Chewing gum as a medium for the delivery of anticariogenic therapeutic agents: a review

Abstract

Objectives. To consider the e"ects of chewing gum on dental plaque and saliva, and to discuss the value of chewing gum as a means of delivering anticariogenic agents. Methods. Literature and data from 1940 to 2007 related to chewing gum and anticariogenic therapeutic agents were sourced using PubMed and hand searches. Results. Chewing of gum increases salivary production and salivary #ow rate. With the increase in salivary #ow, the concentration of bicarbonate and phosphate is higher in stimulated saliva. The resultant increase in plaque pH and salivary bu"ering capacity prevents demineralization of tooth structure. The chewing action also results in the physical removal of plaque and food debris, which assists in cleansing the occlusal surfaces of the teeth. Because gum is repetitively chewed it has a longer period of exposure to the surfaces of teeth than a dentifrice or mouthrinse; thus, it can be a useful adjunct in maintaining oral health, especially if it contains a therapeutic agent that is e"ective topically. Agents that have been added to chewing gum to speci$cally prevent dental caries include: polyols such as xylitol and sorbitol, #uoride, calcium phosphate, carbamide (urea), enzymes, and granules. Conclusions. There is insu!cient published evidence, especially for carbamide, enzymes, and granules, to support the notion that these addictives have a therapeutic role when added to chewing gum. Further investigations are required to justify the anticariogenic claims when chewing gum is the medium of delivery.