Effects of sugar-free polyol chewing gums on gingival inflammation: a systematic review

Abstract

Objectives A systematic review of published data was conducted with the aim of assessing the effects of sugar-free polyol chewing gums on gingival inflammation. Materials and methods Electronic and hand searches were performed to find clinical studies concerning the effects of sugar-free chewing gums on gingival scores. Prospective randomized controlled clinical trials published between 1971 and 2021 were included in the review. Results The initial search identified 46 erythritol, 102 xylitol, 23 sorbitol, and nine maltitol chewing gum articles. After applying inclusion and exclusion criteria, seven xylitol chewing gum studies, one sorbitol, and one maltitol chewing gum study with either high or fair quality were reviewed. In five out of the seven xylitol studies, xylitol gum decreased gingival scores. In two studies, xylitol decreased gingival scores compared to a polyol gum, and in three studies compared to no gum/gum base. As for sorbitol and maltitol, only sorbitol gum chewing showed a small decrease in gingival scores compared to the controls. Conclusions Habitual xylitol gum chewing may reduce gingival inflammation. The low number of studies and their heterogeneity provide clear indications that the effects of sugar-free polyol chewing gums on gingival inflammation need further, well-controlled studies. Clinical relevance Sugar-free chewing gums, especially xylitol gum, may function as adjuncts to toothbrushing for reducing gingival inflammation, but the evidence so far is inconclusive.

Assessment of Oral Masticatory Muscle Activity With Different Chewing Gums: A Cross-Sectional Study Based on Electromyogram Analysis

“…Notably, the sugar-free gums (groups 2 and 3) elicited higher muscle activity compared to the sugar-containing gum types (groups 1 and 4) and the control. The sugar-free chewing gums not only reduced plaque quantity and gingival inflammation but also had a positive impact on the chewing cycle [ 17 ]. The evidence suggests that sugar-free chewing gum has a caries-reducing effect, possibly due to saliva stimulation, a lack of sucrose, and the inability of bacteria to metabolize polyols into acids [ 18 ].…”

Erythritol Can Inhibit the Expression of Senescence Molecules in Mouse Gingival Tissues and Human Gingival Fibroblasts

“…The various benefits of erythritol have been reported in the dental–oral field. Experiments using rats have reported that erythritol is not utilized by Streptococcus mutans , which are caries-causing bacteria in the oral cavity, and it does not cause dental caries itself [ 45 ]. In vitro experiments have shown that, like xylitol, erythritol inhibits the growth of S. mutans and the formation of biofilms [ 46 ].…”

The Role of Sugar-Free Chewing Gum in Dental Caries Prevention

“…Sugar-free gum is chewing gum that uses a sweetener instead of sugar. Popular sweeteners such as xylitol, sorbitol, and mannitol [5]. The general composition of chewing gum includes sweetener (50-65%), gum base (18-30%), corn syrup (12-20%), color and flavor (1-2%), and softeners (0.3-3%).…”