Colombian researchers have questioned the clinical benefits of sugar free chewing gum to prevent dental caries and gingivitis after a double-blind, randomized controlled trial. A scientist from Mondelez has doubted the findings.
Research by the Faculty of Dentistry at the University of Antioquia, Colombia, published in the journal Clinical Oral Investigations found no significant reduction in indicators for gingivitis and dental caries in a study with 130 people.
“The clinical significance of chewing gums as an adjunctive tool for daily oral care remained questionable,” said the researchers.
To reach these conclusions, 130 dental students were randomized into three groups: A control group with no gum, a group consuming a sorbitol and mannitol sweetened gum containing casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), and a group chewing xylitol sweetened non CPP-ACP gum.
Gums studied under the spotlight
CPP-ACP is derived from milk proteins and is known under the brand name Recaldent. Mondelez International has exclusive global rights for Recaldent in gum and candy, which it uses for Trident Xtra Care in the US, Canada and Mexico and in Thailand and Japan under the brand name ‘Recaldent’.
Mondelez claims the gum will not promote dental caries and helps tackle stains for a “white smile”.
Many companies produce xylitol sweetened gums, including market leader Wrigley under its Extra Ice and Orbit Complete brands.
The company says on its website that: “Xylitol is an ingredient with proven dental benefits including preventing plaque formation, and gives it a unique role in preventive strategies for dental health.”
In the study, the students chewing gums were told to chew two gum pellets for 20 mins three times a day after meals for 30 days. All groups were supplied a commercial fluoridated toothpaste and soft texture brush along with usage instructions.
Researchers analyzed saliva samples before and after the experiment.
They found that the CPP-ACP gum group showed a significant reduction in visible plaque score compared to baseline, but said this group also had a better score compared to other groups at baseline.
A similar trend was seen for xyltol gums and total salivary facultative bacterial load.
The researchers said that although the findings may indicate xylitol gum might have some impact on reducing certain types of bacteria “there was only a marginal, if any, benefit from the chewing gums under the study on some microbiological caries and gingivitis related variables”.
Mondelez scientist questions study design
Doris Tancredi, director of health & wellness for global gum & candy at Mondelez International, doubted the validity of the findings.
"The study design is poor because changes in bacterial flora may take longer to materialize as indicated by previously published studies," she told this site.
"The fact that one group had a better visible plaque score vs. baseline, but that the same group had a better score to begin with also indicates that the team did not design the study properly from the beginning. When you randomize into treatment group, you need to randomize so that the variables you are measuring are evenly distributed among the study groups."
Clin Oral Invest
‘Comparison of the effect of two sugar-substituted chewing gums on different caries- and gingivitis-related variables: a double-blind, randomized, controlled clinical trial’
Authors: María C. Martínez-Pabón et al.