Chewing Gum and Fixed Orthodontic Appliances: A RCT

Objectives: To determine if the use of chewing gum reduces the impact and pain of fixed orthodontic appliances on a patient's daily life. Design: a RCT with two parallel groups Setting: Orthodontic Department of the Charles Clifford Dental Hospital, Sheffield, UK. Subjects and Methods: Individuals (<19 yrs old) starting fixed appliance treatment were randomly allocated to one of two groups. The Chewing Gum (CG) group was supplied with chewing gum to relieve pain and discomfort after placement and adjustment of their fixed appliances. The Non-Chewing gum (NC) group was asked not to chew gum. Outcomes: The patients completed a previously validated Impact of Fixed Appliances questionnaire at 24hrs and 1wk after the placement/adjustment of their brace at each visit up until the placement of the working archwire. A visual analogue scale was used to assess the intensity of pain. Appliance breakages were recorded to the end of treatment. Statistical analysis: A Total Impact Score (TIS) was calculated. Differences between the median TIS and VAS recorded by the two groups were tested using the Mann-Whitney U test. Risk ratios for appliance breakages were calculated. Results: 111 patients were screened for eligibility, 68 were randomized and 57 were included in the analysis (29 CG; 28 NC). The difference between the median TIS of the two groups at 24hrs was 16, which was significantly different (P=0.031; Mann-Whitney U test). The difference between the median VAS between the two groups at 24 hours was 25mm, which was significantly different (P=0.038; Mann-Whitney U test). There were no differences at 1 week. None of the risk ratios for appliance breakages were significant. Conclusion: Chewing gum significantly decreased both the impact and pain from the fixed appliances. There was no evidence that chewing gum increased the incidence of appliance breakages. Acknowledgements: Wrigleys UK supplied the chewing gum.