The question has plagued dental professionals for years. Is chewing gum good or bad for your teeth? The rubbery substance has been used for millennia dating back to the Ancient Egyptians and Mayans. Originally gum was used to keep the mouth busy during times or work, ennui or angst but in the latter part of the 19th Century, specially formulated sticks were developed to help keep teeth white and improve breath.
Jump a hundred years later and the benefits of chewing were put under scrutiny. During the 1970s and '80s, a number of studies revealed the lack of any dental benefit. There was no significant plaque reduction unless combined with normal oral health procedures, such as brushing and flossing. In contrast, the addition of sugars and other acid-promoting ingredients made gum an enemy rather than a friend of oral health.
As formulations modified, research revealed some benefit with alternative ingredient lists. The use of sugarless gum was shown to help if only to dilute out the levels of sugar and low pH in the mouth. The addition of sugar-substitutes xylitol and sorbitol helped to reduce the formation of caries. In the case of xylitol, a lower incidence of other secondary problems including ear infections was also seen.
Though research provided some indication of the impact of gum on health, few investigated the effects of chewing on the most populous resident of the mouth, sinuses and respiratory tract: microbes. There was a good reason for this lack of study; until a few years ago, no one really knew the nature of the oral microbiome other than those species known to be associated with dental cavities. As a result, the first studies focused on whether gum could reduce the levels of pathogens without any specific perspective on the rest of the over 250 different types contained in the average human mouth.
But last week, an international team of researchers provided the first comprehensive look at the impact of gum on oral health. Their initial goal was to identify the dynamics of chewing gum on the microbes. Yet, the results provided them -- and us -- with a potential path to even greater oral health with the help of a few moments of chewing pleasure.
The methods were relatively simple. The group asked five volunteers to chew one of two different sugarless gums containing sorbitol and other non-cavity causing ingredients. At varying time points between 30 seconds and 10 minutes, the volunteers spit the well masticated ball into a sterile solution. Then the researchers used a variety of methods ranging from culture to genetic techniques to identify the bacteria in the gum. To make the results even more robust, they looked at pieces under the electron microscope to visualize how the bacteria adhered to the matrix.
When all the data had been analyzed, the group was treated to a surprise. While they expected to see bacteria in the gum -- and they did to the tune of 100 million per piece -- they were taken aback when they found the highest concentrations in gum spit out after the first few minutes. As the time went on, the concentration decreased in a linear fashion.
This reduction in extraction efficiency over time might have been due to a higher level of saliva in the mouth or the lack of stickiness, allowing the bacteria to return to the mouth. Either way, the data suggested the best amount of time to chew in terms of oral health was anywhere from 30 seconds to two minutes. Any time after that, a loss of 10 per cent of the population per minute would occur.
The group then looked at the nature of the microbes in the gum. Again, there was a surprise waiting for them in the data. When they looked at the origin of the bacteria, not all isolates were part of the tooth or the salivary microbiome. In the case of one gum, less than half of the bacteria could be traced. The results suggested the majority of bacteria were transient rather than colonized.
This result was particularly intriguing as the gum could potentially remove any pathogenic invaders who might be on the lookout for a home. The team suggested this radical removal might actually assist the maintenance of health. While the oral cavity has the ability to fight off infections through immune function, enzymes and antimicrobial peptides, physical removal via gum chewing might offer significant help in the process.
The last step of visualization involved what the researchers suggested was akin to looking for a needle in a haystack. Despite the over 100-million bacteria isolated from a stick of gum, the researchers had difficulties finding a bacterium using the electron microscope. When they did, it was alone, not in clumps, and took up only a small surface area.
This latter result suggests a large potential for increased bacterial removal. By incorporating ingredients to make the gum stickier to pathogens, a means of oral health improvement could be developed. This could be beneficial to help individuals who are particularly susceptible to infections as well as those who might be travelling. They can maintain their microbiome by getting rid of the newly introduced strains.
Overall, this particular study reinforces the beliefs of those over a century and a half ago who believed chewing gum could be good for health. Although the road has been bumpy and formulations have changed to reflect the necessities of a healthy lifestyle, the influence of gum on oral health appears to be positive. Whether the goal is fresher breath or removal of pathogens, it seems a few minutes of gum chewing might be an excellent way to keep a healthy mouth.
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