The Journal of the American Dental Association
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J Am Dent Assoc, Vol 139, No 5, 553-563.
© 2008 American Dental Association

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CLINICAL PRACTICE

The Potential of Dental-Protective Chewing Gum in Oral Health Interventions



Kiet A. Ly, MD, MPH, Peter Milgrom, DDS and Marilynn Rothen, RDH, BS

Background. The authors provide an overview of chewing gum as a delivery vehicle for dental-protective agents, highlighting xylitol and its potential application in caries-prevention programs for children.

Types of Studies Reviewed. The authors reviewed selected clinical investigations and previous reviews associated with chewing gum containing substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol and their effects on reducing caries. They searched the MEDLINE database by using the key words "dental caries," "oral health," "calcium," "bicarbonate," "carbamide," "chlorhexidine," "fluoride" and "xylitol."

Results. Chewing gum is being used as a delivery vehicle for substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol to improve oral health and reduce caries. These substances exhibit properties that are protective of the oral environment and mediate common oral diseases. The debate for advocating xylitol use in caries prevention is advancing; however, chewing gum use by young schoolchildren in the United States is hindered by choking hazard concerns and lack of specific xylitol dosing recommendations.

Clinical Implications. The use of chewing gum containing dental-protective substances, particularly xylitol, in caries-prevention programs can reduce the tooth decay epidemic. Chewing gum use by children in the school setting should be reconsidered.

Key Words: Chewing gum; public health; oral health; caries; polyols; xylitol

Abbreviations: {Delta}DMFS: Change in decayed, missing and filled surfaces. • CHX: Chlorhexidine. • CPP-ACP: Casein phosphopeptide-amorphous calcium phosphate. • defs: Decayed, extracted and filled surfaces. • DMFS: Decayed, missing and filled surfaces. • FDA: U.S. Food and Drug Administration. • x/s: Xylitol-sorbitol.







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