I am writing regarding Dr. Frederick Curro’s May JADA supplement article, "Gum Chewing as an Adjunct to Use of Medications" (JADA 2008;139[2 suppl]:6S–8S) and Dr. Kiet Ly and colleagues’ May JADA article, "The Potential of Dental-Protective Chewing Gum in Oral Health Interventions" (Ly KA, Milgrom P, Rothen M. JADA 2008;139[5]:553–563).
Before organized dentistry too hastily endorses the habitual chewing of gum as implying (as Dr. Curro’s article suggests) systemic benefits such as improved alertness, headache relief and potential benefits in treating dementia and Alzheimer disease as well as caries reduction, it should reflect on its recent retreat of support for the purported existence of a causative relationship between periodontal disease and heart disease.
While the anticariogenic benefit of a normal, active saliva flow is unquestionable (and certainly no recent revelation), we have available very effective, proven means of controlling tooth decay with the appropriate use of fluorides, responsible dietary habits and conscientious oral hygiene practices. In my 36 years of dental practice, I’ve observed very effective control of dental caries when these factors are present, and there are no negative "side effects" from employing this regimen.
The endorsement of gum chewing as a daytime activity for school-aged children in the guise of a "public health benefit" in Dr. Ly and colleagues’ article strains the credibility of the profession. Habitual gum chewing has deleterious effects, including increased occlusal enamel wear as with other parafunctional habits, and the exacerbation of temporomandibular joint (TMJ) pain. Often, when a person with TMJ pain ceases a habit of frequent gum chewing, symptoms are completely or at least dramatically improved.
Another consideration is the unappealing prospect of a teacher facing a class of 30-odd adolescents gnashing on gum with the attendant noises and facial contortions. Educators clearly have enough impediments to their success for us to encourage another distraction. It is absurd to expect a teacher to monitor "the duration of the chewing and discarding."
Finally, just because a protocol reduces decay does not make it an infallible axiom of oral care. Full-mouth exodontia or cessation of eating also reduces dental caries dramatically.
