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21-05-2012 | Internal medicine | Article

Chewing gum does not increase salivary flow in older adults


Free abstract

MedWire News: Sugar-free chewing gum improves the perception of oral health in older adults, but does not alter salivary flow, research shows.

The regular use of chewing gum was associated with improvements in plaque and gingivitis measures, report Mustafa Al-Haboubi (King's College London Dental Institute, UK) and colleagues in Community Dentistry and Oral Epidemiology.

Past studies have shown that the regular use of sugar-free chewing gum is associated with oral health benefits in older people living in care homes, a finding attributed to increased salivary flow.

Older patients in nursing homes, however, make up just 5% of the elderly population and previous comparisons have shown there are disparities in the oral health of people living in facilities and those living in the community.

Al-Haboubi and colleagues randomly assigned 186 individuals aged 60 years and older and with at least six teeth from primary care clinics to a gum-chewing group or to a control group. The treatment group chewed xylitol-containing gum twice daily for 15 minutes while those in the control group did not chew gum at all.

At 6 months, there was no significant increase in the stimulated salivary flow rate of participants in the gum-chewing group.

By contrast, those in the no-gum control group had a significant increase in salivary flow. According to the researchers, there is no biologically plausible explanation for this aberrant increase in the control arm, especially since none of the group reported any activity that might increase salivary flow.

"The observed change in the present study could therefore simply be the result of random fluctuation in flow rate," suggest Al-Haboubi et al.

Chewing gum did result in a significant reduction in Plaque and Gingival Index scores, however. Six months after the start of the study, individuals chewing gum had an average Plaque Index score of 0.3, compared with 0.6 for individuals not chewing gum. The corresponding Gingival Index scores were 0.7 and 0.9.

Overall, 5.5% of the gum-chewing participants perceived that their oral health had "improved a lot," compared with just 1.4% of those in the control group. Individuals chewing gum also had a significant improvement in the global rating of oral health, as well as a reduction in "physical pain."

In addition, there was a significant reduction in the number of decayed surfaces and yeast count.

The researchers note that salivary flow was normal in more than half of patients, which would have made an additional increase as a result of the intervention difficult.

They recommend focusing the "use of sugar-free chewing gum in certain susceptible groups of older people with a greater capacity to benefit, such as those taking xerostomic drugs."

By MedWire Reporters

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