The effect of gum chewing on xerostomia and salivary flow rate in elderly and medically compromised subjects: a systematic review and meta-analysis

Abstract

Background Xerostomia negatively affects quality of life. Symptoms include oral dryness; thirst; difficulty speaking, chewing, and swallowing food; oral discomfort; mouth soft tissue soreness and infections; and rampant tooth decay. The objective of this systematic review and meta-analysis was to investigate if gum chewing is an intervention that results in objective improvements in salivary flow rates and subjective relief from xerostomia. Method We searched electronic databases including Medline, Scopus, Web of Science, Embase, Cochrane Library (CDSR and Central), Google Scholar and the citations of review papers (last searched 31/03/23). The study populations included: 1) elderly people with xerostomia (> 60 years old, any gender, and severity of xerostomia), and 2) medically compromised people with xerostomia. The intervention of interest was gum chewing. Comparisons included gum chewing vs. no gum chewing. The outcomes included salivary flow rate, self-reported xerostomia, and thirst. All settings and study designs were included. We conducted a meta-analysis on studies where measurements of unstimulated whole salivary flow rate for both a gum chewing, and no gum chewing intervention (daily chewing of gum for two weeks or longer) were reported. We assessed risk of bias using Cochrane’s RoB 2 and ROBINS-I tools. Results Nine thousand six hundred and two studies were screened and 0.26% (n = 25) met the inclusion criteria for the systematic review. Two of the 25 papers had a high overall risk of bias. Of the 25 papers selected for the systematic review, six met the criteria to be included in the meta-analysis which confirmed a significant overall effect of gum on saliva flow outcomes compared to control (SMD = 0.44, 95% CI: 0.22—0.66; p = 0.00008; I2 = 46.53%). Conclusions Chewing gum can increase unstimulated salivary flow rate in elderly and medically compromised people with xerostomia. Increasing the number of days over which gum is chewed increases the improvement in the rate of salivation. Gum chewing is linked with improvements in self-reported levels of xerostomia (although it is noted that no significant effects were detected in five of the studies reviewed). Future studies should eliminate sources of bias, standardise methods to measure salivary flow rate, and use a common instrument to measure subjective relief from xerostomia. Study registration PROSPERO CRD42021254485.

Pregnancy-related dental problems: A review

“…But has some solutions, like practicing proper dental hygiene, drinking lots of water to stay hydrated, and abstaining from caffeine, tobacco, and alcohol. Additionally, eating sugar-free gum or alternatives for saliva can be protected from xerostomia [ 15 ].…”

“… Dental restoration is safe during pregnancy [ 14 ]. Don't brush your teeth at least 1 h [ 15 ]. Xerostomia Dryness of mouth Maintain good oral hygiene.…”

“… Xerostomia Dryness of mouth Maintain good oral hygiene. Drink 2–3 L of water per day Avoid caffeine, tobacco, and alcohol Saliva substitutes and other interventions [ 15 ] (e.g., chewing sugar-free gum) Tooth decay Food accumulation in the cavity cause pain. Maintain a good oral hygiene routine.…”

Low-Molecular Collagen Peptide Supplementation and Body Fat Mass in Adults Aged ≥ 50 Years: A Randomized, Double-Blind, Placebo-Controlled Trial

“…They are very interested in reducing body fat for health, but have a high risk of injury, so they cannot rely on exercise to change body composition. Older adults prefer to maintain familiar meals and find it difficult to change their eating habits [ 24 ]. Therefore, even if for health, there may be limitations in adapting an unfamiliar 'healthy diet' and maintaining intake.…”

“…This can be a safe and effective method for older people who want to lose body fat. A decrease in food intake is another change with aging, which is often accompanied by decreased appetite and ability to eat [ 24 25 ]. Poor appetite, dysphagia, or chewing difficulty is a very prevalent condition in older adults, affecting approximately 30% of older people.…”