum after a meal increases the salivary flow by stimulating the taste receptors and salivary glands. This helps in flushing away of food debris and oral hygiene maintenance. 

How many chewing gums are ok to have?

It’s better to limit the consumption of sugar-free gums to 5-6 pieces per day. Excess consumption of chewing gums may cause diarrhea. This is due to the poor absorption of sugar substitutes which potentially have a laxative effect.  

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References:

• Déadach na hÉireann IC. The oral health benefits of chewing gum. Journal of the Irish Dental Association. 2012 Oct;58(5):253-61.
• Leveille G, McMahon K, Alcantara E, Zibell S. Benefits of chewing gum: oral health and beyond. Nutrition Today. 2008 Mar 1;43(2):75-81.
• Mujib AB, Grover S, Vinayak V, Mittal S, Kumar M. Chewing gum and oral health. Indian Journal of Contemporary Dentistry. 2013;1(1):72.
• Aravinth H, Ganapathy D, Jain AR. Role of chewing gum in oral hygiene maintenance. Drug Invention Today. 2018 Oct 2;10.
• Wessel SW, van der Mei HC, Maitra A, Dodds MW, Busscher HJ. Potential benefits of chewing gum for the delivery of oral therapeutics and its possible role in oral healthcare. Expert opinion on drug delivery. 2016 Oct 2;13(10):1421-31.
• Wessel SW, van der Mei HC, Maitra A, Dodds MW, Busscher HJ. Potential benefits of chewing gum for the delivery of oral therapeutics and its possible role in oral healthcare. Expert Opin Drug Deliv. 2016 Oct;13(10):1421-31.
• https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/chewing-gum
• https://www.mouthhealthy.org/en/az-topics/c/chewing-gum
• https://www.colgate.com/en-us/oral-health/nutrition-and-oral-health/is-chewing-gum-good-for-your-teeth#
• https://www.dentalhealth.org/sugar-free-chewing-gum

• https://www.nature.com/articles/bdjteam2015151.pdf

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