What Is a Sugar-Free Chewing Gum?
Chewing gum that doesn't use sugar as a sweetener is known as sugar-free gum. Instead, it usually uses aspartame, sucralose, or xylitol—artificial sweeteners—to give sweetness without increasing calorie content or encouraging tooth decay. People who are watching their sugar intake, controlling their weight, or who are worried about their dental health are fond of sugar-free gum. Without any added sugar, it still has the same flavor and chewing satisfaction as regular gum. Furthermore, flavorings, colorings, and other additives for taste and texture may be added to sugar-free gum.
Are Sugar-Free Chewing Gums Beneficial to Oral Health?
Current research and clinical evidence in dentistry show that sugar-substituted chewing gums do not lead to dental caries and may be beneficial for stimulating or strengthening the salivary flow in the oral cavity. In sugar-free chewing gums, the polyols (sugar-free substitutes like xylitol, mannitol, and sorbitol) present are incapable of producing the metabolic acids that are needed to form the dental plaque layer in the tooth enamel.
Gum chewing is usually associated with an increased salivary flow. Several decades ago, dentists and oral physicians had already emphasized the importance of chewing only ‘sugar-free’ gum substitutes. This is because the sugar-filled chewable candies or chewing gums are associated with plaque deposition and the potency to cause dental caries due to bacterial accumulation on the tooth enamel.
On the other hand, sugar-free chewing gums currently manufactured are being recommended by dentists for their protective properties because of their ability to produce more saliva in the mouth or oral cavity.
Saliva is an essential oral fluid with its buffering capacity and mineral supersaturation that has potent cleansing and antimicrobial effects in the mouth. Its agglutinating action and defense against numerous pathogens give saliva the most crucial role in oral immunity. Sugar-free chewing gums would be usually beneficial, according to current research, mainly in the following ways:
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Eliminating the food debris and plaque from teeth post-food consumption.
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Stimulation of salivary flow.
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Raising the plaque pH.
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Decreasing demineralization rates and promoting enamel remineralization.
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Reduction in gingivitis.
However, research also suggests one major drawback of chewing gum. It may exert an adverse effect on the temporomandibular joints (TMJ) when individuals continuously or repeatedly exert pressure on the joint while chewing for a prolonged period.
What Is the Ingredient or Product Label and Composition of Sugar-Free Chewing Gums?
Product Label: Because of the dental research that has now led to the commercial popularity of sugar-free chewing gum substitutes for nearly 20 years, the alert consumer should always check the product or the ingredient label of the chewing gum they purchase. Only those products with labels stating ‘safe for teeth’, ‘does not promote tooth decay’, or ‘tooth-friendly’ mean that the sugars used in them are substituted by sugar-free substitutes.
Composition: Chewing gums are made of the following base ingredients:
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Gum base - It is a mixture of an elastomer and natural or synthetic resin incorporated with fats, emulsifiers, waxes, fillers, and antioxidants
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Sweetening agent.
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Flavoring agent.
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Aromatic agent.
Why Chewing Gum Is Good for Teeth?
Currently, sugar-free chewing gum is the only type containing the ADA Seal. They are sweetened with non-cavity-producing sweeteners like mannitol, xylitol, sorbitol, or aspartame. It has been demonstrated that chewing sugar-free gum increases saliva production, which lowers plaque acid and strengthens teeth while preventing tooth decay.
What Are the Types of Sugar-Free Chewing Gum and Their Dental Health Benefits?
The different types of sugar-free chewing gums recommended by the dental health professional include:
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Medicated 'Sugar-Free' Chewing Gum: These chewing gums have been studied as potential drug delivery agents to bioavailability as they can deliver the drug by avoiding its metabolism in the gastrointestinal tract and the by-passing or without the 'liver-first-pass' effect according to current research because the oral veins drain only into the vena cava. Examples of medicinal chewing gums for locally delivering therapeutic agents usually contain drugs, such as Sulfonamide, used for oral infections, tonsillitis, or pharyngitis. Neomycin-gramicidin, an analgesic, can also be incorporated into chewing gum or even antibiotic agents, such as Miconazole and Nystatin to fight fungal infections of the oral cavity like candidiasis.
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Fluoride-Containing Chewing Gums: These are the fluoride-containing products proposed decades earlier as an effective alternative for fluoride mouth rinses and tablets. These are effective for individuals with rampant dental caries (rapidly growing caries that can cause pulp involvement) and children living in areas with fluoride concentration in drinking water less than 0.7 milligrams of fluoride per liter and community water without salt fluoridation.
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Chlorhexidine-Containing Chewing Gum: The use of chlorhexidine digluconate (CHX) chewing gum would be a possible and potent short-term replacement for mechanical oral hygiene measures. It would also be an adjunct to ensure chemical plaque control methods. Also, as recommended by the dentists, these sugar-free CHX chewing gums would be suitable for individuals suffering from gingivitis, periodontitis, and oral or throat-based infections. However, they are also associated with multiple disadvantages like a bitter taste, and some individuals report an impaired taste perception after regular chewing. Also, reversible staining of teeth or tongue or even the interaction of chewing gum with surface-active substances like toothpaste containing sodium lauryl sulfate are added disadvantages. Unless a dental healthcare professional recommends, it would be wiser to refrain from chlorhexidine-based chewing gums.
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Carbamide Chewing Gum: The incorporation of carbamide or urea into sugar-free chewing gum is proven beneficial for preventing dental erosion of regressive tooth alterations in individuals suffering from hyposalivation (reduced salivary flow) and xerostomia (dry mouth). These sugar-free chewing gums can promote tooth enamel remineralization by eliminating the soluble and fermentable substrate from the oral cavity. It can be an adjunct to mechanical plaque control methods or measures.
Conclusion
Dental surgeons may recommend specific sugar-free chewing substitutes as an adjunct for mechanical plaque control measures for patients at high risk of dental caries, hyposalivation, and xerostomia or for individuals with immunocompromised or systemic conditions. However, the fact to note is that 'sugar-free' chewing gums may not suit every person. Their use is ideal for individuals based on their oral hygiene practices and dental condition and should only be when recommended by a dental health professional. Therefore, the scope of medicated and sugar-free chewing gums with the advent of fluoride, carbamide, and CHX-containing chewing gums and the use of chewing gum for drug delivery systems holds promising future potential.
