Chewing Sugar-free Gum Prevents Cavities

I’ve had many patients ask me how to decrease their risk for cavities.  A simple way to avoid cavities is to chew sugarless gum for 15-20 minutes after eating a meal.  How does this help?

After you eat food your pH level in your mouth drops, making your mouth a more acidic environment. This gives bacteria a better environment to thrive in. Chewing sugar-free gum after eating enhances salivary flow. The increase in salivary flow enhances the buffering capacity of saliva to bring the pH in the mouth back to neutral more quickly. In addition, findings have suggested that chewing sugar-free gum after eating promotes remineralization and inhibits demineralization of tooth structure. Several studies have shown that those that chew sugar free gum after eating have a significant reduction in number of caries (cavities) when compared to a control group.

There are two main types of sugar-substitutes used in sugar-free gum.
1. Sorbitol
2. Xylitol
From a chemical standpoint they are both very similar and are classified as sugar alcohols. Sorbitol is less expensive for manufacturers, and thus tends to be more widely used. These two sugar alcohol’s can be separated by one important factor. Sorbitol is low-cariogenic vs xylitol which is non-cariogenic.
Low-cariogenic: this means that the item, in this case, sorbitol, has a low capacity to promote caries (cavities).
Non-cariogenic: something that is non-cariogenic actually inhibits caries formation, such as xylitol.
Both options would be a good option to replace regular gum, but in terms of caries prevention, a gum made with xylitol would be better.

Some xylitol-containing chewing gums for your caries prevention:
1. Spry Gum(this gum has the highest concentration, and thus most effective use of xylitol)
2. Emerald Forest Chewing Gum(this is also a good option)
3. Trident
4. Ice Breakers
*Although trident and ice breakers gum doesn’t offer as much xylitol as spry and emerald forest, they are easier to find at any drug store or grocery store and still should be incorporated as part of your caries prevention.

Chewing gum that has the American Dental Association seal of approval
1. Dentyne Ice Sugarless Gum
2. Stride Sugarless Gum
3. Trident sugar-free Gum
4. Wrigley’s Extra sugar-free Gum
5. Wrigley’s Orbit sugar-free Gum
*Although these contain the ADA seal, they do not necessarily all contain xylitol. Some of them contain sorbitol.

To reference a JADA article in 2006 titled, “The use of sorbitol- and xylitol-sweetened gum in caries control”:
‘The ability of chewing gum to aid in caries control comes from the chewing action itself—which stimulates saliva flow—and the noncariogenic sugar substitutes used as sweeteners. Sugared gum is cariogenic (meaning it causes caries aka cavities), so all gums used in caries-control regimens need to include a nonsugar sweetener. The rationale is that when sugar is plentiful in a person’s diet, cariogenic bacteria such as mutans streptococci thrive in plaque flora, but they can become suppressed when the person’s diet is low in sugars. Xylitol-sweetened chewing gums are being studied for their anticariogenic action—that is, whether they actively assist in remineralizing early carious lesions as opposed to playing just a neutral role.’

For more information click the following links:
Sorbitol vs Xylitol
The effects on chewing sugar free gum after meals on clinical caries
The use of sorbitol- and xylitol-sweetened chewing gum in caries control
Maintaining Mutans Streptococci Suppression
ADA’s List of Approved SF Gums