WHAT do Trident, Icebreakers, Stride, Orbit, Pure, Mentos, Tic Tac, and Life Savers have in common? They are all chewing gum containing xylitol, which is a healthy sweetener. For centuries, it has been known that salivation contributes positively to oral hygiene by literally washing away the colonies of caries-producing germs that constantly proliferate on the tooth’s surface. Chewing gum originated with keeping a smooth pebble in the mouth to resist bad breath.

The diet, and by the pattern of its consumption by the host, play a crucial role in oral health. Its dependency on fermentable dietary carbohydrate (sugar) ingestion is beyond question. However, caries do not occur in germ-free animals, no matter what their diet, thus establishing it as a fundamental microbiological disease. Based on these facts, researchers are working consistently to identify new ways to combat tooth decay.

The merits of chewing gum concerning preventing tooth decay are well-publicised. Literature and TV advertisements refer to saliva’s buffer effects on dental plaque; everyone knows that chewing gum provokes salivary flow. But there is a new mechanism whereby chewing gum helps prevent caries. That aspect has to do with the actual composition of the chewing gum. Several studies of humans have examined the effects of partial or total sugar substitution by xylitol in chewing gum. Xylitol is sweet but is not a fermentable sugar. Actually, it is chemically classified as an alcohol.

As part of the famous Turku Sugar Studies, a comparison of caries experience was made among three groups of adults whose diets contained diverse foods in which fructose-substituted-for sucrose, xylitol-substituted-for sucrose, or the usual sucrose-containing foods were exclusively consumed. The results after two years, supported by various microbiological, salivary and other observations, demonstrated dramatic reduction of decay incidence, about 85 percent compared with the ordinary sugar diet.
Studies clearly demonstrate the non-cariogenicity of gum with high xylitol (65 percent) content. They also suggested that such chewing gums were caries inhibitors, despite the limited time and quantity and exposure of the dentition to the gum. Of course, it should be recognised that chewing gum would seem to be an ideal vehicle for delivering caries-inhibitory substances at relatively high concentrations to the surfaces of the teeth, although the quantities ingested may be very small.

The factors conducive to tooth decay are remarkably localised to the surfaces of the teeth. They are plaque, its bacterial population, the acid produced from sugar in the plaque in juxtaposition to the tooth surface, and the sugar challenge to the plaque flora.

Finally, certain factors should be involved with chewing gum for the sake of oral hygiene. The chewing gum must contain xylitol sweetener instead of sugar. The content of xylitol should be high, that is, over 60 percent because it is the xylitol specifically attacks the germ (strep mutans) which causes tooth decay. The gum should be chewed for at least a total of 20 minutes a day. This implies that one may chew the gum four times for five minutes during the entire day to derive the maximum effect. Now, even tooth-whitening gum is sold on the local market.