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Medical Forum / General / Dentistry / October 2006Bubble gum with fruit juice and xylitol
I'm used to chewing sugar free gum with xylitol after meals, the gum claims to be recommended by the FDI. But now my kids have discovered a bubble gum which they love, which is sugar free and contains xylitol (5%), however it also contains fruit juice (3%) and citric acid. Is this bubble gum likely to be good, bad or neutral as far as dental health goes? TIA -- Andy > I'm used to chewing sugar free gum with xylitol after meals, the gum claims to be > recommended by the FDI. [quoted text clipped - 8 lines] > -- > Andy Other than muscle fatigue issues, most bubble gums (even sugared ones) are little risk for caries. By the same token, xylitol is far from a panacea. So from the caries point of view, it's fairly neutral (I'll hedge a bit because I haven't seen any real figures for xylitol. But the same issues that make sugar a small risk in bubble gum--the fact that it has little substantivity and is cleared from the mouth clearly--are likely to limit the prophylactic effects of xylitol too). Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > > I'm used to chewing sugar free gum with xylitol after meals, the gum claims to be > > recommended by the FDI. [quoted text clipped - 13 lines] > that it has little substantivity and is cleared from the mouth > clearly--are likely to limit the prophylactic effects of xylitol too). Thanks. If the bubble gum itself is neutral then presumably chewing it after a meal, or after eating a chocolate bar/candy etc is beneficial as it'll help clear sugar & acid from the mouth? -- Andy >>>I'm used to chewing sugar free gum with xylitol after meals, the gum claims to be >>>recommended by the FDI. [quoted text clipped - 25 lines] > -- > Andy I don't think chewing gum gives you license to eat other sugar-rich foods without brushing and flossing afterwards. If you can't brush, vigorous rinsing with water will help clear cariogenic debris away until you can brush. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Thanks. If the bubble gum itself is neutral then presumably chewing it after a meal, >> or after eating a chocolate bar/candy etc is beneficial as it'll help clear sugar & [quoted text clipped - 9 lines] > >Steve 008, licensed to chew ;-]] > > Thanks. If the bubble gum itself is neutral then presumably chewing it after a meal, > > or after eating a chocolate bar/candy etc is beneficial as it'll help clear sugar & > > acid from the mouth? > > I don't think chewing gum gives you license to eat other sugar-rich > foods without brushing and flossing afterwards. I'm not asking if it does! I'm asking whether it is benefical to chew gum after eating, especially after eating sugary food, in a situation where brushing afterwards or even rinsing is not practical. -- Andy >>>Thanks. If the bubble gum itself is neutral then presumably chewing it after a >> [quoted text clipped - 17 lines] > -- > Andy I would be less than honest if I told you I'd read anything credible suggesting it has a protective effect I think I have heard xylitol gums making that claim however. I could guess, but it would just be speculatin'. Steve > >>>Thanks. If the bubble gum itself is neutral then presumably chewing it after a > >> [quoted text clipped - 18 lines] > suggesting it has a protective effect I think I have heard xylitol gums > making that claim however. I could guess, but it would just be speculatin'. OK, but regardless of the xylitol, isn't it accepted that chewing gum after eating helps clean the mouth of sugar/acids by stimulating saliva production? -- Andy >>>>> Thanks. If the bubble gum itself is neutral then presumably chewing it after a >>> meal, [quoted text clipped - 22 lines] > -- > Andy That is intuitive; however, I can't say that this has actually been demonstrated. Certainly it should be less destructive than a slow release of highly concentrated sugar (for example, lifesavers or hard candies). But while Dentine chewing gum used this rationale in their advertising for eons, I haven't seen the literature. Steve Here is a quick abstract about the effects of chewing gum on saliva. Archives of Oral Biology. 49(8):665-9, 2004 Aug. OBJECTIVE: To determine the effect of gum chewing for 2 h on salivary flow rate and composition. DESIGN: Five male and five females each collected whole saliva at intervals over a 2 h period on three separate days, prior to which they collected unstimulated saliva for 5 min. For one 2 h session they continued to collect only unstimulated saliva while for the others one tablet of Wrigley's Extra peppermint- or fruit-flavoured (peach) gum was chewed continuously. Flow rates were calculated and the saliva was assayed for pH and for Na, K, Ca, Cl, inorganic P and protein concentrations. The data were subjected to repeated-measures ANOVA and Duncan tests. RESULTS: When only unstimulated saliva was collected, there was no significant change in salivary flow rate over the 2 h. With the chewing gums the flow rate increased initially and then, after 35-40 min, fell to similar plateau values which remained significantly higher than the initial unstimulated flow rate and significantly higher than the flow rate at the corresponding time intervals when only unstimulated saliva was collected. With both gums the salivary pH from 2 min to 2 h was significantly higher than that of unstimulated saliva. The changes in the salivary electrolyte and protein concentrations due to the flow rate increase elicited by the chewing gum were largely as expected from previous studies on parotid and submandibular saliva. CONCLUSION: During prolonged chewing gum use, both salivary flow rates and pH remained significantly above the values for unstimulated saliva. >> >>>Thanks. If the bubble gum itself is neutral then presumably chewing >> >>>it after a [quoted text clipped - 32 lines] > -- > Andy I would run some medline searches. You can probably find a free engine on the internet to use. Here are two quick abstracts: Journal of Dental Research. 85(2):177-81, 2006 Feb. Xylitol is promoted in caries-preventive strategies, yet its effective dose range is unclear. This study determined the dose-response of mutans streptococci in plaque and unstimulated saliva to xylitol gum. Participants (n = 132) were randomized: controls (G1) (sorbitol/maltitol), or combinations giving xylitol 3.44 g/day (G2), 6.88 g/day (G3), or 10.32 g/day (G4). Groups chewed 3 pellets/4 times/d. Samples were taken at baseline, 5 wks, and 6 mos, and were cultured on modified Mitis Salivarius agar for mutans streptococci and on blood agar for total culturable flora. At 5 wks, mutans streptococci levels in plaque were 10x lower than baseline in G3 and G4 (P = 0.007/0.003). There were no differences in saliva. At 6 mos, mutans streptococci in plaque for G3 and G4 remained 10x lower than baseline (P = 0.007/0.04). Saliva for G3 and G4 was lower than baseline by 8 to 9x (P = 0.011/0.038). Xylitol at 6.44 g/day and 10.32 g/day reduces mutans streptococci in plaque at 5 wks, and in plaque and unstimulated saliva at 6 mos. A plateau effect is suggested between 6.44 g and 10.32 g xylitol/day. Journal of the American Dental Association. 137(2):190-6, 2006 Feb. BACKGROUND: The author compared the caries-inhibitory action of sorbitol- and xylitol-sweetened chewing gum and assessed the role of these products in caries prevention. TYPES OF STUDIES REVIEWED: The author reviewed studies including randomized field trials with substantial numbers of participants and observational studies. He did not review case studies. He found studies through a MEDLINE search and by hand searching. RESULTS: When compared with sugar-sweetened gum, sorbitol-sweetened gum had low carcinogenicity when it was chewed no more than three times per day. Xylitol-sweetened gum was noncariogenic in all of the protocols tested. Some studies claimed that xylitol-sweetened gum had an anticariogenic effect, though these claims need further study. There also is good evidence that when mothers of infants and young children chew xylitol-sweetened gum, it will block transmission of mutans streptococci from mother to child. CLINICAL IMPLICATIONS: The evidence is strong enough to support the regular use of xylitol-sweetened gum as a way to prevent caries, and it can be promoted as a public-health preventive measure. Chewing xylitol-sweetened gum, especially for patients who like chewing gum, can be fitted readily into a regimen that includes frequent fluoride exposure, good oral hygiene and regular dental appointments. [References: 45] > I'm used to chewing sugar free gum with xylitol after meals, the gum > claims to be [quoted text clipped - 12 lines] > -- > Andy > I would run some medline searches. You can probably find a free engine on > the internet to use. Here are two quick abstracts: [quoted text clipped - 16 lines] > streptococci in plaque at 5 wks, and in plaque and unstimulated saliva at 6 > mos. A plateau effect is suggested between 6.44 g and 10.32 g xylitol/day. Well, that's awfully dramatic. I'd like to see long-term caries data. I wonder what other changes in oral flora are found, esp. in long-term use. Steve > Journal of the American Dental Association. 137(2):190-6, 2006 Feb. > [quoted text clipped - 34 lines] >> -- >> Andy Acid. Bad. SignatureChristopher A. Young You can't shout down a troll. You have to starve them. . I'm used to chewing sugar free gum with xylitol after meals, the gum claims to be recommended by the FDI. But now my kids have discovered a bubble gum which they love, which is sugar free and contains xylitol (5%), however it also contains fruit juice (3%) and citric acid. Is this bubble gum likely to be good, bad or neutral as far as dental health goes? TIA -- Andy |
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