Dental Chewing Gum and Caries – a systematic review

Objective: To appraise existing evidence on the caries reducing effect of dental (sugarless) chewing gum Methods: 9 anglo- and 2 lusophone databases were searched using English and Portuguese key words (9 March 2006). Relevant articles in English, German, Portuguese and Spanish were included for further review. Only in-vivo and in-situ trials were accepted. Trials were excluded on lack of randomisation, control group, blinding and baseline data; drop out rate > 33%; no statistical adjustment of baseline differences and lack of assessment of clinically important outcomes. Reviews were excluded if information on article selection criteria, search strategy, key words, searched databases and study-by-study critique tables were missing. In case of multiple reports from the same study, the report of the longest period was included. Two reviewers independently reviewed articles and extracted information. A quality assessment of accepted articles was carried out. Results: From the identified articles 43 were judged to be relevant. 12 reviews and 19 trials were subsequently excluded. Of the 12 accepted articles 2 trials of reasonable quality did not demonstrate any significant caries reducing effect. 10 trials (strong quality = 2; good quality = 7; reasonable quality =1) did demonstrate significant (p < 0.05) caries reduction with main focus on occlusal tooth surfaces as compared to the controls: no gum use (= 7 trials), oral health education (= 1 trial), use of sucrose gum (= 1 trial) and observation on extra-oral enamel disks (1 = in-situ trial). Conclusion: The evidence suggests that sugarless dental chewing gum can have a caries reducing effect, particularly on occlusal tooth surfaces. Support or Funding: The review was supported by GC Asia and Midentistry.com